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The embryology of the eye

Nobody claims to like embryology. At least nobody I know. It has been a neglected part of the curriculum since time immemorial and a vicious cycle occurs in which those with an incomplete understanding fail to appreciate the inherent beauty...

Embryology in clinical practice

The fascinating world of embryology is both beautiful and practical. It is a home video of our evolutionary history through the ages from the single cell through to the life aquatic, the development of gut, limbs and brain, and most...

The approach to trabeculectomy postoperative complications

Performing a trabeculectomy is like giving birth to a baby. It may be traumatic and there is scope for devastating error but once the operation is completed only then does the real work begin. The bleb must be nurtured into...

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....

Digital eyecare – enabling better communication between primary and secondary care

Alexander Chiu and his co-authors highlight innovations influencing healthcare advancement and how trainees can get involved. Hospital eye services (HES) were under great pressure to meet demand, even before the COVID-19 pandemic. This pressure has increased with the cancellation and...

The power of the full blood count

Vishal Shah walks us through his thought process whilst highlighting the importance of routine investigations when dealing with unusual retinovascular presentations. Retinal changes can arise in anaemia, leukaemia, lymphoma, myeloproliferative and myelodysplastic syndrome. They are often the first manifestation of...

Ocular electrophysiology

A 34-year-old woman, who is a CEO in a multinational firm, has been losing vision over the last 12 months. She has seen her opticians, who initially tried different glasses but could not improve things. Clinical examination is unremarkable. How...

Discussing treatment modalities for bilateral wet AMD

A 65-year-old lady with bilateral wet AMD and vision of 6/24 comes with an internet search about current therapies. How do you explain the various treatment modalities available? There are two NICE approved treatments for wet age-related macular degeneration (AMD)....

The management of possibly progressive pterygium

A 43-year-old Sudanese male patient is referred by his GP with a fleshy lesion encroaching the nasal cornea for the last six months. History Make note of: risk factors, i.e. UV exposure and ocular irritation - history of living in...

The management of antiplatelets and anticoagulation in elective ophthalmic surgery

Clinical scenario: A 57-year-old gentleman who is scheduled to have Mohs micrographic surgery and reconstruction for a medial canthal basel cell carcinoma (BCC) has been started on aspirin and clopidogrel following a coronary stent three weeks ago. Does the antiplatelet...

Ultrasound biomicroscopy (part 2): primary angle closure

Patients with primary angle closure or primary angle closure glaucoma [PAC(G)] comprise a significant subgroup affecting around 10% of glaucoma patients amongst Caucasians. Assessment of the patient with angle closure, or narrow angles, requires gonioscopy. However, whilst identifying the presence...