Biologics and the Eye: Dupilumab

  • Reading time:4 mins read
  • Post author:Sinthiya Sivarajah
  • Post category:Article

Dupilumab is a biologic agent licensed in the treatment of multiple atopic conditions such as atopic dermatitis, asthma and rhinosinusitis with nasal polyps. However, with continued use, reports of ocular side-effects associated with dupilumab use seem to be increasing. Ocular side effects range from mild eye disease such as conjunctivitis and blepharitis, to more severe ocular manifestations such as ulcerative keratitis.

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Uveitis-Glaucoma-Hyphema (UGH Syndrome): An Overview

  • Reading time:7 mins read
  • Post author:Mohib Naseer
  • Post category:Article

Uveitis glaucoma hyphema syndrome also known as Ellingson Syndrome is a complication that occurs due to intraocular chafing and rubbing of intraocular lens against uveal tissue in the eye that leads to iris trans illumination defect, micro hyphema (red blood cells in anterior chamber), gross hyphema, pigment dispersion, raised intraocular pressure (glaucoma) and intraocular inflammation of uveal tissue (uveitis).  It can present with symptoms such as decrease in vision, redness, pain, and sensitivity to light. Clinical signs include raised intraocular pressure, anterior chamber inflammatory activity (red blood cell and inflammatory cells), cystoid macular oedema and optic nerve cupping if persistent for long term. Symptoms can be controlled with topical medication like steroids and pressure lowering drops but surgical intervention like repositioning, removal and exchange of intraocular lens is definitive surgical treatment.

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Improving Medication Compliance in Glaucoma: Structured Medication Reviews in Primary Care

  • Reading time:11 mins read
  • Post author:Jessica Mendall
  • Post category:Article

Glaucoma is one of the leading causes of global blindness, responsible for approximately 8.4% of all blindness cases worldwide in 2020. Medical treatment of glaucoma, ocular hypertension and glaucoma suspect involves use of long-term topical medications to lower intraocular pressure and thereby minimise optic nerve damage and sight loss. However, adherence to topical glaucoma medication is often poor, with reported rates of non-adherence varying from 30% to 80%. Poor adherence can be attributed to a range of factors, including patient beliefs, potential or perceived side effects of medications, forgetfulness, difficulty with eye drop administration and insufficient patient education. It is important to educate patients about the importance of medication adherence and attending glaucoma clinic appointments for monitoring of the disease, given that glaucoma is irreversible, and the more chronic forms are usually asymptomatic until the later stages. Whilst glaucoma is typically diagnosed and monitored in secondary care settings, GPs and other primary care professionals can play an important role in providing patients with long-term support, coordinating care, and promoting compliance with medication.

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Differentials for Common Ophthalmic Presentations

  • Reading time:10 mins read
  • Post author:Madiah Mahmood
  • Post category:Article

Teaching and placement opportunities within ophthalmology vary across UK medical schools and the foundation programme. Ophthalmic pathology can present in various settings, such as acutely in the emergency department, in general practice, and among inpatients where patients may develop an ocular complaint or an ophthalmic manifestation of systemic disease. It is therefore important to develop a strong foundational knowledge of this speciality.

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Osteo-Odonto-Keratoprosthesis: An Overview

  • Reading time:10 mins read
  • Post author:Amr Mousa
  • Post category:Article

Osteo-Odonto-Keratoprosthesis (OOKP), also known as "tooth-in-eye surgery," is a highly specialized surgical procedure designed to restore vision in patients with severe corneal blindness who are not candidates for traditional corneal transplantation. It was first pioneered by Professor Benedetto Strampelli in the 1960s in Italy and established in the United Kingdom by Professor Christopher Liu. OOKP involves the use of the patient's tooth and surrounding bone as a support structure for a prosthetic optical cylinder, making it one of the most intricate and unique ophthalmological procedures.

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Acute Retinal Necrosis vs. Progressive Outer Retinal Necrosis: A Comparative Analysis

  • Reading time:10 mins read
  • Post author:Isaamuddin Alvi
  • Post category:Article

Acute Retinal Necrosis (ARN) and Progressive Outer Retinal Necrosis (PORN) are two major clinical entities of necrotising herpetic retinitis, a severe and vision-threatening condition caused by herpes viruses. Both conditions lead to rapid retinal necrosis, but they differ significantly in their affected populations, clinical presentations, inflammatory responses, and prognoses. Understanding these differences is crucial for early diagnosis, appropriate treatment, and vision preservation.

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North Carolina Macular Dystrophy: A Developmental Maculopathy

  • Reading time:8 mins read
  • Post author:Haseeb N. Akhtar, Ayesha Salejee, Hassan A. Mirza
  • Post category:Article

North Carolina Macular Dystrophy (NCMD) is a rare autosomal dominant disorder characterised by congenital macular abnormalities. It was first described in a large cohort of patients from North Carolina, USA in the 1970s. Despite its name, NCMD has been reported globally, with considerable phenotypic variability, ranging from subtle drusen-like deposits to severe coloboma-like macular lesions. The condition is linked to non-coding variants upstream of the PRDM13 gene on chromosome 6. This variant leads to disruption of retinal development and gene expression. Early diagnosis is important to inform genetic counselling and monitoring for secondary complications, e.g. choroidal neovascularisation.

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Autosomal Dominant Drusen: A Review

  • Reading time:9 mins read
  • Post author:Haseeb N. Akhtar, Ayesha Salejee, Hassan A. Mirza
  • Post category:Article

Autosomal Dominant Drusen (ADD), also known as Doyne Honeycomb Retinal Dystrophy, Malattia Leventinese and Familial Dominant Drusen is an inherited retinal disease characterised by early-onset drusen deposits in the macula and peripapillary region. First described in 1899, ADD is caused by pathogenic variants in the EFEMP1 gene, which encodes fibulin-3, an integral extracellular matrix protein. The aforementioned variant leads to a disruption in protein secretion; consequently, there is drusen accumulation beneath the retinal pigment epithelium (RPE) and within Bruch’s membrane. Unlike age-related macular degeneration (AMD), ADD manifests earlier, often within the first four decades of life, with a distinct radial drusen pattern and a significant risk of choroidal neovascularisation (CNV). As such, early diagnosis is crucial in order to initiate treatment against CNV.

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Fuchs’ Endothelial Corneal Dystrophy: An Overview and Latest Updates

  • Reading time:8 mins read
  • Post author:Luai Kawar
  • Post category:Article

Fuch’s endothelial corneal dystrophy (FECD) is a progressive inherited endothelial dystrophy. It is characterized by the formation of guttae in Descemet’s membrane and corneal oedema. It remains a significant cause of visual loss worldwide. This article aims to provide an overview of the aetiology, pathophysiology, clinical presentation and advances in treatment.

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Central Retinal Vein Occlusion vs. Branch Retinal Vein Occlusion: A Comparative Overview

  • Reading time:11 mins read
  • Post author:Isaamuddin Alvi
  • Post category:Article

Retinal vein occlusion (RVO) is the second most common vascular disease of the retina after diabetic retinopathy, with a growing global burden. In 2008, an estimated 16.4 million people were affected worldwide, increasing to 28.06 million by 2013. Of these cases, 23.38 million involved branch retinal vein occlusion (BRVO), while 4.67 million were due to central retinal vein occlusion (CRVO). RVO occurs when the retinal veins become blocked, leading to fluid accumulation, haemorrhages, and potential vision impairment. It is broadly classified into central and branch occlusions, each with distinct clinical features and implications. Understanding these differences is essential for timely diagnosis and effective treatment. This article explores their causes, risk factors, symptoms, diagnostic methods, treatment options, and prognoses.

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