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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...

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’....

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...

My top five: Emerging alternatives to manage and treat nAMD

Wet (exudative or neovascular) age-related macular degeneration (AMD) is characterised by choroidal neovascularisation, in which new blood vessels from the choroid invade through Bruch’s membrane. These blood vessels proliferate beneath or through the retinal pigment epithelium (RPE), causing patients to...

The management of chronic central serous chorioretinopathy

Central serous chorioretinopathy (CSCR) is a common retinal disease characterised by one or more serous neurosensory detachments. Patients present with acute onset blurring of vision, metamorphopsia and / or central scotomas. The condition is six times more common in men...

Typical or surprisingly uncharacteristic presentations of neuro-ophthalmic emergencies

Irrespective of geographical location or patient cohort, emergency departments are high risk locations capable of inspiring extreme anxiety and dread in patients and doctors alike. The stress multiplies when a walk-in or referred case is suspected of underlying neurological pathology....

Specialist high-street eye clinics for managing patients with retinal disorders can enhance care standards

The author examines the successful introduction of community-based retinal clinic services by Manchester University NHS Foundation Trust. Dr Sajjad Mahmood, Consultant Ophthalmologist, MREH, shares experience of establishing community-based medical retina clinic services. Sight loss from age-related macular degeneration (AMD), cataract,...

Diabetic retinopathy screening in Belize: a country’s journey towards reducing blindness from DR

The rise of diabetes mellitus (DM) and its complications is a public health concern in the Caribbean. The Caribbean Diabetic Retinopathy (DR) Programme, managed by the London School of Hygiene & Tropical Medicine (LSHTM) and funded by the Queen Elizabeth...

Advances and developments in medical retina

The author provides an update on late breaking clinical trial results in neovascular age-related macular degeneration (nAMD) and presentations on diabetes management from the American Academy of Ophthalmology Retina Subspecialty Day, held during the Academy’s annual meeting in Chicago, October...

Renewed momentum in ocular gene and cell therapy, broadening application to chronic disease

Gene and cell therapies offer the prospect of ground-breaking new avenues for the treatment of diseases, reflected in a renewed explosion of interest and investment in retinal gene therapy. Rod McNeil reports recent clinical trial readouts across a diverse range...

The management of retinal vein occlusions: a summary

Retinal vein occlusions (RVO) are the most common cause of visual loss from retinal vascular disease second to diabetic retinopathy. Vision is lost due to ischaemia, macular oedema and / or haemorrhage which ultimately effects a patient’s quality of life...

Cancer associated retinopathy

Abdul Muhyemin Tarin reviews the presentation, pathophysiology and management of this paraneoplastic syndrome. Case presentation A 60-year-old hypermetropic female patient presented with several months’ history of painless blurred vision. Visual acuity (VA) was 6/24 and 6/9-1 in right and left...