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Headaches in ophthalmology (part 1)

Ophthalmologists see a large number of patients with headaches or facial pain in the ophthalmic outpatient clinics or in emergency clinics. Over two articles, I will discuss several causes of headaches, ocular manifestations and proposed management and referral options. It...

Quiz Dec/Jan 2020

History A 69-year-old female patient was referred to the uveitis clinic from her local district general hospital with a left posterior uveitis which had been unresponsive to high dose steroids. She had no other previous ophthalmic history nor significant systems...

Feb/Mar 2017 Quiz

History A 40-year-old male patient presented with a right lower eyelid swelling with gradual enlargement for two months. On examination there was a large lesion apparently involving lid margin, part of palpebral conjunctiva and skin. No other local or systemic...

Complex Biometry Clinics: a new service development

In this article we describe a new local service development, the ‘Complex Biometry Clinic’ at Leicester Royal Infirmary. Retrospective data analysis of patients referred between October 2012 and October 2013 was performed. The aim was to provide a one-stop service...

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....

Traumatic ‘toy’ gun injury leading to permanent vision loss

Pseudoxanthoma elasticum (PXE) is a progressive, inherited disorder of connective tissue that affects the skin, cardiovascular system and retina. Ocular manifestations of the disease are related to Bruch’s membrane, a thin elastic tissue layer located between the retinal pigment epithelium...

The last three patients: general medicine (Patient Two)

For the second reflection in this series (see Patient One here), Professor Jonathan Rees recounts his experiences of the last patient he saw as a medical registrar, telling the tragic story of a young man’s death and the risks that...

Herpes zoster ophthalmicus: the essentials

Herpes zoster, also referred to as shingles, is a common infection most typically caused by the reactivation of varicella zoster virus that lies dormant (sometime for decades) in the dorsal root nerve ganglion following primary chickenpox infection [1]. In 10-20%...

More action on sepsis needed as NHS Ombudsman still seeing same failings a decade on

The UK’s Health Ombudsman has warned that sepsis is still taking too many lives due to the same hospital failings we were seeing over ten years ago.

Choroidal folds

Choroidal folds are undulations of the choroid, Bruch’s membrane and pigment epithelium, with wrinkling of the overlying retina. They may be idiopathic but can also be caused by a number of different conditions. Case report A 60-year-old male patient was...

Working smarter not harder: How to transform eyecare delivery in the United Kingdom (part 2)

Are we doing enough to meet the current demands on ophthalmic services? In part two of a two-part series (see Part 1 here), Rosalind Harrison explains how efficiency can be improved by setting up eye services in community hubs. The...

Lessons from an unusual case of syphilis

The rise of syphilis transmission rates over the past two decades has been one of public health’s great puzzles. In the UK, the situation has reached epidemic levels, with a 126% increase between 2013 and 2018 [1]. We present a...