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Is thrombolytic treatment warranted for central retinal artery occlusion?
Central retinal artery occlusion (CRAO) is a subtype of acute ischaemic stroke which results in severe visual loss. Acute CRAO is equivalent to a brain acute ischaemic stroke (AIS), as the obstruction of the central retinal artery (CRA) causes end-organ...Immunoglobulin G4-related ophthalmic disease – what is it? (Part 2)
Part 2: Clinical presentation and treatment (see part 1 here) Introduction IgG4-related disease (IgG4-RD) is understood to have a vast clinicopathological spectrum; nearly every organ has had reported involvement. Similarly, IgG4-related ophthalmic disease (IgG4-ROD) is known to affect nearly every...A complicated case of cytomegalovirus viremia: “What would you do doctor?”
Mrs W walked gracefully into my urgent care clinic. It was another busy session and I hoped she did not have anything serious going on which might slow the clinic further. She was an elegant 72-year-old lady who seemed like...
RCT review of surgery for open angle glaucoma
This systematic review and meta-analysis examined eight randomised controlled trials (RCTs) to compare the intraocular pressure (IOP) reducing effect of three types of microstent implantation (Hydrus, iStent, CyPass) combined with phacoemulsification versus phacoemulsification alone for patients with open-angle glaucoma (OAG)...
Subfoveal choroidal thickness and PCV
This report studies the prognostic factors for visual improvement and the need for additional treatments at one year after the initial combination therapy of intravitreal ranibizumab injection or intravitreal aflibercept injection followed by PDT in eyes with PCV. Fifty-six eyes...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....
DSEK – five year results
This UK based study examined long-term descemet stripping endothelial keratoplasty (DSEK) results, looking at graft survival and endothelial cell losses. Data on 210 grafts were included in analysis. Most frequent indication for DSEK was Fuch’s endothelial dystrophy (81.4%) and 46.3%...Bridging the gap – Supporting our patients across the primary / secondary care divide
Providing the best care for patients is surely a fundamental goal for all healthcare professionals. When waiting-times are long and getting longer, clinics are full, colleagues are off with stress-related illness and patients are complaining, is it possible to still...What to expect when meeting a statistician
There are a growing number of statisticians working closely with ophthalmologists. They have different training but they are driven by the same goal: to perform high quality evidence based clinical research [1,2]. In a perfect world we would simply conduct...A missed opportunity
Back in 2000 Sir Liam Donaldson wrote a piece of work commissioned by the then Secretary of State for Health entitled “An Organisation with a Memory”. We are now 18 years on and still some of the recommendations from them...
Retrobulbar amphotericin B for rhino-orbital-cerebral mucormycosis
Rhino-orbital-cerebral mucormycosis (ROCM) is a rare and often fatal infection usually occurring in immunocompromised patients from diseases such as diabetes, haematological malignancy and solid organ transplantation. Current standards of care include systemic antifungal therapy and debridement, including exenteration. This study...
