An 87-year old African-Caribbean lady presented with a two week history of severe right ocular pain, worse in the evenings. The patient had previously been diagnosed to have asymptomatic iridoschisis in 2007 and attended the diabetic retinopathy screening service annually. There was no known family history of eye disease.
Referrals to the Urgent Eye Clinic (UEC) are rising, leading to an increased demand on services. Many of these referrals are deemed as non-urgent. One method of referral to the UEC is via Accident and Emergency (A&E). In some areas in the country, patients who present to A&E with an acute eye problem will be initially seen by A&E clinicians and be referred to the UEC to be reviewed by ophthalmologists. As a foundation doctor working in ophthalmology, it has been clear that many referrals from A&E have been inappropriate. These have included blepharitis, conjunctivitis and deterioration in vision over the course of a few months being referred to the weekend UEC. I have witnessed all three of these referral examples. Inappropriate referrals from A&E and General Practices lead to increased demand on the UEC.
While serious eye conditions remained prioritised, many patients were too fearful to attend essential clinic appointments. Statistics showed that there was a 79% reduction in ophthalmic appointments in the UK (the highest of any medical specialty) during the pandemic. It is estimated that more than three thousand people have lost vision due to delays in the identification and treatment of eye disease during the pandemic (2). The pandemic crisis will end, sooner or later but the real challenge remains: the episodes of avoidable sight loss that may have occurred due to backlog of services.
PVD is a common condition that all clinicians may encounter throughout their career. It is important to know the relevant symptoms so that we can counsel patients and to appropriately refer to rule out sinister causes.
If you’re a final year medical student thinking about how to rank your foundation jobs, first of all congratulations for making this far! We all know ranking foundation jobs can be tough and stressful. The choices you make will potentially have a great impact on what area you specialise in. Thinking about a career in ophthalmology? This article serves to give you some insight into a foundation job in ophthalmology and hopefully guide you along your decision.
Direct ophthalmoscopy (fundoscopy) is a technique to examine the back of the eye. It is referred to as direct because the retinal image formed is erect/upright (1,2). This type of examination magnifies the retinal image inspected by approximately 15 times. Direct ophthalmoscopy is an extremely useful tool for detecting retinal, vascular, optic disc and choroidal pathologies. Hence, it has been an important form of examination that is not only taught to trainees but also to undergraduate medical students.
Alice Ditchfield Abstract Cytomegalovirus (CMV) retinitis primarily affects immunocompromised individuals. It causes full-thickness retinal necrosis and viral inclusion bodies are seen in infected cells. Patients present with painless vision loss…
Angle-closure glaucoma (ACG) is a condition that leads to optic nerve neurodegeneration caused by increased intraocular pressure (IOP). It’s an ophthalmic emergency that may cause irreversible visual impairment if left untreated. ACG causes can be classified into Primary and Secondary causes. This article will focus on Primary Angle Closure Glaucoma (PACG). In this article, we will briefly outline the pathophysiology, diagnosis, and management of acute PACG.
Visual snow is a newly recognised condition that presents with debilitating visual symptoms. Historically, due to the lack of clinical criteria, many patients have been misdiagnosed or had a significant delay in diagnosis. This article is aimed at improving understanding and recognition of visual snow amongst clinicians.
Presenting research in a medical conference can seemingly be a daunting task for many medical students and junior doctors. Medical conferences are, after all, attended by experts and specialists from the various fields which can be unnerving for the naïve presenter. However, for most doctors, who have an interest in research, delivering presentations in conferences is often inevitable. Here I present my top tips to consider when preparing an oral presentation at a medical conference.