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The results of the last survey Dec22

I am regularly faced with litigation whereby the claimant’s cornea has decompensated after cataract surgery. The procedure may have been complicated but sometimes it is not. The eye may have been high risk, for example, a shallow anterior chamber with...

Cytomegalovirus retinitis post intravitreal triamcinolone in an immunocompetent patient with juvenile glaucoma

Figure 1: Fundus photograph shows active CMV retinitis four weeks after IVTA in the right eye. Figure 2: Fundus photograph of the left eye with no CMV retinitis; atrophic disc as a result of juvenile glaucoma. Case report A 29-year-old...

Acute retinal necrosis presumably caused by Epstein-Barr virus infection

Acute retinal necrosis (ARN) is an uncommon, but serious and potentially blinding condition. ARN is characterised by panuveitis, occlusive vasculopathy and progressive peripheral necrotising retinitis. The diagnosis is clinical but confirmation is sought via aqueous and vitreous sampling. Varicella zoster...

Usefulness of gonioscopy to investigate cause of corneal oedema after cataract surgery

A 72-year-old man with ocular hypertension presented three months after routine right phacoemulsification and toric intraocular lens (IOL) implantation with a two-week history of an irritated right eye and a sudden deterioration in right vision. His preoperative spherical equivalence was...

Ophthalmology survey results August/September 2019

I am delighted to see another great response to the practice variance survey. I am extremely grateful to all of you who took part and would encourage those of you who didn’t to try this survey. It literally takes mere...

The results of the last survey Apr 2020

As ever, I would like to thank all those who participated in the last edition’s survey. A lot of data was generated and I do not intend to go through each individual finding. What is staggering again is the degree...

The results of the last survey Oct21

This edition’s survey questions moved away from the deep and ethically charged questions of the recent surveys and focussed on simple and straightforward issues. This is really where the surveys began in exploring the minor practice variations which we have...

Preventing refractive surprises by real time biometry during cataract surgery

A few months ago a retired lady presented for second eye cataract surgery. I noted on the pre-op ward round that the outcome of her first eye’s surgery looked like a refractive surprise as her spherical equivalent in that eye...

An arm and a leg

“It cost me an arm and a leg.” – Mr B told me. An arm and a leg to be seen by the famous Russian eye surgeon who said that everybody can be spectacle-free. He took Mr B’s money (roughly...

Managing cataract surgery in a patient with diabetic maculopathy

A 56-year-old type 2 diabetic with previously treated bilateral diabetic maculopathy develops a cataract requiring surgery in the right eye. He has had grid laser previously, followed intermittently by intravitreal triamcinalone, Avastin and more recently Lucentis in both eyes. His...