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Flashes and floaters in community optometry – diagnosing a posterior vitreous detachment

Managing patients who attend a practice with symptoms of flashes and floaters is a regular occurrence in community optometric practice. It’s often very distressing for patients; symptoms can be quite dramatic and an internet search can indicate imminent blindness from...

Addressing medical risk factors for diabetes and understanding the new systemic treatments

As global diabetes figures continue to rise, the importance of reducing the burden of macrovascular and microvascular complications of diabetes has never been so great. By 2025 it is estimated that five million people in the UK will have diabetes...

Appeal for fundus cameras and OCT machines for Nigeria

Nigeria has the highest population of people living with diabetes mellitus (DM) in sub-Saharan Africa. As at 2013 the population of people living with DM stood at 4.9 million, of whom an estimated 1.7 million had diabetic retinopathy (DR). There is currently no national DR screening and treatment programme.

Minimally Invasive Glaucoma Surgery – A Practical Guide

The treatment of patients with mild to moderate glaucoma has evolved rapidly in the last decade. Traditionally, medical and laser treatments were the mainstay of therapy for this group of patients. Trabeculectomy, non-penetrating surgery and glaucoma drainage implants were reserved...

Ranibizumab safety in pregnancy

Vascular endothelial growth factor (VEGF) plays a pivotal role during pregnancy, and systemic anti-VEGF administration during this period should thus be avoided. VEGF is expressed in multiple embryonic and foetal tissues during development, with the highest levels found in the...

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...

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....

A European ophthalmology perspective

Europe: from the Greek eurus: broad, wide, and ops: eye, face, sight. Thus Europe = the far-sighted (lady). For my first contribution to this column – as the successor of Jonathan Park, whose witty observations and entertaining style many of...

App and web service recommendations

This article offers some app and web service suggestions. A few are new and others well established, but all offer useful features. Messaging for teams Many businesses provide their employees with instant messaging services to allow calling, messaging and collaboration....

100 years since Sir William Duke-Elder graduated from the University of St Andrews

With sincere thanks to Andrew King, Ophthalmic Optician and owner of Andrew King Opticians near Glasgow, for his extensive research into Duke-Elder’s life.' Sir William Stewart Duke-Elder. Photo credit: Edward Irvine Halliday, Institute of Ophthalmology. In the world of ophthalmology,...

Should we move towards procedure-specific consent forms?

The consent process represents the patient’s acceptance of the information provided to them and an agreement to undergo an intervention as suggested by a health professional. Effective doctor-patient communication, ensuring the succinct delivery of the necessary points in a way...

A practical guide to anisocoria

Anisocoria means the presence of difference in the size of the right and left pupils. It is a sign of an abnormality in the efferent pathway. The first question facing the ophthalmologist is to ascertain if anisocoria is present or...