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Dark circles and facial rejuvenation

A 45-year-old socialite lady comes for cosmetic consultation and wants a remedy for dark circles and facial ageing. How do you manage this patient? Issues of dark circles and facial ageing should be addressed separately. Facial ageing should be considered...

A case of ‘60-day glaucoma’

Neovascular glaucoma (NVG) has been called ‘90-’ or ‘100-day glaucoma’ in the past due to its typical development three months after the onset of central retinal vein occlusion (CRVO). In reality, NVG can occur anywhere between two weeks and two...

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...

Bovine pericardium scleral patch graft associated scleritis: Ahmed valve implant for pupillary block glaucoma

Processed bovine pericardium is a lyophilised collagen sheet used as a surgical armamentarium. It renders the material antigenically inert with minimal inflammation [1]. Sclera patch pericardium graft (Tutopatch) is a collagenous membrane derived from solvent preserved, irradiated bovine pericardium [2]...

Feb/Mar 2014 Quiz 1

History A 55-year-old diabetic male presents with some annoying floaters in his left eye. Slit-lamp examination shows multiple well defined bodies within the vitreous cavity, in an eye otherwise showing background diabetic retinopathy. The patient elects to undergo a vitrectomy....

Transient thickening of the macular retinal nerve fibre layer in acute optic neuritis

Acute optic neuritis (ON) causes axonal degeneration, which can be quantified from the blood by neurofilament protein (Nf) levels. Within about three months, atrophy of the retinal nerve fibre layer (RNFL) follows. However, it remains challenging to explain why there...

Optic nerve swelling – your survival guide (part 1)

Assessment of optic nerve appearance and functions is a daily routine in neuro-ophthalmology. Following a recent high profile court case there has been a significant increase in the amount of referral to ophthalmology departments to assess the optic nerve and...

Managing cataract surgery in a patient with diabetic maculopathy

A 56-year-old type 2 diabetic with previously treated bilateral diabetic maculopathy develops a cataract requiring surgery in the right eye. He has had grid laser previously, followed intermittently by intravitreal triamcinalone, Avastin and more recently Lucentis in both eyes. His...

Acute dacryoadenitis secondary to COVID-19

Acute dacryoadenitis is defined as the rapid onset of discomfort and swelling of the lacrimal gland, classically giving rise to an S-shaped ptosis [1]. Dacryoadenitis is the most common cause of a painful mass in the lacrimal gland in young...

The original smooth operator: Sir Robin Millar

As an early 80s kid, if you lacked sufficient pocket money, building a music collection entailed recording your favourite songs off the radio with a cassette deck and hoping the presenter didn’t interrupt at any point, with a finger hovering...

Technology for remote working and COVID-19 resources

The COVID-19 pandemic has altered every aspect of how we live, and how healthcare needs to be provided for the welfare of patients and staff. I thought I would try to summarise a few potential technology tools that could be...

Friendly felines and a spot diagnosis

A nine-year-old girl presented to me in eye casualty with a three-week history of blurred vision in her left eye. Otherwise she was apparently well, with no past ophthalmic, medical, drug or relevant family history. Visual acuity was 6/4 right...