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The approach to trabeculectomy postoperative complications

Performing a trabeculectomy is like giving birth to a baby. It may be traumatic and there is scope for devastating error but once the operation is completed only then does the real work begin. The bleb must be nurtured into...

Irido-corneal endothelial syndrome: an overview

Irido-corneal endothelial (ICE) syndrome is a rare group of eye related disorders that constitute three different clinical entities: Chandler syndrome (CS), essential / progressive iris atrophy and iris naevus / Cogan-Reese syndrome. ICE syndrome is sporadic in its presentation as...

Ophthalmic learning through the lens of cognitivism and constructivism

Learning in ophthalmology is multi-faceted, from understanding the fundamentals of eye anatomy and physiology to higher order skills such as performing cataract and vitreoretinal surgery. Having a strong foundation in the basics is a necessity for higher order knowledge synthesis,...

Phaco nightmares

I am interested in the stressful nature of cataract surgery from the surgeon rather than the patient’s perspective. It is an issue that has quite literally kept me awake at night. Part of getting to grips with a problem is...

The vitreoretinal priesthood

When I first started doing cataract lists, the consultant at the time, a Mr Brown from Carmarthen, used to say that phacoemulsification was more akin to flying a jet fighter for short dangerous bombing runs than a boring long haul...

Training the trainers

Learning phakoemulsification is a psychologically demanding process. Every ophthalmologist passing through the UK training system will almost certainly have many stories to tell of difficulties faced along the way; hideous disasters where lessons were learnt, as well as glorious triumphs...

Neuro-ophthalmology: the extended role of an orthoptist

Neuro-ophthalmology has always been a speciality of interest during my studies and now in my career. In 2018, I started a Band 7 post which gave me an extended role in neuro-ophthalmology and the responsibility of developing an orthoptic led...

The results of the last survey Jun23

*Please be aware that this data does not form part of a peer reviewed research study. The information therein should not be relied upon for clinical purposes but instead used as a guide for clinical practice and reflection. I continue...

Toxic nutritional optic neuropathy (TON)

Toxic optic neuropathy are a group of conditions manifested by reduction of visual functions secondary to damage to the anterior visual pathways from exposure to a toxin. The implicated toxin could be work-based, food or drink related, or iatrogenic medication....

A case of late spontaneous subluxation of in-the-bag intraocular implant

An 82-year-old frail lady was referred by her optometrist with a finding of subluxated implant in the right eye. She had uneventful phacoemulcification with in-the-bag intraocular implant 17 years earlier. There is no history of having had pseudoexfoliation (PXF) or...

Ophthalmology survey results June/July 2019

Firstly may I thank all of you who took the time to answer the survey. I hope you will agree that the findings are very interesting. From a medicolegal perspective we always consider the Bolam test which can be summarised...

Managing a dislocated intraocular lens

A 70-year-old male patient is referred from the optician with a history of onset of double vision and examination shows a dislocated / subluxated IOL. How will you manage this patient? If the double vision is causing serious concern to...