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Quiz Dec/Jan 2023

History A 35-year-old female presented to the emergency eye clinic with an acutely red, painful, photophobic left eye. She was a contact lens-wearer but denied swimming, showering, or sleeping in her lenses. She resided on a farm and worked as...

Aug/Sep 2018 Quiz

History A seven-year-old girl presented with a presumed papillomatous lesion on right inferior fornix (Figure 1). Her parents said the lesion was increasing in size for two weeks. CT scans (Figure 2) revealed a lesion occupying the right medial canthus....

Apr/May 2014 Quiz 2

History A 29-year-old woman presented to the emergency department with a two week history of floaters and patchy peripheral visual field loss in the left eye (LE). She had no relevant medical history and she was not on any current...

Unconscious bias

Swansea University invited me to an Away Day. There was a whole day of lectures planned at a hotel conference suite just outside Swansea but due to clinic commitments I only caught the afternoon session; a ‘workshop’, on how to...

How to consent patients

I attended a morning seminar at the recent College Congress in Liverpool about how to properly and legally consent a patient for a procedure. There has been a lot of interest in this of late following the Montgomery ruling, in...

Handover of power

Election time comes every five years in the United Kingdom. It is usually a time of excitement and trepidation as people wonder what will change, for whom and over how long, depending on which party might win power. Usually it...

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...

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...

An unusual presentation of sarcoidosis

*Equally contributing co-first authors. Case report A 45-year-old man presented to his local optometrist with a three-week history of severe intermittent left eye pain with associated blurred vision and tenderness around his left temple. Two days prior, he developed weakness...

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...

Hydroxychloroquine toxicity

Being the subject of litigation is stressful and upsetting. Having to look back over your previous decisions and justify the care you delivered in good faith can be difficult. Sadly, we all live with the Sword of Damocles above us...

The Re-humanising Revolution: Breaking the conspiracy of silence

Over the last few years, the mental and emotional wellbeing of those who work in medicine has come under scrutiny. The author introduces a new resource. Working in healthcare has always been stressful but never more so than today. In...