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Ultrasound biomicroscopy (part 2): primary angle closure

Patients with primary angle closure or primary angle closure glaucoma [PAC(G)] comprise a significant subgroup affecting around 10% of glaucoma patients amongst Caucasians. Assessment of the patient with angle closure, or narrow angles, requires gonioscopy. However, whilst identifying the presence...

Caring for adults with an ocular tumour

Detection If you screen for an intraocular tumour, dilate the pupil. If the patient is driving, use phenylephrine only. If the patient declines, document this in the casenotes. Don’t forget to look for sentinel vessels, which would indicate a ciliary...

Jun/Jul 2017 Quiz

History A 57-year-old female patient presented with gradual painless diplopia over the last six months. Examination revealed restricted upward eye movements and 4mm proptosis which did not increase with Valsalva manoeuvre. Intraocular pressure was normal, no visual defects were noted,...

Ocular Dirofilariasis: a diagnosis on the rise?

Dirofilaria repens is one of 40 species of Dirofilaria. It is a zoonotic filarial nematode that commonly impacts dogs, however, human infection can occur through affected organs like skin, lung and eyes [1]. Although, there have been case reports of...

East of Ealing

“And Cain said unto the Lord, my punishment is greater than I can bear. Behold, thou hast driven me out this day from the face of the earth; and from thy face shall I be hid. And Cain went out...

Projectors and Stagefright

Choosing the correct aspect ratio for a presentation There are several mistakes that are easy to make when using PowerPoint. The most common one I see is the failure of a video to play because the video file wasn’t copied...

Will it change management?

Like most doctors I have read and am a fan of Samuel Shem’s House of God, with my favourite Rule being Rule 10: “If you don’t take a temperature you can’t find a fever.” If you don’t intend to treat...

Cyanoacrylate nail glue accidentally instilled into the eye instead of eye drops

Three hundred thousand cataract operations take place each year in the UK alone and each patient will receive a four week course of drops in order to cover them for any postoperative inflammation or infection. Accidental instillation of cyanoacrylate glue...

The medical student syndrome

It is often said that “a little learning is a dangerous thing,” but being super savvy can’t put us at the brink of harm, can it? Each year as thousands of students commence their medical degrees, they begin a journey...

The COVID-19 ‘frontlines’: a foundation doctor’s perspective

Staring through the fragmented stained glass of the Virgin Mary and her assorted angels, I reflected on the strangeness of the workplace I now found myself working in and the irony of a workforce now working together more enthusiastically than...

Effect of postoperative swelling on lid surgery outcomes

This is a review of patients undergoing upper lid external levator resection ptosis surgery or blepharoplasty, to assess whether the degree of early postoperative swelling affects the final lid position. Twenty-five patients undergoing ptosis surgery and 29 upper lid blepharoplasty...

Unilateral cataract extraction outcomes in older children compared to two studies with younger cohorts

The authors present a retrospective study of children undergoing cataract surgery between the ages of two and seven-years-old at one centre, over a 24-year period. Data including demographics, ocular history, ophthalmic findings, operative reports, adverse events, and record of re-operations...