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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,...

A patient report of pseudoxanthoma elasticum, angioid streaks and choroidal neovascularisation

Angioid streaks (AS) on their own do not cause many problems, with the majority of patients remaining asymptomatic [1]. However, once choroidal neovascularisation (CNV) occurs, the visual prognosis of the patient rapidly declines [2]. Treatment is imperative to try and...

Biometry and IOL choice errors

In the next instalment of this series I focus on problems associated with biometry and intraocular lens (IOL) selection for cataract surgery. I have taken previous medicolegal cases I have dealt with and tried to extract some learning points and...

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....

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’....

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...

Decontamination and sterilisation of surgical instruments and medical devices

Ann-Marie Ablett is a Theatre Nurse and Team Leader who volunteers with Orbis. This has allowed her to gain a wealth of experience on ophthalmic procedures, nursing in under-privileged parts of the world, leadership, management and use of scarce resources....