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Traumatic optic neuropathy

In neuro-ophthalmology we get asked a lot about management of patients who suffered significant trauma and presented with loss of vision secondary to presumed traumatic optic neuropathy (TON). TON happens usually in the context of significant craniofacial trauma. The incidence...

Severe conjunctival cicatrisation secondary to chronic glaucoma therapy

The timing of glaucoma filteration surgery during the course of chronic progressive glaucoma remains a contentious issue amongst glaucoma specialists. The vast majority support the use of maximal medical treatment initially to achieve the target pressure. Surgical procedures are only...

The 2020 Milgram Experiment

Will ophthalmology recover from COVID-19? Learning Curve columnist Gwyn Samuel Williams shares his thoughts on the developing impact of the pandemic “It’s busy today,” the nurse in green chuckles. “There are six patients I think.” Six. This clinic is designed...

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...

The results of the last survey Apr24

It has been a few years now since we started these surveys and I continue to be amazed by the variance in our practice. As a patient, I think I would expect there to be more consistency and evidence-based practice....

Photophobia: an unusual symptom of a pituitary macroadenoma

Introduction Photophobia, defined as ‘an abnormal intolerance to light’, is commonly associated with a range of both ocular and neurological pathologies such as dry eye, blepharospasm, corneal pathologies, cataracts, uveitis, retinal dystrophies, optic neuritis, migraine, meningitis, and traumatic brain injury...

21st Century retinal laser treatment in the anti-VEGF era

In today’s world, macular laser treatment has a vital role in the treatment of diabetic macular oedema (DMO). DMO is one of the most common causes of visual impairment. Despite expensive intravitreal treatment courses of anti-VEGF, many will agree that...

Myopia-related strabismus – heavy eye syndrome

Introduction Myopia can be associated with any type of strabismus, but high myopia has increased frequency of esotropia and vertical heterotropia. The incidence and severity of the strabismus increases with the degree of myopia and age of the patient. Classification...

Surgical strategies to manage incomitant strabismus in adults

Incomitant vertical and / or horizontal strabismus is a challenging presentation. Patients are usually symptomatic as the onset is either sudden so they haven’t developed any coping mechanisms or very complex so that any coping mechanisms will not cover all...