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Streamlining cataract lists: how are you managing it?

Mr Jonathan Ross, in conversation with Ms Bita Manzouri, provides a personal perspective on challenges and opportunities shaping the future of cataract surgery services across the hospital eye service. Redesigning cataract pathways in response to COVID-19 Bita Manzouri: Over the...

Cavernous sinus syndrome

Anatomically the cavernous sinus is a plexus of multiple veins that are connected and within this plexus there are several important vascular and neurological structures. These include cranial nerves III, IV, V1 (and sometimes V2), VI as well as the...

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....

OCT Angiography in Retinal and Macular Diseases

OCT angiography (OCT-A) is based on the concept that in a static eye, the only moving structure in the fundus of the eye is blood flowing through the vessels. This book explains how the technique allows a depth-resolved analysis and...

Transient thickening of the macular retinal nerve fibre layer in acute optic neuritis

Acute optic neuritis (ON) causes axonal degeneration, which can be quantified from the blood by neurofilament protein (Nf) levels. Within about three months, atrophy of the retinal nerve fibre layer (RNFL) follows. However, it remains challenging to explain why there...

Retinal pigment epithelium tears

In this paper the authors review the current knowledge of retinal pigment epithelium (RPE) tears. Although rare these can cause loss of visual acuity. They can occur spontaneously in pigment epithelial detachment (PED) due to occult choroidal neovascularisation (CNV), retinal...

Good news: new study links moderate wine consumption to lower risk of cataract surgery

An observational study published today in Ophthalmology (the journal of the American Academy of Ophthalmology) indicates that low to moderate alcohol consumption is associated with a lower risk of requiring surgery for cataracts, although the nature of the study means it does not definitively prove a direct causal effect.

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...

Refined glaucoma referral practice offers prospect of improved capacity and expanded role for primary eye care professionals

Glaucoma is the most frequent cause of irreversible blindness worldwide and the second leading cause of blindness in the UK [1,2]. The global prevalence of glaucoma in 2010 was approximately 3.5% for people aged 40-80 years, according to Jonas et...

A closer look at the new wave of glaucoma surgery – radical or old school?

Glaucoma is a challenging condition to treat because the exact pathophysiology remains unclear and the only readily modifiable factor is the intraocular pressure (IOP). Additionally, most glaucoma patients are completely asymptomatic, yet are often subjected to lifelong medical therapy. The...

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’....

Upper eyelid ulceration as a presenting sign of frontal sinus mucocele

Introduction A sinus mucocele is an epithelium-lined sac filled with mucus and desquamated epithelium. It forms secondary to inflammatory processes that occur in a sinus with an obstructed ostium. Predisposing conditions include previous trauma, surgery, tumours, anatomical abnormalities, and chronic...