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The medical student syndrome

It is often said that “a little learning is a dangerous thing,” but being super savvy can’t put us at the brink of harm, can it? Each year as thousands of students commence their medical degrees, they begin a journey...

A life outside ophthalmology

Lloyd Paul Aiello. It was an absolute privilege to speak to Lloyd Paul Aiello, Professor of Ophthalmology, Harvard Medical School, and Vice President of Ophthalmology and Director, Beetham Eye Institute, Joslin Diabetes Center, USA. Prof Aiello is a third-generation ophthalmologist,...

Non-arteritic anterior ischaemic optic neuropathy (NA-AION): a review

Ischaemic optic neuropathy (ION) is the commonest adult optic neuropathy encountered today in our ageing population, is a common cause of irreversible visual loss and is usually associated with underlying vascular disease. The condition is classified as follows: (a) Anterior...

Using a pupillometer to confirm presence of RAPD in post stroke homonymous hemianopia

It has been reported that relative afferent pupillary defects (RAPDs) may be present in patients with occipital lobe lesions. However, a small contralateral RAPD due to a difference in the crossed and uncrossed fibres can be difficult to detect using...

Light reflex in preterm infants

In this study, the pupillary size and light reflex was examined in premature infants using infrared video-pupillography and stimuli of red and blue light. Only eyes of infants without retinopathy of prematurity were included in the study. Pupillary light reflexes...

Advances in cataract surgery

This article covers recent clinical findings in mydriasis and anaesthesia for cataract surgery, shared by Sathish Srinivasan and Keith Davey at a surgical meeting in Manchester. Towards dropless cataract surgery Day case cataract surgery is the standard of care in...

Conservative management of concomitant strabismus

The aim of management for all patients with strabismus should centre around four goals: to prevent amblyopia, to alleviate symptoms, to restore binocular single vision (BSV) and to improve ocular alignment. The conservative management options available for strabismus include observation,...

The assessment of pupils and 
pupillary reactions

Understanding pupillary reactions is vital in understanding basic neuro-opthalmology. It is a skill required in eye casualty, clinics and perhaps most importantly, exams. To start at the beginning, the pupil is the central aperture of the iris, its size controlling...

Cortical blindness

Cortical blindness is a rare but recognised entity. Cerebrovascular accident is a well-known risk factor. We report a case of an 84-year-old lady with bilateral cortical blindness with multiple cardiovascular risk factors. Case report An 84-year-old lady was admitted under...

Myasthenia Gravis Masquerading as a Third Cranial Nerve Palsy

A 65-year-old man presented with a week’s history of binocular diplopia (in all directions of gaze) and a right partial ptosis. He was systemically well. His past medical history was unremarkable except for vitiligo. At presentation acuity was 6/6 bilaterally....

Third nerve palsy following cataract surgery with sub-Tenon’s anaesthesia

Figure 1: Photograph showing partial ptosis of the right eye two months after surgery (photo by R McLeod). An 83-year-old lady had routine right eye cataract surgery under uncomplicated sub-Tenon’s anaesthesia. She presented two weeks later, explaining that following the...

Effects of phacoemulsification on IOP and drug use in glaucoma

For patients with comorbid cataract and primary open-angle glaucoma (POAG), guidance is lacking as to whether cataract extraction and traditional filtering surgery should be performed as a staged or combined procedure. Achieving this guidance requires an evidence-based understanding of the...