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Apr/May 2017 Quiz

History A five-month-old baby was seen in clinic with bilateral congenital corneal opacities. The right cornea is shown in Figure 1. Figure 1. Examination revealed corneal oedema and opacities of Descemet’s membrane and endothelium with a few vesicular lesions. Corneal...

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...

Feb/Mar 2016 Quiz 2

History A 30-year-old male presents with a phthisical left eye and undergoes enucleation. He has some lesions in his right eye that are under ophthalmic surveillance. Figure 1 is a low power of the enucleation. Figures 2, 3 and 4...

Oct/Nov 2014 Quiz

History 12-year-old cattle herder in Bangladesh. Loss of vision right eye – over 2/12 to no perception of light (NPL). B-scan showed choroidal thickening. Suspected to be choroidal ‘tumour’. Enucleated. Figure 1. Figure 2. Figure 3. Figure 4. Figure 5....

Aug/Sep 2014 Quiz 1

History A 50-year-old female with a history of smoking, weight loss and cough presents to the ophthalmology clinic with a distorted pupil. Examination reveals a mass on the surface and within the iris (see Figure 1). The ophthalmologists decide to...

Jun/Jul 2014 Quiz

History An 80-year-old male had a cataract removed with intraocular lens (IOL) seven years previous. He presented with cloudy vision and it was noted that the IOL was intrinsically opaque. The IOL was replaced and sent for ophthalmic pathology assessment....

The butterfly effect

One of the most fascinating aspects of being a consultant is seeing the workings of the machine that is medical training from the other side. For two years now I have taken part in the specialty recruitment interviews and it...

It’s easy when you know the rules

As I was travelling along a deserted road on a Sunday last month I saw in my peripheral vision a disconcerting flash of light behind me. Much as I tried to convince myself that the flash was due to the...

Specialty doctor interviews

I started my training as an ophthalmologist in the Wild West of Carmarthenshire where I did my first laser procedure, first phacoemulsification and first slit-lamp examination. All of these firsts were done under the tutelage of very skilled staff grade...

Phaco nightmares

I am interested in the stressful nature of cataract surgery from the surgeon rather than the patient’s perspective. It is an issue that has quite literally kept me awake at night. Part of getting to grips with a problem is...

Effecting change

I took a picture of my new identity badge and sent it to everyone I knew. In fact, I put it up on Facebook as well. The two key words were ‘Consultant Ophthalmologist’ and let us ignore for now that...

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...