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Cavernous sinus syndrome

Anatomically the cavernous sinus is a plexus of multiple veins that are connected and within this plexus there are several important vascular and neurological structures. These include cranial nerves III, IV, V1 (and sometimes V2), VI as well as the...

Covidiot quiz

I like to read, but on account of the COVID-19 pandemic have probably read more over the past two years than ever before. One of the books that resonated the most was called The 900 Days and was about the...

Old dogs

It is always nice to get a thank you card, especially so when it comes from someone at the tail end of an overbooked clinic who had waited patiently well past their appointed slot. Such was the case when I...

What you learn after performing 10,000 cataracts

What do you do when the anterior chamber shallows, or the zonules give way? How do you handle the stubborn epinuclear plate? Raymond Radford shares the benefit of his experience when dealing with tricky cataract surgery. Firstly, you realise you...

My COVID-19 songs

A portrait of Anna by Tamara Jovandic-Everson as part of #portraitsforNHSheroes. I am a consultant eye surgeon and these are my COVID songs. First of all, I have not even had time to digest the past six months, partly because...

Thinking outside the box – adapting to the COVID-19 lockdown

How can we avoid further delays to follow-up in glaucoma patients? The author asks if there is a socially distanced way to check IOPs in those at high risk of losing vision. Glaucoma is an asymptomatic condition. Loss of the...

Severe conjunctival cicatrisation secondary to chronic glaucoma therapy

The timing of glaucoma filteration surgery during the course of chronic progressive glaucoma remains a contentious issue amongst glaucoma specialists. The vast majority support the use of maximal medical treatment initially to achieve the target pressure. Surgical procedures are only...

End stage glaucoma management

A 48-year-old female has had multiple drug treatment for glaucoma and is still losing field of vision. How do you manage this over time? This patient is at high-risk for going blind and should be managed aggressively to protect remaining...

What’s Eating Gilbert Pete

“Please phone Mr C Lyon ASAP on 0131 334 9171” This was a message from my secretary waiting for me on my computer one morning shortly after I was appointed a consultant. The name did not ring any bells but...

My ophthalmic elective: Lerdsin Hospital, Thailand

My decision to undertake elective in Thailand was made to help broaden my horizons on ophthalmic conditions and practices. Additionally, I hoped to improve my Thai medical vocabulary to communicate with Thai patients fluently. As I got an opportunity to...

Just sign here: the intricacies of consent in the post-Montgomery era

The consent process is a vital part of the patient pathway and is far more than just getting the patient to sign on the dotted line. In my work in litigation I often see issues around informed consent resulting in...

How good does my vision have to be to drive this thing? Visual standards for various occupations

We can all picture that moment in clinic: you are about to tell someone that they’re no longer legally able to drive, ready to deploy our ‘breaking bad news’ techniques. For some patients this may have been expected, or they...