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Diagnosis and management of IV cranial nerve palsy

Aetiology: Trochlear nerve palsy can be divided into acute or congenital. Congenital trochlear nerve palsy is usually noted in childhood with development of abnormal head posture. Various pathologies can lead to acute IV nerve palsy, most commonly trauma. Other causes...

Do we really need the College to be Royal?

It is taken for granted in this country that all the best medical colleges are Royal. That they have the royal seal of approval from on high and therefore must be the best. I have been somewhat confused for a...

Specialty doctor interviews

I started my training as an ophthalmologist in the Wild West of Carmarthenshire where I did my first laser procedure, first phacoemulsification and first slit-lamp examination. All of these firsts were done under the tutelage of very skilled staff grade...

How to consent patients

I attended a morning seminar at the recent College Congress in Liverpool about how to properly and legally consent a patient for a procedure. There has been a lot of interest in this of late following the Montgomery ruling, in...

Effecting change

I took a picture of my new identity badge and sent it to everyone I knew. In fact, I put it up on Facebook as well. The two key words were ‘Consultant Ophthalmologist’ and let us ignore for now that...

The results of the last survey Jun23

*Please be aware that this data does not form part of a peer reviewed research study. The information therein should not be relied upon for clinical purposes but instead used as a guide for clinical practice and reflection. I continue...

A refractive surprise after vitrectomy and capsulectomy

Figure 1: Right posterior capsule small aperture. We report a case of a pseudophakic patient who underwent vitrectomy and posterior capsulectomy. In spite of good visual acuity and absence of floaters, he was unhappy with the visual outcome. Case report...

Refractive surprise after cataract surgery caused by posterior capsular striae

Cataract removal with intraocular lens (IOL) implantation is one of the most frequently performed surgeries in current clinical practice [1,2]. New microsurgical techniques and refined IOL power calculations allow excellent refractive outcomes. Refractive surprise following cataract surgery is uncommon [1-3]...

The results of the last survey Oct20

The point of this series is to find variations in practice and to raise them to you, the readership, so you can review and reflect upon them. I am aware there is not always a ‘correct’ way of doing things,...

On the wrong track

A 65-year-old very high myope lady presented with sudden blurred vision down to count fingers to her right eye after a short and sharp pain. She also described seeing a black swirly line and as all these symptoms were exactly...