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Has ‘reduce, reuse and recycle’ gone too far?

The past few decades of surgery since the ‘mad cow disease’ have been dominated by a push to switch to disposable instruments. The reason is to prevent cross-contamination and reduce the risk of surgical site infections – especially so with...

Turn up anytime

When I was starting off in ophthalmology my then boss had a standard spiel after completing a cataract case. It did not vary and I do not recall an instance of it not taking place. “The operation went well and...

The only thing to fear is fear itself

There is a song by the Amateur Transplants called ‘Finals Fantasy’ which describes in humorous detail how stressful clinical exams can be. Having not done any viva or objectively structured clinical examination (OSCE) style exams for many years indeed I...

Acanthaemoeba keratitis

In the second of this series I describe a case of Acanthaemoeba keratitis (AK) that was misdiagnosed for a prolonged period which resulted in a devastating outcome. This is one of half a dozen similar medico-legal cases I have dealt...

The results of the last survey Apr22

The answer to the first question was interesting in that it seems an increasing number of units are doing same-sitting bilateral cataract surgery. It is becoming accepted practice and mainstream. Immediately sequential bilateral cataract surgery (ISBCS) involves performing phacoemulsification with...

Fundus photography in Malawi – setting up a screening programmefor diabetic retinopathy

We present the case of a 53-year-old lady who presented to the diabetes outpatient clinic at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. She was diagnosed with type 2 diabetes mellitus six years ago, for which she takes metformin orally. She...

Paraproteinaemia: a patient with atypical corneal findings

A Bence Jones protein is a monoclonal globulin protein or immunoglobulin light chain found in the urine, with a molecular weight of 22-24 kDa [1]. Detection of Bence Jones protein may be suggestive of multiple myeloma or Waldenström’s macroglobulinemia. Multiple...

The Wachter Review

Professor Robert Wachter (pronounced Wokter) is well known in the NHS IT sector. In late 2015 Jeremy Hunt announced he had tasked Dr Wachter to lead a review of the digital future of the NHS. The resulting Wachter Review was...

OrCam MyEye – innovative sight assistance (Part 1)

For Jun/Jul 20201 and Aug/Sep 2021 we have a two-part review (see Part 2 here) of an innovative piece of sight impairment technology. The device is called a MyEye, made by OrCam. I was given the opportunity to use the...

Open source and tele-manufacturing for ophthalmology

Open source or crowd-sourcing and crowd-collaboration are concepts almost always associated with software and public online projects such as Wiki project. Never had I imagined that my team would apply the same principle in ophthalmology. Just less than a month...

Is optician led service an answer to ever increasing demand on eye emergency clinics?

The demand for eye casualty appointments has been steadily increasing in the UK, leading to pressures on the hospital emergency services. The incidence of presentations to eye casualty services has been estimated at 20-30 per 1000 per year [1]. Evidence...

Comic leaflets: an innovative method of patient education

Nowadays almost everyone has been exposed to comics, especially during childhood. In a way, this is a natural form of progression from children’s story books, which also contain words and pictures. This exposure has helped us to develop the graphic...