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A pituitary tumour from 1927

The author shares a clinical case from Edinburgh Royal Infirmary’s archives. It is not often in the course of a clinical career that one gets the opportunity to review a patient who had been treated by a pioneer neurosurgeon some...

Non-arteritic anterior ischaemic optic neuropathy (NA-AION): a review

Ischaemic optic neuropathy (ION) is the commonest adult optic neuropathy encountered today in our ageing population, is a common cause of irreversible visual loss and is usually associated with underlying vascular disease. The condition is classified as follows: (a) Anterior...

A revolution in modern genetic testing for the clinical management of ocular disease

Recent years have seen a huge increase in our understanding of the genetic factors underlying a wide variety of eye diseases. This has included common conditions such as glaucoma and age-related macular degeneration, as well as those conditions which have...

Visual disturbance heralding stroke: are we seeing the signs in time?

Isolated visual symptoms may be an early presenting feature of stroke, and timely recognition of such atypical cases is important because treatment for stroke has a limited time-window of efficacy. Stroke occurs in approximately 150,000 people per year in the...

Rainspotting. Choose your future. Choose Pete’s Hidden Curriculum Part 2.

See Pete's Hidden Curriculum Part 1 here Interviewer: “Mr Murphy, what attracts you to the leisure industry?”Spud: “In a word: pleasure. It’s like pleasure in other people’s leisure.”Interviewer: “Do you see yourself as having any weaknesses?”Spud: Shakes head, then: “Oh,...

Acute management of retrobulbar haemorrhage

The authors discuss the importance of rapid diagnosis and correct management of acute RBH presentation to avoid the risk of permanent blindness. Retrobulbar haemorrhage (RBH) is an ocular emergency that occurs due to arterial bleeding in the orbital cavity behind...

Recurrent corneal erosions secondary to isotretinoin use

Isotretinoin (13–cis-retinoic acid) is the first line treatment for moderate to severe nodulocystic or papulopustular acne [1,2]. Although it is a safe medication, it has several adverse side-effects, including ophthalmic manifestations, as shown in Table 1 [3]. These side-effects need...

Principles of contact lens fitting in keratoconus

Keratoconus is an ectatic condition of the cornea characterised by progressive conical distortion with irregular astigmatism, myopia and apical protrusion. Most cases progress slowly resulting in varying degrees of myopic astigmatism. Management of keratoconus includes spectacles, soft contact lenses, a...

Light in darkness – manual small incision cataract surgery in India

Cataract has been documented to be the most significant cause of bilateral blindness in India, where vision <20/200 in the better eye on presentation is defined as blindness [1,2]. Estimation of blindness in India by the World Health Organization (WHO)...

In vivo confocal microscopy, principles and use in keratitis Part 1: Principles

In 1968 Maurice introduced the concept of high powered specular microscopy, it was in that very year that the first scanning confocal microscope was proposed. Marvin Minsky developed the first confocal microscope in 1955 named the ‘double focusing scanning microscope’....

Don’t ignore the black lesion! It might be mucormycosis

Keeping mucormycosis infection in the foreground of your differential diagnosis, especially in those more vulnerable patients, will help save their lives if recognised and managed appropriately. Mucormycosis is a fulminant infection caused by the fungi of the family Mucoraceae. It...

Decontamination and sterilisation of surgical instruments and medical devices

Ann-Marie Ablett is a Theatre Nurse and Team Leader who volunteers with Orbis. This has allowed her to gain a wealth of experience on ophthalmic procedures, nursing in under-privileged parts of the world, leadership, management and use of scarce resources....