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Quality matters in the management of serious eye disorders

The author discusses the first quality standard for serious eye disorders from NICE and takes a look at new care models for enhanced service delivery. Patient backlogs pose risks to patient safety, with research showing that people are losing sight...

Diagnosis and management of IV cranial nerve palsy

Aetiology: Trochlear nerve palsy can be divided into acute or congenital. Congenital trochlear nerve palsy is usually noted in childhood with development of abnormal head posture. Various pathologies can lead to acute IV nerve palsy, most commonly trauma. Other causes...

Randomisation, confounding & observational methods in ophthalmic epidemiology

Randomisation and confounding Understanding the relationship between an exposure and an outcome of interest is the central challenge in ophthalmic epidemiology. The exposure may be aetiological, taking the form of a putative risk biological factor, or therapeutic, in the form...

Toxic nutritional optic neuropathy (TON)

Toxic optic neuropathy are a group of conditions manifested by reduction of visual functions secondary to damage to the anterior visual pathways from exposure to a toxin. The implicated toxin could be work-based, food or drink related, or iatrogenic medication....

Virtual reality pupil assessment software

For Oct/Nov 2021 we review a virtual reality (VR) solution for training and assessing pupil function. Different types of VR exist, and the application described here is used on the Oculus Quest or Pico headsets. The user wears a headset...

Disseminated cutaneous zoster – a masquerade

Reactivation of varicella zoster infection in the elderly commonly presents to ophthalmologists as herpes zoster ophthalmicus (HZO), affecting the Va trigeminal dermatome. In patients with impaired immunity, zoster infection occurs with increased severity and may be complicated by visceral and...

The results of the last survey Feb22

This edition’s survey took a slightly different tack and tried to look at the problems we face in litigation. Litigation is unpleasant. It is horrible being involved in it and the process of litigation can be extremely stressful. From the...

Macular imagery: observing the visual sensations pre- and post-Jetrea injections

A 63-year-old woman, a professional painter, was diagnosed with vitreomacular traction (VMT) in 2017. She had a history of metamorphopsia, drop in visual acuity (VA) in the left eye (6/6 in the RE; 6/18 in the LE), foveal vitreomacular traction...

Internuclear ophthalmoplegia: a case study

A 44-year-old patient presents with binocular, mostly horizontal diplopia when fixating on moving objects. This has been ongoing for approximately five years. He is known to have multiple sclerosis and had an episode of optic neuritis six years prior in...

A rare neonatal presentation of bilateral dacryocele and choanal atresia

Following a routine pregnancy, a newly delivered baby boy, born at term, was found to have increased work of breathing, stridor and a left medial canthal swelling. The baby required 100% oxygen via a face mask to maintain oxygen saturations....

The results of the last survey Aug22

The first question really highlights how we can become enshrined in the way we do things. I genuinely thought that everyone was using a cohesive viscoelastic for their cataract surgery. It was what I was taught, and I believe everyone...

Leading sight organisations to merge

Two international sight organisations have announced that they will merge from January 2021 to better tackle the global vision crisis.