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Adaptive optics imaging: resolving single cells in the living eye

The human retina is unique in the central nervous system (CNS) in that it can be directly visualised non-invasively. Technological advances of several imaging modalities, including optical coherence tomography (OCT), multichannel scanning laser ophthalmoscopy (SLO) and fundus photography, have afforded...

Recurrent corneal erosions secondary to isotretinoin use

Isotretinoin (13–cis-retinoic acid) is the first line treatment for moderate to severe nodulocystic or papulopustular acne [1,2]. Although it is a safe medication, it has several adverse side-effects, including ophthalmic manifestations, as shown in Table 1 [3]. These side-effects need...

An eye on novel anti-cancer agents: an evidence-based approach to external eye assessment

Novel anti-cancer therapies have led to significant advancement in cancer treatment, however, they can be associated with external eye complications. It is important to be mindful of such adverse effects during assessment of patients enrolled in clinical trials. Annually, approximately...

How to diagnose and treat Acanthamoeba keratitis

Corneal ulceration caused by Acanthamoeba is on the rise, and recent publications indicate an outbreak in the UK over the last few years [1]. Since Acanthamoeba keratitis often presents with atypical features, diagnosis from slit-lamp examination alone can often be...

Oct/Nov 2016 Quiz

History A 67-year-old female patient had chronic left canaliculitis becoming painful and more recently complicated by left lower blepharitis. Examination revealed a small fleshy lump on the medial aspect of the left lower eyelid. There was also swelling of the...

Acanthaemoeba keratitis

In the second of this series I describe a case of Acanthaemoeba keratitis (AK) that was misdiagnosed for a prolonged period which resulted in a devastating outcome. This is one of half a dozen similar medico-legal cases I have dealt...

IgG4-related disease or Graves orbitopathy

This is retrospective review of patients who had been diagnosed with both IgG4-related ophthalmic disease (IgG4-ROD) and Graves orbitopathy over a four year period. Eight patients were identified. The diagnosis of IgG4-ROD was based on 10 or more IgG4+ plasma...

Caffeine concentration in the vitreous after drinking coffee

Caffeine is known to penetrate many bodily fluids, including the vitreous. In this prospective study, investigators measured caffeine levels in vitreous samples from patients undergoing vitrectomy and epiretinal membrane peel. Patients were divided into habitual and non-habitual coffee drinkers. One...

Investigating the effect of signal strength on mean retinal nerve fibre layer

The aim of this study was to determine the effect of signal strength on mean retinal nerve fibre layer (RNFL) using spectralis optical coherence tomography (S-OCT). Thirty normal subjects were imaged with S-OCT using variably dense Bangerter foils to alter...

The embryology of the eye

Nobody claims to like embryology. At least nobody I know. It has been a neglected part of the curriculum since time immemorial and a vicious cycle occurs in which those with an incomplete understanding fail to appreciate the inherent beauty...

Surgical options for the treatment of hyperopia

The modern refractive surgeon has a variety of options available to treat patients with hyperopia who wish to be independent of spectacles and contact lenses. Unlike in low myopia where presbyopic patients may have the ability to see well for...

Amnion-assisted conjunctival epithelial redirection (ACER): Enhancing stem cell transplantation treatment of total limbal stem cell deficiency

An exploration of Professor Harminder Dua’s recent work using a technique called amnion-assisted conjunctival epithelial redirection (ACER) to aid the success of conjunctival-limbal grafting procedures. ACER provides a refined way to use amniotic membrane (amnion), such as Omnigen® (NuVision® Biotherapies,...