Consultant Ophthalmologist
A clinical log for optometrists and eye care professionals.
Cases are drawn from NHS and private medical retina practice in Brighton, covering a range of conditions encountered in routine optometry referrals and emergency eye care. Each case includes OCT interpretation, differential diagnosis and management.
A 58-year-old man with a six-month history of a central dark patch in his left eye. OCT, fundus photography and fluorescein angiography confirm chronic CSCR, treated with photodynamic therapy.
Read case →A 42-year-old woman attending a virtual OCT clinic for diabetic macular oedema monitoring. The scan for oedema is clear — but closer inspection reveals pre-retinal neovascularisation, requiring urgent PRP laser on the same day.
Read case →A 29-year-old man with bilateral central blurring. OCT reveals bilateral hyperreflective bands in the inner nuclear layer — characteristic of paracentral acute middle maculopathy.
Read case →A 62-year-old man referred for 'cystoid macular oedema' is found to have microcystic macular oedema on OCT — a sign of retrograde retinal change secondary to a previous ischaemic optic neuropathy.
Read case →A 69-year-old woman with sudden onset of a paracentral scotoma. OCT and infrared imaging confirm acute macular neuroretinopathy, with partial resolution at two months.
Read case →A 60-year-old woman on long-term hydroxychloroquine for lupus is found to have bilateral parafoveal outer retinal loss on routine OCT — a reminder of the importance of screening guidelines.
Read case →A 35-year-old man with sudden bilateral central visual disturbance. OCT shows bilateral ellipsoid zone disruption at the fovea — caused by alkyl nitrite ('poppers') use the previous night.
Read case →A 59-year-old man seen routinely after left cataract surgery is found to have a small sub-ILM haemorrhage nasal to the fovea. The OCT appearance and differential diagnosis are discussed.
Read case →A 52-year-old lady referred for a left epiretinal membrane. Good acuity and absence of symptoms meant surgical intervention was not indicated — and a direct optometrist-to-consultant email saved a clinic appointment.
Read case →A 47-year-old asymptomatic woman with bilateral, multiple pigment epithelial detachments found at a routine sight test — a rare variant of central serous chorioretinopathy.
Read case →A 63-year-old man with one week of pixelated central vision. Serial OCT scans document the natural history of a branch retinal vein occlusion, from oedema through to ischaemic thinning.
Read case →An 84-year-old lady with a progressive dark spot in her right eye. OCT shows subretinal fluid and hyperreflective material at the fovea — typical of neovascular AMD.
Read case →