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Evolving towards an interventional glaucoma mindset

Traditionally, a newly diagnosed glaucoma patient would be treated first with medical therapy. As the disease progressed or the initial intervention failed to adequately control intraocular pressure (IOP), clinicians would add more drops, selective laser trabeculoplasty (SLT), repeated SLT and...

Upper eyelid ulceration as a presenting sign of frontal sinus mucocele

Introduction A sinus mucocele is an epithelium-lined sac filled with mucus and desquamated epithelium. It forms secondary to inflammatory processes that occur in a sinus with an obstructed ostium. Predisposing conditions include previous trauma, surgery, tumours, anatomical abnormalities, and chronic...

The treachery of images – making sense of OCT imaging

In 1929 Belgian surrealist Rene Magritte produced his painting La Trahison des Images. It depicted an old fashioned pipe for smoking tobacco and underneath were the words “ceci n’est pas une pipe”, this is not a pipe. You may wonder...

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...

Genetic profiling for personalised healthcare solutions in AMD – an update

Age-related macular degeneration (AMD) is a multifactorial condition influenced by genetics and lifestyle factors (Table 1). This article outlines several recent advances in AMD genetics, as well as evolving therapeutic concepts and established practical measures for the treatment and /...

Blurred vision post liver transplant: to blame the house cat or not?

This article outlines a case of atypical ocular toxoplasmosis associated with immunosuppression. There were two potential sources of infection in this patient and we describe how we concluded which was the most likely. Case report A 33-year-old female was referred...

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...

Disseminated cutaneous zoster – a masquerade

Reactivation of varicella zoster infection in the elderly commonly presents to ophthalmologists as herpes zoster ophthalmicus (HZO), affecting the Va trigeminal dermatome. In patients with impaired immunity, zoster infection occurs with increased severity and may be complicated by visceral and...

Changing the post cataract surgery review pathway – is patient safety compromised?

Cataract surgery continues to be the most commonly performed elective surgical procedure in the UK, with an annual rate of approximately 4150/100,000 people over the age of 65 accounting for a significant proportion of the surgical workload of most ophthalmologists...

An anterior segment lump: a diagnostic and treatment challenge

Case presentation A 50-year-old female presented to eye casualty with a lump on the left medial lower eyelid with associated redness and occasional bleeding. The lump was present for a few months with recent enlargement (Figure 1). Her past medical...

The Global Vision Database

The overall goal of the Global Vision Database (GVD) [1] is to develop and deploy new and improved evidence on the prevalence of blindness and vision impairment (VI) globally. It is a repository which allows us to assess the causes...

A look into the IOL space

Advances in the design and performance of intraocular lenses (IOLs) continue to be driven by demand for better outcomes, presbyopia correction and spectacle independence, alongside a better understanding of the dynamics of the crystalline lens, newer theories of accommodation and...