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Trabeculectomy with erroneous Mitomycin-C concentration – a near miss

Trabeculectomy is the most commonly performed surgical procedure for glaucoma in the United Kingdom and worldwide. Modifications to the technique have been made since its introduction in 1963, perhaps the most significant being the adjunctive use of mitomycin-C (MMC), which...

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...

Diabetes macular oedema in pregnancy self-resolving postpartum

*Equally contributing co-first authors. Diabetic macular oedema (DMO) is a common clinical presentation to ophthalmology clinics. Ample evidence exists for management of DMO in non-pregnant patients. However, there is a paucity of evidence on the optimal management of DMO in...

Biometry and IOL choice errors

In the next instalment of this series I focus on problems associated with biometry and intraocular lens (IOL) selection for cataract surgery. I have taken previous medicolegal cases I have dealt with and tried to extract some learning points and...

The most frequent complaints and claims in ophthalmology – a Medical Protection Society (MPS) analysis

The authors look at the reasons behind medico-legal cases reported to MPS and share key learning points. Complications following ophthalmology surgery are rare, however, medico-legal cases are not uncommon due to the significant impact they can have on patients’ lifestyles....

The results of the last survey Feb 2020

I appreciate that I keep on reiterating it, but again we see so much practice variance. Who is right and who is wrong? Is there a right or wrong approach? And does it matter? I think it probably does matter....

A Multidisciplinary Approach to Neovascular Glaucoma in a Patient with Waldenström’s macroglobulinemia

An 84-year-old Caucasian male attended eye casualty with a four month history of reduced vision, a dull ache and photophobia in both eyes. He had also reported dizziness, weakness and intermittent epistaxis in the nine months prior to presentation. There...

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...

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’....

A near miss

A 55-year-old gentleman presented with a ‘blurry patch’ to his left eye which he had noticed for the past two months. The visual acuity with correction was 6/5 in the right eye and 6/6 in the left eye on the...

An interview with Professor John Forrester

What made you choose ophthalmology as a career and how did your interest in academia develop? During Medical School at Glasgow University, I was getting progressively disillusioned with the career options while my colleagues and friends all seemed to quickly...

Diabetic Macular Oedema

Diabetes mellitus is a metabolic disorder that affects the metabolism of all three categories of carbohydrates, lipids and proteins. This condition is characterised by chronic hyperglycaemia [1]. This can cause end organ damage. The estimated worldwide diabetes prevalence for 2010...