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 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 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.
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.
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.
Infective conjunctivitis is a common ophthalmic condition encountered in general practice. Topical antibiotics are often routinely prescribed in primary care for this generally self-limiting condition, despite evidence-based guidance consistently recommending otherwise. Injudicious antimicrobial prescribing has important social, economic, and public health consequences. This review discusses the evidence-based management of infective conjunctivitis and the implications of overprescribing antibiotics for this condition in primary care.
Diabetic retinopathy is a serious sight-threatening complication of diabetes, where high blood glucose damages the small blood vessels throughout the body, including in the retina. These damaged blood vessels are prone to blood and fluid leakage resulting in retinal tissue swelling. In order to compensate for these blocked vessels, the eye facilitates growth of new abnormal blood vessels that tend to leak and bleed easily.
The importance of ophthalmic knowledge for physicians to prevent visual loss and disability for their patients is clear. However, as the ophthalmology field becomes more isolated from the rest of medicine, this is reflected in the diminishing allocation given to ophthalmic teaching in undergraduate education. The direct impact is a lack of confidence of physicians to deal with ophthalmic problems and therefore an inability to protect the sight of their patients’.
Presumed ocular histoplasmosis syndrome (POHS) is an inflammatory condition that continues to be cause for debate. Although the evidence is not robust, it is thought to be associated with infection with the fungus Histoplasma capsulatum. Although H. capsulatum is endemic to specific regions within the United States (US), there have been reports of cases in India, United Kingdom and Mexico.
Asian blepharoplasty is a well-established and popular surgical procedure among individuals of East Asian descent, primarily concerned with creating a well-defined upper eyelid crease. The academic literature on this procedure has been mainly dedicated to surgical techniques and anatomical considerations. However, the popularity of this procedure that purports to modify race-typical features among Asians has generated debates on its wider social implications. This review discusses the anatomy of the Asian upper eyelid as well as ethnocultural and ethical implications of the Asian blepharoplasty.