Results indicate that on-axis OCCIs are a reliable and practical way of reducing preexisting corneal astigmatism. The change in SE was negligible and thus can be ignored during biometry.

No abstract

Purpose: Our oculoplastic service piloted a new video consultation (VC) clinic in response to the COVID-19 pandemic. Data were collected to determine whether specific patients are better suited to VC, and to quantify the true benefit of VC in patients that successfully attended. Methods: Data were collected prospectively on predetermined data collection forms, including consultation duration, diagnosis, management plan, and issues that arose. Results: 37.8% of new referrals and 60.9% of return patients were vetted as suitable for VC. Of those invited to attend, 83.4% agreed to a VC appointment. Of the patients appointed to a VC clinic, 71.7% (new)/75% (return) successfully completed VC, 14.9%/15.8% attempted a VC which ultimately failed, and 13.4%/9.2% did not attend. VC successfully prevented face-to-face consultation in 81.3% of new cases and 91.1% of returns. Ectropion, entropion and dermatochalasis (new referrals), and postoperative follow-up (return patients) were well suited to VC, while patients with “watery eye” (new), and lid or conjunctival lesions (return), often required face-to-face consultation. Problems (most common issues with patients connecting to the consultation, video quality, and audio quality) were encountered during 50.3% of calls, although 82.6% of attempted calls were ultimately successful. Age was not associated with the proportion of calls that were successful. Conclusions: VC is a useful tool for oculoplastic patients, irrespective of age, as long as the patient’s notes/referrals are carefully vetted to determine suitability. Patients with ectropion, entropion and dermatochalasis, and postoperative reviews are better suited to VC than those with “watery eye,” lid lesions, and conjunctival lesions.

BACKGROUND/AIMS: Oculoplastics is a predominantly visual specialty and many of the pathologies can be diagnosed based on external appearance. An image-based eyelid lesion management service was piloted to reduce the number of patients who would require outpatient clinic review. The aim of this study was to determine its accuracy and feasibility, both as a hospital-based and community optometrist-based service. If successful, the service was envisaged to significantly reduce the number of patients that require face-to-face (F2F) review, in accordance with current post-COVID-19 principles of social distancing. METHODS: Patients with lid lesions attending an oculoplastics clinic were assessed by consultant oculoplastic surgeons in an F2F consultation (Arm A). The lesions were photographed by a professional clinical photographer (Arm B) and by an optometrist with a handheld digital camera (Arm C). These images were reviewed by independent consultants masked to the outcome of the F2F clinical encounter. Data were collected prospectively including patient demographics, diagnosis, suspicion of malignancy and management. The image-based clinic results were compared to the F2F clinic results. RESULTS: Ninety-five patients were included. Clinical diagnoses were compared for intra-observer variability and substantial agreement was demonstrated between gold-standard F2F clinic visit (Arm A) and Arm B (Ƙ = 0.708) and C (Ƙ = 0.776). There was no statistically significant difference in the rate of discharge and all cases of malignancy were either identified or flagged for F2F review in the image-based arms. CONCLUSION: This pilot demonstrated substantial diagnostic agreement of image-based diagnoses with F2F consultation and image review alone did not miss any cases of malignancy.

The case highlights the importance of early recognition of the symptoms and signs of endogenous endophthalmitis in any patient with systemic infection by all clinicians and the necessity of prompt ophthalmological referral if a useful level of vision is to be preserved.

Fig. Ib) but exact localisation of the foreign body in relation to adjacent ocular structures was not possible. UBM more clearly identified a foreign body lying on the posterior iris surface, close to the iris root and not involving the ciliary body. This showed up as a dense echo from the iris and the posterior iris surface (Fig. Ic). Right phacoemulsification of the cataract with intraocular lens implant was performed followed by a peripheral iridectomy with removal of the foreign body within the resected iris. A 10.0 prolene suture was used to close the iridectomy medially so that a smaller peripheral iridectomy was achieved. The post-operative course was uneventful and the patient regained 6/6 vision 3 days after surgey.

Introduction: Endogenous endopthalmitis is a diagnostically challenging ophthalmic and medical emergency. It has the ability to manifest at any age and is associated with a number of predisposing factors. The rapid progression of disease poses catastrophic risk for adverse outcomes both localised and systemic. To our knowledge, we describe the first reported iatrogenic case of endogenous Escherichia coli–induced endopthalmitis progressing to pan-endopthalmitis as a consequence of endoscopic retrograde cholangiopancreatography. Diagnosis, Interventions and Outcomes: The patient presented with reduced visual acuity and painless red eye; however, apart from biochemistry results suggesting biliary sepsis, no other clinical features of acute disease were noted. Despite rigorous systemic and intravitreal treatment, the rapid progression of disease led to irreversible damage to the eye. Conclusion: Clinicians must maintain a very high index of suspicion when encountering patients after interventional procedures, as misdiagnosis by trained ophthalmologists for endogenous endopthalmitis remains a common occurrence. Prompt identification and diagnosis ensured our patient avoided evisceration and early ophthalmic biopsies guaranteed the correct systemic intervention was started to address the severe subsequent septicaemia.

A 62-year-old woman with no significant past medical history was referred to the ophthalmologist on account of a 3-week history of blurred vision. Examination revealed visual acuities of 6/36 and 6/18 for her right and left eye, respectively. Anterior segments and intraocular pressures were normal but she had bilateral multiple widespread retinal haemorrhages with Roth spots (image on the left above). Full blood count showed a significantly high white blood cell count (WBC) at 542 × 10 9 /L, haemoglobin (Hb) 110 g/L and platelets 256 × 10 9 /L and a blood film appearance in keeping with chronic myeloid leukaemia (CML). Her BCR-ABL1 mutation screen was positive and her bone marrow did not show an excess of blasts. Chronic-phase CML was diagnosed and adequate treatment was instituted.A 40-year-old man was seen by the opticians for a visual assessment on account of 2-month history of blurring of central vision.