Objectives: To assess current standards of diabetic retinopathy screening in primary care against the NICE guidelines for type 1 and type 2 diabetes mellitus1. Moreover, to determine whether patients were screened for diabetic retinopathy no later than 3 months from referral to the local eye screening service and no later than 1 year from their last retinal screen.

Introduction: Diabetic retinopathy is a microvascular complication of both type 1 and type 2 diabetes mellitus and is one of the most common causes of sight loss in people of working age.
The NHS retinopathy screening programme reduces the risk of sight loss through early detection and treatment of diabetic retinopathy.
The NICE guidelines state that retinal screening should be performed no later than 3 months from referral to the local eye screening service, and that retinal screening should be performed annually thereafter.

Materials / method: A retrospective audit was undertaken at Broad Lane Surgery. Data was collected from the health records of patients placed on the type 1 or type 2 diabetes register from 01/01/2013 to 01/01/2018. Patients who were diagnosed with diabetes whilst registered at a different practice, who had pre-diabetic retinal screening or were referred onto a different screening pathway were excluded. A total of 51 records were audited and data collection involved demographics, diabetes type, dates patients were placed on the diabetes register and dates of attendance and non-attendance to screening

Results: 15.7% patients in the audited period underwent retinal screening which adhered to the NICE guidelines. Of the cohort which did not adhere, 58.1% patients experienced an interval greater than 3 months between diagnosis and first retinal screening and 65.1% patients experienced a screening interval greater than 1 year.

Conclusion: Diabetic retinopathy screening of patients could be improved according to the NICE standards. Interventions should be implemented to increase the awareness within general practitioners and practice nurses to ensure all diabetic patients receive their first retinal screening within the first 3 months of diagnosis with regular annual screening thereafter.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: Savoir reconnaitre un strabisme, le classer, savoir poser l’indication chirurgicale et suivit des patients
Le but de la prise en charge chirurgicale est d'obtenir un angle de déviation le plus faible possible, stable dans le temps, et de normaliser au mieux l'oculomotricité.

Introduction: Le strabisme correspond à un défaut d’alignement des deux yeux il est caractérisé par une déviation des yeux. Il s’agit d’une pathologie complexe résultant d’une perturbation du système de contrôle cérébral de la position des yeux.
Les patients sont très demandeurs d’une prise en charge chirurgicale, et ceux d’autant plus que l’angle est important entrainant un retentissement sur la vie social plus ou moins important
Le rôle de l’ophtalmologiste est alors primordial pour la prise en charge tant anatomique que psychologique.

Materials / method: Nous décrirons ici, une petite série de patients, présentant un strabisme congénital, précoce ou tardif, ainsi qu’un cas de paralysie post traumatique, nous décriront ainsi le tableau clinique et les indications chirurgicales des différents patients.

Results: Les patients opérés pour troubles oculomoteurs, sont majoritairement féminin (73% F / 26% H); Présentent pour la plus part des ésotropies (80%), ce qui est conforme à la littérature, contre 20% d’éxotropie.
Dans les antécédents personnels des patients, un seul présente des ATCD chirurgicaux de strabisme, et dans 26% des cas , on retrouve des ATCD familiaux.
Tous nos patients ont bénéficié d’une prise en charge chirurgicale. 13% des patients ont bénéficié d’une chirurgie monoculaire, contre 86% de chirurgie binoculaire.
86% des patients sont satisfait de leurs chirurgies.

Conclusion: La prise en charge des strabismes est complexe, nécessitant une bonne connaissance de la physiologie des mouvements binoculaires, et le bon calcul de l’angle. La clé du succès, comme souvent, repose sur la précocité du diagnostic et de la prise en charge.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): ALCON

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work is presented thanks to the support of: ALCON

Objectives: What is Peer-led Learning, and is there evidence to support its use in medical education?
Is Peer-led Teaching an effective method of learning in Ophthalmology?
Who benefits the most from Peer-led Teaching?
What are the sub-specialties that trainees in Ophthalmology struggle with most?

Introduction: Peer-led teaching is common in postgraduate medical education but there are no data on its use in ophthalmology. Our study assesses the effectiveness of this method of education in this specialty.

Materials / method: We asked Senior House Officers (SHOs), Registrars and Consultants at 25 trainee-led education sessions to self-rate: 1) Knowledge of Topic, 2) Confidence in Diagnosis, and 3) Confidence in Management, before and after each presentation. Parameters were measured on a Likert scale of 1 (very low) to 5 (very high). Median scores for before and after the teaching sessions were compared using paired non-parametric testing.

Results: Scores for Knowledge of Topic, Confidence in Diagnosis, and Confidence in Management each rose by 1 point from 3 to 4: statistically significant differences (p <0.0001). Each subgroup (SHOs, Registrars, Consultants) showed a significant increase. SHOs rated prior knowledge of topics lowest, and benefited most from the sessions, with a mean improvement of 1.0, 1.3 and 1.3 for each of the three respective parameters. Trainees benefited equally from teaching delivered by either SHOs or Registrars.
Attendees rated prior knowledge of Paediatrics and Emergencies lowest compared to other specialties.

