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Anisometropia following cataract surgery and its non-surgical treatment

The desired result of cataract surgery is improved visual acuity without the use of spectacles. In practice most patients following initial cataract extraction are likely to be symptomatic of anisometropia giving rise to prismatic effects (anisophoria) and unequal retinal image...

A closed angle seldom comes alone

Case report An 89-year-old lady with dementia was referred to me out of hours by her GP with a few days history of an angry looking left eye for suspected elevated intraocular pressure (IOP). I discovered that this lady first...

“Herr Doktor, I can’t see but I am driving”

This 56-year-old lady was quite puzzling. With her own glasses and the pinhole she merely managed to see the 1.3 and 1.0 logMAR lines with her right and left eye, respectively (I am currently working in Germany again, so goodbye...

The approach to angle-closure glaucoma

Further to my last article in Eye News (print issue) describing the diagnostic approaches to various clinical scenarios in glaucoma, the approach to angle-closure glaucoma (ACG), a situation terrifying for patient and registrar alike, will be discussed. Please refer to...

“We try our best”, but we should still be open and transparent

In a recent discussion with colleagues, someone recognised that many, when asked what they do, say, “I am a doctor”. Rather than “I work as a doctor”. This sense of belonging, pride and duty comes with responsibility. Becoming a surgeon,...

Managing a patient with ptosis

A 50-year-old male patient is referred from the Accident & Emergency department with a history of ptosis. How will you manage this patient? Mr Bertie Fernando Clinical management Clinical management starts with a sound clinical history. Current history The history...

The screening and treatment of retinopathy of prematurity

A male child is born at 31 weeks and requires 100% oxygen supplementation with intensive care. What would be the ophthalmic management of this child? In the first instance, it will be useful to know the screening criteria and protocol....

Just sign here: the intricacies of consent in the post-Montgomery era

The consent process is a vital part of the patient pathway and is far more than just getting the patient to sign on the dotted line. In my work in litigation I often see issues around informed consent resulting in...

Demyelinating optic neuropathy

Introduction Optic neuritis (ON) is an inflammatory process affecting the optic nerve. After glaucoma, it is the most common optic neuropathy affecting patients under the age of 50. The usual presentation of typical ON is unilateral subacute loss of vision...