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Doctor in the House

“What’s the bleeding time?”“10 past 10 sir”. These are the famous lines uttered by Chief Surgeon Sir Lancelot Spratt (James Robertson Justice) and Medical Student Simon Sparrow (Dirk Bogarde) on a pre-op ward round at the fictional St Swithin’s Hospital,...

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...

The results of the last survey Feb 2020

I appreciate that I keep on reiterating it, but again we see so much practice variance. Who is right and who is wrong? Is there a right or wrong approach? And does it matter? I think it probably does matter....

Principles of contact lens fitting in keratoconus

Keratoconus is an ectatic condition of the cornea characterised by progressive conical distortion with irregular astigmatism, myopia and apical protrusion. Most cases progress slowly resulting in varying degrees of myopic astigmatism. Management of keratoconus includes spectacles, soft contact lenses, a...

Light in darkness – manual small incision cataract surgery in India

Cataract has been documented to be the most significant cause of bilateral blindness in India, where vision <20/200 in the better eye on presentation is defined as blindness [1,2]. Estimation of blindness in India by the World Health Organization (WHO)...

In vivo confocal microscopy, principles and use in keratitis Part 1: Principles

In 1968 Maurice introduced the concept of high powered specular microscopy, it was in that very year that the first scanning confocal microscope was proposed. Marvin Minsky developed the first confocal microscope in 1955 named the ‘double focusing scanning microscope’....

Diabetic Macular Oedema

Diabetes mellitus is a metabolic disorder that affects the metabolism of all three categories of carbohydrates, lipids and proteins. This condition is characterised by chronic hyperglycaemia [1]. This can cause end organ damage. The estimated worldwide diabetes prevalence for 2010...

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...

Embryology in clinical practice

The fascinating world of embryology is both beautiful and practical. It is a home video of our evolutionary history through the ages from the single cell through to the life aquatic, the development of gut, limbs and brain, and most...

Don’t ignore the black lesion! It might be mucormycosis

Keeping mucormycosis infection in the foreground of your differential diagnosis, especially in those more vulnerable patients, will help save their lives if recognised and managed appropriately. Mucormycosis is a fulminant infection caused by the fungi of the family Mucoraceae. It...