Preservative Free Intracameral Pilocarpine for Intraoperative Miosis

  • Reading time:5 mins read
  • Post author:Abdullah Cheema, Babar Khan
  • Post category:Article

We describe use of 0.5% intracameral preservative free pilocarpine during cataract and glaucoma surgery for pupillary miosis, as alternative to commonly used intraoperative intracameral miotic agents such as acetyl choline and carbachol. This agent is safe and effective in achieving intraoperative miosis and free of corneal toxicity and causing intraocular inflammation.

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Lyme Disease Associated Orbital Myositis: A Rare Cause of Orbital Swelling

  • Reading time:7 mins read
  • Post author:Abdullah Cheema, Raina Goyal
  • Post category:Article

A 61-year-old man presented with a 1-day history of right eye pain, right periorbital swelling, and painful diplopia upon right gaze. He was triaged as having Orbital Cellulitis in the emergency room and was given intravenous metronidazole and ceftriaxone. The patient has a medical history of Type 2 diabetes, right subclavian thrombosis, and Lyme disease, for which he was treated with Doxycycline and Rifampicin. He also has colour blindness and a raised immunoglobulin level, as well as a history of soft tissue thickening and acute inflammatory changes in the right periorbital region. Upon examination, the patient's visual acuity was 6/9 in both eyes, and the right eye showed swelling and tenderness at the superior and inferior margins, chemosis, and restriction of left abduction and upgaze. Blood tests showed elevated CRP levels and a positive rheumatoid factor.

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Ophthalmology Specialty Training (OST) Portfolio Criteria (2022 changes)

  • Reading time:12 mins read
  • Post author:Ahmed Elsaadawy
  • Post category:Article

Until the time of writing this article, candidates are allowed to submit their portfolio evidences on-line in the first half of February. This follows your submission of the main OST application in November and attempting the MSRA in January (please see Oriel in the year you are applying for accurate dates). Further information about the on-line evidence portal is usually sent to candidates just before the portal opening.

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My 5 Star Taster Week at St Thomas’ Hospital London

  • Reading time:6 mins read
  • Post author:Aisha Ismail Abubakar
  • Post category:Article

Some things are almost too good to be true. This feeling resonates with me every time I look back at my taster week in Ophthalmology at St Thomas’ Hospital in London. It was February 2022 and I had just started a new job in the Orthopaedic department of Guys and St Thomas’ NHS Foundation Trust.

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Diplopia: Overcoming the Diagnostic Challenges Associated with Double Vision

  • Reading time:7 mins read
  • Post author:Sarah Walker-Date
  • Post category:Article

This article aims to improve junior doctor’s ability to assess and manage patients presenting with diplopia.  Diplopia is an important sign to be able to recognise, often being the first manifestation of a serious systemic, muscular or neurological disorder.

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Sjogren’s Syndrome: An Ocular Overview

  • Reading time:13 mins read
  • Post author:Sarah Coates
  • Post category:Article

Sjogren’s syndrome (SS) is a chronic systemic autoimmune disorder which predominantly affects the salivary and lacrimal glands (exocrine glands) resulting in presentation of dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia), collectively known as sicca symptoms. Although ren SS primarily affects glands, in some cases there is extra-glandular involvement indicating an autoimmune response can occur in other organs and tissues. SS is categorised into primary, when symptoms occur in isolation, or secondary, when symptoms occur in conjunction with another autoimmune disorder such as rheumatoid arthritis or systemic lupus erythematosus.

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Moebius Syndrome: An Ocular Overview

  • Reading time:10 mins read
  • Post author:Sarah Coates
  • Post category:Article

Moebius syndrome is a rare congenital neurological disorder whereby there is an underdevelopment or absence of cranial nerve VI (abducens) and cranial nerve VII (facial), leading to weakness or paralysis of facial and extraocular muscles. Abnormalities can also occur in other cranial nerves including the 3rd, 5th, 8th, 9th, 11th and 12th. This article will focus upon the ocular manifestations of Moebius syndrome.

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A Suspected Link Between Recreational Nitrous Oxide Use and Papilloedema

  • Reading time:11 mins read
  • Post author:Syed Husain and Diya Baker
  • Post category:Article

Herein, we present a case report of a young male with worsening headaches and visual disturbance who was found to have papilloedema. Through exclusion, there is a high index of suspicion that this was related to N2O abuse. Therefore, we hope clinicians will adopt a low threshold for taking a detailed drug history and investigation for raised intracranial pressure (ICP) in this patient population, including ophthalmological assessment.

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Attending the Teach-the-Teachers Course for the Ophthalmology Specialty Training Portfolio

  • Reading time:4 mins read
  • Post author:Husnain Shah
  • Post category:Article

During the course of one’s medical career, there will be plenty of opportunity to be involved in formal and informal teaching. Attending a Teach-the-Teachers course is a useful way to learn and practice the principles of teaching adults. Moreover, it is a good way to collect a point for the  ophthalmology specialty training (OST) application. There are a number of companies which run this course, the most prominent of which are Oxford Medical and ISC Medical. Here I detail my experience of attending the Oxford Medical course.

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An Overview of Epithelial and Stromal Corneal Dystrophies

  • Reading time:12 mins read
  • Post author:Ahmed Hassane
  • Post category:Article

Principally, corneal dystrophies are a set of conditions that impact corneal transparency and distorts corneal structure. They are commonly bilateral, progressive, and differs from corneal degeneration as they are often inherited through autosomal dominant or recessive modes as well as x-linked modes.  Several genes have been implicated in corneal dystrophies and will be elaborated on in the description of dystrophies in this article. Management of corneal dystrophies depend on severity of symptoms and require specialist input. Mildly symptomatic dystrophies do not warrant management. However, in those with progressive disease and/or poor vision, surgical options may be of use. Techniques commonly involved in the management of dystrophies include deep lamellar endothelial keratoplasty, penetrating keratoplasty, or the area of disease is ablated using a photo-therapeutic keratectomy.

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