This article is a guide to help you prepare for the Duke Elder exam. The Duke Elder Exam is an undergraduate award exam available to medical students in the UK and Ireland. If you are even slightly considering ophthalmology as a career you should sit the exam because it is worth application points which you simply cannot get after graduation. This is especially important when considering how competitive the application process is.
Posterior IOL dislocation is a complication of cataract surgery which can present many years after the initial procedure with an incidence rate as high as 3%. Weak zonular fibres are a major cause of IOL dislocation. Late onset dislocation is associated with progressive zonular weakening whereas zonular rupture is seen in early dislocation.
This article aims to help the reader understand the serious and potentially sight-threating causes of red eye. With an increased demand on hospital eye services, more patients with eye symptoms are being seen in primary care settings. Therefore, it is extremely important for primary care physicians to know when to refer urgently for specialist assessment
Conjunctival melanoma is a rare ophthalmic cancer which requires a high index of clinical suspicion in order to be managed promptly and appropriately. We present an interesting case of a 74-year-old man with conjunctival melanoma and a red-herring in the form of an ipsilateral peri-ocular benign haemangioma that delayed diagnosis
The retina is one of the few parts of the central nervous system observable from the exterior. The direct ophthalmoscope enables the user to screen the wellbeing of the retina, optic nerve, vasculature and vitreous humour, with the examination generating an upright image of 10-15 times magnification. Fundoscopic examination can identify pathological process otherwise invisible and is a useful tool in staging the degree of both diabetes and hypertension. The direct ophthalmoscope is still an important instrument for fundoscopic examination in clinical practice.
Age-related macular degeneration (AMD) is a well-characterised disease responsible for being the principal cause of visual impairment in elderly patients (1). Generally, it is subdivided into two categories: ‘dry’ and ‘wet’. Dry AMD is more common than wet AMD, accounting for more than 85% of AMD cases (2). However, the severity of wet AMD is such that it is responsible for 80% of cases with severe visual impairment (2).
Varicella-zoster virus commonly causes shingles in the elderly population. Atypical presentations require astute knowledge of the distribution pattern of the nerve affected and a thorough history and systemic examination to allow diagnosis. We present a rare case of maxillary division shingles with ocular manifestations in a 71-year-old woman post cataract operation.
Intravitreal injection is the delivery of a drug via needle directly into the vitreous humour. This is useful in conditions where there is retinal oedema such as in wet AMD, diabetic macular oedema, or retinal vein occlusion. In these conditions, drugs such as Anti-VEGF or corticosteroids are injected intravitreally.
Doctors and allied health professionals are often presented with patients who complain of an issue with their eye. Many professionals do not feel confident taking an accurate and comprehensive ophthalmic history. Learning how to take a good history has several benefits.