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Doctor in the House

“What’s the bleeding time?”“10 past 10 sir”. These are the famous lines uttered by Chief Surgeon Sir Lancelot Spratt (James Robertson Justice) and Medical Student Simon Sparrow (Dirk Bogarde) on a pre-op ward round at the fictional St Swithin’s Hospital,...

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...

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....

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...

Light in darkness – manual small incision cataract surgery in India

Cataract has been documented to be the most significant cause of bilateral blindness in India, where vision <20/200 in the better eye on presentation is defined as blindness [1,2]. Estimation of blindness in India by the World Health Organization (WHO)...

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...

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...

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...