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Neurofibromatosis type 2 – diagnosis, features and MDT approach
NF2 is a genetic condition caused by mutation in a single gene (NF2 gene) on chromosome 22. The NF2 gene provides instructions to produce a protein called merlin, also known as schwannomin. This protein functions as a tumour suppressor, preventing...
Time is vision in central retinal artery occlusion
Central retinal artery occlusion (CRAO) is a rare but devastating vascular episode that can have severe impact on vision. Treatment is very time-limited and needs to be initiated very quickly to salvage any vision. The majority of patients present to...
Vitreomacular traction and full thickness macular hole
Clinical scenario: A 64-year-old lady presented to the clinic with a few weeks history of sudden onset of metamorphopsia, central blur and reduced vision in her right eye. The ocular examination and ocular coherence tomography confirmed right eye focal vitreomacular...
21st Century retinal laser treatment in the anti-VEGF era
In today’s world, macular laser treatment has a vital role in the treatment of diabetic macular oedema (DMO). DMO is one of the most common causes of visual impairment. Despite expensive intravitreal treatment courses of anti-VEGF, many will agree that...
The management of chronic central serous chorioretinopathy
Central serous chorioretinopathy (CSCR) is a common retinal disease characterised by one or more serous neurosensory detachments. Patients present with acute onset blurring of vision, metamorphopsia and / or central scotomas. The condition is six times more common in men...
The interpretation and use of ultrasound biomicroscopy (part 1)
Ultrasound Biomicroscopy (UBM) has become increasingly important for the diagnosis of a variety of anterior segment pathologies. Most ophthalmologists are familiar with conventional B-scan ultrasonography techniques, which operate at lower sound frequencies (7.5 to 20MHz). UBM is an ultrasound technique...
Caring for adults with an ocular tumour
Detection If you screen for an intraocular tumour, dilate the pupil. If the patient is driving, use phenylephrine only. If the patient declines, document this in the casenotes. Don’t forget to look for sentinel vessels, which would indicate a ciliary...
The management of chronic uveitis
A 40-year-old company executive is referred from another unit with recurrent anterior and posterior uveitis for 12 months and the inflammatory markers are raised. Review of systems This is a case of chronic uveitis which needs a thorough workup and...
The perfect interview to land the dream consultant job
Eight top tips for consultant interviews: 1. A person is not just an ophthalmologist. Trusts are appointing the person not just the ophthalmologist. On a consultant interview panel (AAC) there will be non-ophthalmologists (e.g. medical director, chief executive, lay chair)...
Discussing treatment modalities for bilateral wet AMD
A 65-year-old lady with bilateral wet AMD and vision of 6/24 comes with an internet search about current therapies. How do you explain the various treatment modalities available? There are two NICE approved treatments for wet age-related macular degeneration (AMD)....
The screening and treatment of retinopathy of prematurity
A male child is born at 31 weeks and requires 100% oxygen supplementation with intensive care. What would be the ophthalmic management of this child? In the first instance, it will be useful to know the screening criteria and protocol....
