This case report follows the case of a 27 year old female who presented to her optometrist with a 10-day history of floaters in her left eye. The optometrist noted papilloedema and she was advised to attend the Emergency Department for further assessment and imaging. A CT brain showed no acute intracranial findings, however upon examination a left swollen disc was noted and the right pupil was unreactive to light. She was referred to eye casualty for specialist input. Her visual acuity was 0.16 in her right eye and 0.42 in her left eye. Ishihara plates could be read fully. Pupillary reflexes were normal in the left eye however the patient reported that the right eye has been unreactive since birth.
The Eye-Si simulator is a surgical simulator that can be used by trainees to gain and develop surgical techniques which are utilised in ophthalmology. More information can be found in an EyeSi overview by Rubia Akhtar. This article aims to provide a personal user review of the simulator. To begin with, I was unable to use the Eye-Si simulator until an assigned tutor provided me with a login – there was no option to register myself. Once I finally had the login, I was told I must use the machine supervised by someone on my first go – as there was no instructions or manual on how to use the equipment and the tools were very delicate.
Mask wearing may increase the risk of ocular infections with organisms that are not usually encountered as pathogenic. Moraxella Non-liquefaciens is normally commensal in the upper respiratory tract, non-pathogenic, and rarely found to be the causative organism in microbial keratitis. At the Ophthalmology department covering the England West Midlands North we encountered 4 patients, each with a unique Moraxella strain after the end of the second lockdown.
The Eye-Si is a surgical simulator used in ophthalmic training to help build trainees familiarity and proficiency in intra-ocular surgical techniques. It provides a safe environment to polish and refine surgical techniques prior to approaching patients in the theatre.
Neonatal ophthalmic pathologies should be identified as early as possible in order to address problems before they progress and become irreversible. In the UK, this is made achievable by the standard Newborn Infant Physical Examination. This comprises an assessment looking for external structural abnormalities in the eye which may inform a number of genetic syndromes, identifying the red reflex, direct ophthalmoscopy and other tests. This article aims to provide an overview of the manifestations of congenital eye infections and their management.
Eyesight is often regarded as the most valuable human sense. Thus, the identification and prevention of ophthalmic pathologies in neonates is a key component of the newborn examination in order to commence the management of ophthalmic conditions before they persist and lead to irreversible damage. In the UK, the standard Newborn Infant Physical Examination (NIPE) comprises an assessment of the eye in order to identify features such as abnormal eye movements, decreased visual acuity and symmetry of gaze that may point to early pathologies. As practitioners, it is important to identify signs that warrant further specialist examination, with appropriate follow-up, or features that can actually be normal in infants and children to reassure parents and caregivers. This article aims to provide an overview of this examination.
Neglected tropical diseases (NTDs) are defined as diseases that mainly affect individuals living in the most deprived populations globally and continue to persist as a consequence of poverty. The World Health Organization (WHO) has estimated that greater than 1.7 billion individuals are affected by NTDs, largely in countries of lower to middle-income or low-income. Several factors influence the persistence of NTDs including inadequate data regarding the conditions, poor political support, ineffective ways to remove human waste safely, and limited availability of clean water. There are 20 currently listed NTDs. Several NTDs can impact eye health such as blinding trachoma and onchocerciasis (river blindness) which table 1 outlines. This article provides an overview of the WHO initiatives to manage trachoma and onchocerciasis, two NTDs that can affect the eyes.
As clinical teaching fellows, we have had the privilege to teach medical students between August 2020 to August 2021. In a usual year, this would involve exclusively face-to-face teaching for both lectures and clinical examination sessions. However, following the announcement of the second lockdown in October 2020 we had to adapt our programme. To reduce the number of students on site, one day a week became a ‘virtual learning day’, involving both small and large group tutorials. Following being tasked with the responsibility of teaching ophthalmology to the fourth-year medical students, an important question loomed: how can we ensure that teaching via a virtual learning platform is both engaging and beneficial? This was further compounded by the fact that ophthalmology is a sub-speciality in which most medical students have limited teaching in the UK . Following our experiences, we have outlined the key strategies which enabled us to teach effectively during the pandemic.
Corneal disease and pathology is the 5th leading cause of blindness worldwide. As the cornea possesses inert immune-privilege, corneal transplantation is a highly successful way of improving clinical outcomes. The history of corneal transplantation goes back decades with the first successful human allograft and penetrating keratoplasty (PK) being performed in 1905. Since then there has been a tremendous amount of development with introduction of newer surgical techniques and instrument devices.
The FRCOphth Part 1 exam is the first of three fellowships exams completed during ophthalmology training. Despite this, it has one of the lowest pass rates at around 40% (April 2021). The exam consists of two papers, each containing 90 multiple-choice questions. Each paper lasts 2 hours with a 1-hour break in between. Due to the COVID pandemic, it is currently conducted as an online proctored examination. There are various opportunities to sit the exam throughout the year (January, April and October), with a maximum of 6 attempts allowed per candidate.