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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...

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...

What can we learn from Jimmy McGill?

A few months ago, my eldest son got me interested in a Netflix series called “Better Call Saul”. This is a spin-off from another series called “Breaking Bad”, although I confess to not having seen any of those episodes as...

What’s next in retinal imaging? Faster, deeper and full-on

Fast-evolving technological leaps are opening the way toward clinically useful ocular coherence angiography, generating 3-dimensional microvasculature maps without intravenous dye injection, as well as whole-eye imaging, handheld patient-operated optical coherence tomography (OCT) devices and, for challenging vitreoretinal procedures, integrated intraoperative...

A paradigm shift in the way we approach cataract surgery

Cataract surgery is the most common elective surgical procedure in the UK [1], with in the region of 350,000 cases being conducted each year. With an ageing population, this figure will only continue to rise over time. Cataract surgery is...

Emerging therapies for geographic atrophy: complement inhibitors show potential to slow progression and preserve RPE and photoreceptor integrity

Geographic atrophy (GA) is an advanced form of age-related macular degeneration (AMD) characterised by progressive, irreversible loss of the retinal pigment epithelium (RPE) and photoreceptors and is estimated to account for approximately 10% of AMD-related blindness [1-4]. The Age-Related Eye...

Flashes and floaters in community optometry – diagnosing a posterior vitreous detachment

Managing patients who attend a practice with symptoms of flashes and floaters is a regular occurrence in community optometric practice. It’s often very distressing for patients; symptoms can be quite dramatic and an internet search can indicate imminent blindness from...

Gene therapy for inherited retinal disease: the Manchester Ocular Gene Therapy Group MDT service

The authors describe the process set up in Manchester for the optimum delivery and assessment of a new gene therapy treatment for patients with RPE65 IRD. Inherited retinal dystrophies (IRDs) are the second commonest cause of severe visual impairment in...

Sustainability in eyecare: Intraocular gases and the climate emergency

In 2020 the NHS became the first national health system to commit to delivering ‘net zero’ carbon emissions by 2040. The author investigates how the impact of ophthalmic surgery can be reduced. Medical gases have been used in ophthalmic surgery...

Amnion-assisted conjunctival epithelial redirection (ACER): Enhancing stem cell transplantation treatment of total limbal stem cell deficiency

An exploration of Professor Harminder Dua’s recent work using a technique called amnion-assisted conjunctival epithelial redirection (ACER) to aid the success of conjunctival-limbal grafting procedures. ACER provides a refined way to use amniotic membrane (amnion), such as Omnigen® (NuVision® Biotherapies,...

Optical coherence tomography – reinventing the eye examination

It has been 25 years since Huang et al. presented the first optical coherence tomography (OCT) images in Science [1]. With vast improvements in OCT technology over the years, it is now possible to acquire high-resolution cross-sectional images of the...

Grading of ocular inflammation in uveitis: an overview

Anterior uveitis is the commonest form of uveitis, which can lead to severe morbidity if not treated appropriately [1]. Data from general ophthalmology practices suggest around 90% of uveitis encountered by comprehensive ophthalmologists is anterior uveitis [2]. Intermediate (vitreous), posterior...