Optical coherence tomography – reinventing the eye examination
It has been 25 years since Huang et al. presented the first optical coherence tomography (OCT) images in Science [1]. With vast improvements in OCT technology over the years, it is now possible to acquire high-resolution cross-sectional images of the...
Management of diabetic macular oedema in vitrectomised eyes
Diabetic macular oedema (DMO) is one of the leading causes of blindness; its prevalence is on the rise with progressive increase in numbers of people suffering from diabetes. The management of DMO has evolved significantly over the past few years....
A revolution in modern genetic testing for the clinical management of ocular disease
Recent years have seen a huge increase in our understanding of the genetic factors underlying a wide variety of eye diseases. This has included common conditions such as glaucoma and age-related macular degeneration, as well as those conditions which have...
The refractive index in the eye lens – implications for clinical practice and optical design
The eye may appear to be a comparatively simple organ and yet its optical system is complex and continues to be a source of investigation and research. The major optical elements are considered to be the cornea and the lens...
Grading of ocular inflammation in uveitis: an overview
Anterior uveitis is the commonest form of uveitis, which can lead to severe morbidity if not treated appropriately [1]. Data from general ophthalmology practices suggest around 90% of uveitis encountered by comprehensive ophthalmologists is anterior uveitis [2]. Intermediate (vitreous), posterior...
The role of inflammation in the pathophysiology of DMO
Diabetic macular oedema (DMO) is a major cause of visual loss in diabetes, with a complex multifactorial pathogenesis. In the UK alone it is estimated that there are nearly 2.5 million diabetic patients aged over 12 years. Approximately 65,000 of...
A complicated case of cytomegalovirus viremia: “What would you do doctor?”
Mrs W walked gracefully into my urgent care clinic. It was another busy session and I hoped she did not have anything serious going on which might slow the clinic further. She was an elegant 72-year-old lady who seemed like...
Initiatives in macular service provision
A report from Monitor in October 2015 identifies good practices that will realise most of the potential productivity gain in elective care available to NHS hospitals. These include: stratifying patients by risk and creating low-complexity pathways for lower-risk patients (tailoring...
Pathophysiology of diabetic macular oedema: why combination therapy may be better
The prevalence of diabetes has continued to increase over the years. It is currently estimated that there are 382 million with diabetes worldwide in 2013, and that this figure is expected to rise to 592 million by 2035 [1]. In...
Strategies for managing neovascular AMD and DMO in routine clinical care
Treatment practice in the management of neovascular age-related macular degeneration (AMD) and diabetic macular oedema (DMO) illustrate increasing adoption of patient-tailored treatment approaches based on initial diagnosis and regular monitoring of imaging and visual outcomes in routine clinical care. The...
Genetic profiling for personalised healthcare solutions in AMD – an update
Age-related macular degeneration (AMD) is a multifactorial condition influenced by genetics and lifestyle factors (Table 1). This article outlines several recent advances in AMD genetics, as well as evolving therapeutic concepts and established practical measures for the treatment and /...
Intravitreal injections delivered by ophthalmic clinical nurse specialists
Intravitreal injections of the anti-vascular endothelial growth factor (anti-VEGF) agent ranibizumab, for the treatment of wet age-related macular degeneration (AMD) was approved by National Institute for Health & Care Excellence (NICE) in 2008 [1]. The Manchester Royal Eye Hospital (MREH),...