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Caring for adults with an ocular tumour

Detection If you screen for an intraocular tumour, dilate the pupil. If the patient is driving, use phenylephrine only. If the patient declines, document this in the casenotes. Don’t forget to look for sentinel vessels, which would indicate a ciliary...

Vitreomacular traction and full thickness macular hole

Clinical scenario: A 64-year-old lady presented to the clinic with a few weeks history of sudden onset of metamorphopsia, central blur and reduced vision in her right eye. The ocular examination and ocular coherence tomography confirmed right eye focal vitreomacular...

Ambitions for sustainable service recovery amidst an escalating post-COVID backlog

Rod McNeil reviews plans, activity and solutions to better address the post-COVID backlog and bolster sustainable service recovery. Ophthalmology was the busiest outpatient specialty during the three years to March 2020 across the English NHS and again recorded the highest...

Childhood glaucoma

When a child is given a diagnosis of glaucoma, the impact upon that child and their family is enormous; equivalent to the diagnosis of a cancer [14]. This article outlines the knowledge, techniques and approaches that offer solutions to the...

An update on inherited retinal disorders (part 2): Approaches to therapy for IRDs

Part 1 of this topic can be found here There are currently no proven cures for inherited retinal disease (IRD). However, multiple avenues of research are being investigated to better understand disease mechanisms and trial potential therapies that may slow...

Initiatives in macular service provision

A report from Monitor in October 2015 identifies good practices that will realise most of the potential productivity gain in elective care available to NHS hospitals. These include: stratifying patients by risk and creating low-complexity pathways for lower-risk patients (tailoring...

Telemedicine strategies in ophthalmology: harnessing established and emerging technologies for lasting solutions

The author considers recent progress and shares insights from leading practitioners in telemedicine applications and digital technology strategies. Amidst COVID-19 and combined mitigation and suppression measures, hospitals and clinics have responded rapidly to strengthen telemedicine strategies and virtual healthcare services...

Understanding and confronting bacterial endophthalmitis

Abdus Samad Ansari highlights the importance of early recognition of this condition using an unusual presentation. Endophthalmitis is a medical emergency with devastating consequences. Despite adequate treatment, severe cases frequently result in permanent blindness. Endophthalmitis involves inflammation of both the...

Cancer associated retinopathy

Abdul Muhyemin Tarin reviews the presentation, pathophysiology and management of this paraneoplastic syndrome. Case presentation A 60-year-old hypermetropic female patient presented with several months’ history of painless blurred vision. Visual acuity (VA) was 6/24 and 6/9-1 in right and left...

Headaches in ophthalmology (part 2)

Ophthalmologists see a large number of patients with headaches or facial pain in the ophthalmic outpatient clinics or in emergency clinics. Over two articles, I will discuss several causes of headaches, ocular manifestations and proposed management and referral options. It...

Cementing a VISION 2020 LINK partnership between Blantyre and Liverpool – building capacity for DR services alongside research

Malawi is a small land-locked country in eastern Africa with a growing population of over 17 million people. About 45% of the population is aged 14 or under; only 5% are aged 60 or over. The gross national income per...

Real world data of post-IVT endophthalmitis, from a nurse-delivered intravitreal injection service

Introduction Intravitreal injection of neutralising anti-vascular endothelial growth factor (VEGF) antibody was licenced more than a decade ago, and over the years there has been proportionate increase in the number of intravitreal injections [1]. Injection of a therapeutic agent through...