Conclusion: Our data show that ophthalmologists regard peer-led teaching as beneficial, and that trainees of all levels are effective in delivering clinical education. Our study has also assisted in identifying areas that require increased attention for future teaching sessions.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: 1. Clarify Different Differential Diagnosis
2. Identify Risk factors For Vitreous Changes
3. Unusual Clinical presentation , Be vigilant to odd cases
4.Simplicity is sometimes the Clue
4. Going so far with Your Differential Diagnosis may harm your patient
5. Describe clinical characteristics of Posterior Vitreous detachment presentation.

Introduction: Spontaneous posterior vitreous detachment (PVD) is a common age-related condition in patients aged ≥45 years. The prevalence has been reported to be as high as 24% among patients aged 50–59 years and 87% among patients aged 80–89 years.1,2

Vitreous is composed of collagen fibers (~0.5%), hyaluronic acid (~0.5%), and water (~99%).3 It amounts to ~2/3 of the total volume of the eye. The initial gel-like consistency of the vitreous degenerates through a physiological process with age.4 At the age of ≤50 years, 25% of the vitreous exists in water phase, while at 80 years 62% of the vitreous would

Materials / method: Case Presentation of Thirty two years old Lady presented to Casualty Clinic with sudden loss of vision in her left eye , She Has No past Ophthalmic History, No Past Medical history and No history of trauma to the eye or to the head.
On Examination , RE VA6/6 , LE HM,
No RAPD , Ishihara plates 17/17 RE, 0/17 LE. Anterior Segment examination Non Abnormality Detected Both eyes
Dilated Fundus examination Right Eye Normal Disc, Normal Macula , Normal Retina.
Left Eye , Vitreous Haemorrhage +1,
Disc Haemorrhage covering the whole Optic Disc .Normal Macula and Normal Retina .

Results: Scans and Blood test were ordered to rule out inflammatory Causes,
Optical Coherence Tomography ,FFA( Fluroscein Fundus Angiography ) and Optus pictures were taken, All cam back Normal .
CRP ( C Reactive Protein) , ESR , FBC, Cxray ,ANCA, ACE , Plasma Viscosity ,Lyme Serology and antiphospholipid antibodies all came back normal .
On Regular Follow up, Vision gradually improve and three months later , VA improved to 6/6 .

Conclusion: Hemorrhagic Posterior Vitreous Detachment can Mimic lots of Retinal Diseases .
Proper Investigation and Observation is the answer to the Mystery .
Proper History and examination as well can save you lots of time and efforts .

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: To present real life data of function and structural outcomes in patients with centrally-involved diabetic macular oedema (CI-DMO) treated with Ozurdex implant as compared to the MEAD clinical trial.

Introduction: Diabetic macular oedema affects around 6.8% of all diabetic patients and is the most common cause of visual loss in the predominantly working age population [Moss et al. 1998; Bunce and Wormald, 2008; Yau et al. 2012]. Ozurdex is recommended by NICE guidance (TA349) as an option for treating CI-DMO in pseudophakic patients with no restriction on central macular thickness (CMT) levels. In the MEAD trials, Ozurdex has demonstrated a mean increase in visual acuity and mean reduction in CMT but with side effects including glaucoma. [Boyer et al. 2014]

Materials / method: Retrospective audit review of clinical notes and Optical Coherence Tomography imaging for all patients with CI-DMO treated with Ozurdex implant in Sunderland Eye Infirmary (SEI) from January 2016 to October 2019 and followed for a 2 year period. The primary outcome measures were mean changes in best corrected visual acuity (BCVA) and CMT from baseline. Secondary outcomes included proportions of patients with ≥15 letters gain or ≥10 letters loss; mean number of Ozurdex implants, IOP related adverse events and any additional treatments used.

Results: 87 eyes (74 patients) were included. Mean number of Ozurdex treatment was 2.1 over 2 years (4.1 over 3 years in MEAD). Mean average change in BCVA was 2.89 letters (3.5 letters in MEAD). Mean average reduction in CMT from baseline was -63.3μm (−111.6 in MEAD). The percentage of patients with ≥15-letter improvement in BCVA from baseline at study end was 9% (22.2% in MEAD). Increase of ≥10 mmHg from baseline was 17.9% (27.7% in MEAD). IOP lowering medication were used in 21.2% of cases (41.5% in MEAD) and 44.3% of patients required extra treatment with 2.49 average extra treatment events at 12m

Conclusion: The real life results of our audit suggested that patients with CI-DMO are potentially under treated as reflected by the average numbers of implants during the audit period as compared to clinical trials. This would have led to reduced visual gains as well as structural improvements. This could be a result of current capacity challenges facing medical retina services as well as various factors including real-life case mix as well as the delayed adoption of the treatment with steroid implants in patients with CI-DMO which could lead to compromised final outcomes.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability