December 2021 - Journal of the Foundations of Ophthalmology

Direct ophthalmoscopy – salvageable skill or pointless pursuit?

Post published:December 19, 2021
Reading time:13 mins read
Post author:Akshay Narayan
Post category:Article

The direct ophthalmoscope was invented in 1851 and ophthalmologists were first able to visualize retinal detachment through it in 1853. Subsequently, the first viewings of central retinal artery occlusion and papilloedema were obtained in 1855 and 1860, respectively. Despite being around for more than a century, today’s medical students still lack the confidence and competence to perform it well. Concerningly, this lack of confidence is not exclusive to medical students. Amongst junior doctors, only one in five foundation year doctors felt confident identifying papilloedema by the end of foundation year. Amongst more senior doctors, up to 43% of General Practitioners admitted to lacking confidence in performing direct ophthalmoscopy.

Acanthamoeba Keratitis: An Overview

Post published:December 17, 2021
Reading time:7 mins read
Post author:Loay Nawaz Rahman
Post category:Article

Acanthamoeba keratitis involves inflammation of the cornea, the thin protective transparent layer at the front of the eye, caused by the protozoa Acanthamoeba. It is rare but can be sight-threatening with an annual incidence of 1.4 per million per annum, and typically affects contact lens wearers (1).

Retinoblastoma: An Overview

Post published:December 4, 2021
Reading time:5 mins read
Post author:Mussa Adil Butt
Post category:Article

Retinoblastoma is the most common childhood intraocular cancer. It originates from a mutation of the retinoblastoma (RB1) gene, a tumour-suppressor gene. Infants are usually diagnosed through an incidental finding of leukocoria. The disease is classified by size, location and number of tumours and it is used to determine treatment. Management includes surgery, radiotherapy, photocoagulation and chemotherapy. Early diagnosis and treatment is key to preserving vision and therefore a thorough understanding of the condition is important.

Bell’s Palsy: An Overview

Post published:December 4, 2021
Reading time:10 mins read
Post author:Brendan Leng Yong Ji
Post category:Article

Bell’s Palsy is a unilateral lower motor neuron facial nerve paralysis of unknown cause. It is the most common cause of acute unilateral facial paralysis and a condition many medical practitioners will encounter throughout their working career (1). With respect to Ophthalmology, paralysis of the orbicularis oculi exposes the eye to significant pathology which will usually require Ophthalmic input to manage and reduce the risk of adverse long-term sequelae.

Cataract: An Overview

Post published:December 4, 2021
Reading time:6 mins read
Post author:Mussa Adil Butt
Post category:Article

A cataract is the opacification of the lens in the eye. Blindness secondary to cataracts is the leading cause of reversible blindness worldwide. However, this is more prevalent in the developing world due to a lack of access to surgery. In the developed world, surgery to remove a cataract, known as phacoemulsification, is the commonest surgical procedure that is carried out. The UK has an ageing population and therefore the prevalence of age-related cataracts will likely increase. Therefore for ophthalmology trainees in the UK, they must have a baseline knowledge of this condition.

Topical Treatment for Open Angle Glaucoma

Post published:December 4, 2021
Reading time:9 mins read
Post author:Lois Crabtree
Post category:Article

Glaucoma refers to a group of conditions that lead to damage of the optic nerve head, typically caused by raised intra-ocular pressure. Primary open angle glaucoma is the commonest glaucoma type in the UK and affects 8% of people at 80 years old. In open angle glaucoma the iridocorneal angle is open but aqueous flow is diminished. As glaucoma progresses, it can lead to peripheral visual field loss. The mainstay of treatment initially is with eye drops with the aim of lowering intraocular pressure. Intraocular pressure is determined by the production, circulation and drainage of aqueous humour and is considered normal if between 11-21mmHg. If treated, glaucoma progression can be delayed and most people will not have severe visual impairment.