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A practical guide to anisocoria

Anisocoria means the presence of difference in the size of the right and left pupils. It is a sign of an abnormality in the efferent pathway. The first question facing the ophthalmologist is to ascertain if anisocoria is present or...

The assessment of pupils and 
pupillary reactions

Understanding pupillary reactions is vital in understanding basic neuro-opthalmology. It is a skill required in eye casualty, clinics and perhaps most importantly, exams. To start at the beginning, the pupil is the central aperture of the iris, its size controlling...

An unusual case of silicone oil in the anterior chamber simulating intraocular implant

Silicone oil internal tamponade has been used for over 50 years, even prior to pars plana vitrectomy [1].Over a course of time silicone oil may migrate to the anterior chamber through the pupil. This may disperse in the form of...

How to examine the visual system Part 2: Accommodation, pupils, fundoscopy and additional tests

Examining the visual system can be a tricky skill for medical students to master, yet it is a task that is frequently tested in examinations. This is the second of a two-part series of articles, which together aim to improve...

Introduction of the Mydriasert insert at the Manchester Royal Eye Hospital

The authors report on a study to examine the effects of the Mydriasert insert on time, effects, patient comfort and tolerability at Manchester Royal Eye Hospital. Mydriasert is an insoluble ophthalmic insert indicated for mydriasis prior to ophthalmic surgery, which...

The history of ophthalmology: John Argyll Robertson and Douglas Moray Cooper Lamb Argyll Robertson

The author shares the story of an extraordinary father and son, two of the major figures in defining the specialty of ophthalmology as we know it today. The renowned Glasgow Surgeon Peter Lowe described ophthalmic surgery in his legendary surgical...

Identifying drugs associated with intraoperative floppy iris syndrome

Before David Chang MD from the University of California found out about intraoperative floppy iris syndrome (IFIS), ophthalmologists were mystified each time they came across cataract surgeries that were characterised by sudden intraoperative iris prolapse and pupil constriction. The biggest...

Ultrasound biomicroscopy (part 2): primary angle closure

Patients with primary angle closure or primary angle closure glaucoma [PAC(G)] comprise a significant subgroup affecting around 10% of glaucoma patients amongst Caucasians. Assessment of the patient with angle closure, or narrow angles, requires gonioscopy. However, whilst identifying the presence...

Advances in cataract surgery

This article covers recent clinical findings in mydriasis and anaesthesia for cataract surgery, shared by Sathish Srinivasan and Keith Davey at a surgical meeting in Manchester. Towards dropless cataract surgery Day case cataract surgery is the standard of care in...

Cataract surgery in uveitis patients

Cataract formation is a common complication of uveitis, causing up to 40% of vision loss in these patients. Cataract results from inflammation +/- corticosteroid therapy and is usually posterior subcapsular, but a small proportion have a rapid increase in nuclear...

The approach to angle-closure glaucoma

Further to my last article in Eye News (print issue) describing the diagnostic approaches to various clinical scenarios in glaucoma, the approach to angle-closure glaucoma (ACG), a situation terrifying for patient and registrar alike, will be discussed. Please refer to...

Embryology in clinical practice

The fascinating world of embryology is both beautiful and practical. It is a home video of our evolutionary history through the ages from the single cell through to the life aquatic, the development of gut, limbs and brain, and most...