Universal Medicine

Vision is one of our most precious possessions. Multiple polls globally show that most people are more fearful of becoming blind than losing any other sense. (1,2) With sight being such a valuable asset, one would assume that eyecare is at the forefront of medical services across the world. Living in the developed world, we perhaps take for granted the simple and yet crucial services available to us such as regular eye tests, glasses, contact lenses and high-quality ophthalmic care - most of which can be accessed for free or at a subsidised price. However, in many parts of the world this is not the case. 285 million people worldwide are visually impaired, with 90% being from developing countries. (3) In China, for example, levels of blindness are increasing each year, however critically, rates of blindness have been reported at up to 4 times higher in the developing world as compared to more economically developed countries (4, 5). This is particularly worrying given that around 80% of...

As the current Co-President of my university’s ophthalmology society and general practice (GP) societies, I’ve always considered whether I could marry these interests when it came to pursuing my career in medicine. Several clinicians have thought similarly, with some GPs developing an ‘extended role’ (previously known as a ‘specialist interest’) in ophthalmology. These clinicians may run specialist clinics at GP surgeries for ophthalmological complaints or work part-time as ‘hospital doctors’ whilst continuing to be a GP. Primary care is an important part of the NHS. It is the first point of contact for patients and ensures continuity of care within a healthcare system, as well as being responsible for referring and coordinating other specialist care that patients might need. GPs and eye health services (such as opticians) are the primary care services that are likely to deal with ophthalmological complaints. Despite public perceptions that community opticians just sell glasses, optici...

Ocular drug delivery is where drugs are directly administered to the eye via injections/eye drops. It is one of the most challenging aspects of ocular pharmacology. Patients requiring injections have to go out of their way to attend uncomfortable procedures at outpatient clinics. The efficacy of eye drops is dependent on the patient’s skills, but even the perfect placement of eye drops will only result in 1-10% of the total administered dose being absorbed. These cons are responsible for low patient compliance, and consequently worse outcomes than predicted. After 20 years of trialling new ocular drug vehicles, ophthalmic pharmacies have devised ocular inserts as a novel solution. Their administration is speedier and more comfortable for the patient, they ensure better drug absorption at a regular rate, and they don’t have to be replaced as frequently. Ocular inserts are thin, drug-impregnated devices placed into the cul-de-sac or conjunctival sac of the eye. They can release steroids ...

Laser eye surgery – many have heard about it, and those among us who wear glasses have dreamed of having it ourselves. But despite being a glamorous solution to refractive errors like long- and short-sightedness, it remains a mystery, even with its huge implications for ophthalmology. Laser eye surgery, also known as laser vision correction, is an umbrella term for different surgeries that reduce refractive errors using laser treatment. In normal vision, light entering the eye converges at a certain point on the retina (the part of the eye that detects light) - this is called the focal point. Refractive errors are disorders caused by eyeball length being too long or short, so the focal point occurs in front of, or behind the retina. In myopia (short-sightedness) the eyeball is too long, which means the focal point occurs in front of the retina instead of on it. On the other hand, in hyperopia (long-sightedness), the eye is too short, which means the focal point is behind the retina. No...

Artificial intelligence (AI)  is a fast-growing branch of computer science and is being increasingly explored in medical research for utility across various fields. Of particular interest is the concept of machine learning (ML), referring to the capacity of a ‘machine’ to autonomously acquire its own programming for completing a task without a pre-written set of instructions. Impressively, these ‘machines’ can adapt (and, if necessary, correct) their algorithms according to new data and subsequently implement these programs for pattern recognition, determinations and predictions.  Furthermore, technological advances in computation tools and data acquisition, storage, and transfer are dramatically expanding the volume and speed of multi-modal data processing and communication. Ophthalmology, being an image-based speciality, lends itself to benefit from these digital ecosystems.  The recent global health crisis has incentivised the maturation of virtual health delivery infr...

Hello and welcome to the Ophthalmology section of Universal Medicine! We have a dedicated team of writers and editors passionate about sharing new and exciting posts across all Ophthalmic subspecialties. Stay tuned for posts over the coming weeks. Introducing the committee for the Ophthalmology Section! Gabriel (Editor and Writer): I  retina book  somewhere that eyes are the windows to the soul. For doctors, they're also the windows to all kinds of systemic diseases. So they're worth a closer look! Omar ( Editor and Writer ): I've been interested in eyes and ophthalmology since 1st year of medical school. Ophthalmic emergencies and retinal issues are two areas that really catch my eye ;) Expect more stuff related to these topics. Nada ( Editor and Writer ): I have always been passionate about ophthalmology. It is a very versatile specialty and combines academia, research, and clinical practice. Gagandeep ( Editor and Writer ): I became interested in ophthalmology as it is ...

Shreya Gupta Eczema, also known as Atopic Dermatitis (AD), is a skin condition characterized by dry, red and flaky skin which is often itchy. Eczema is usually caused by allergens or excess toxin buildup, and although uncomfortable it can be managed in a number of ways. However, no drug or therapy has yet been discovered to fully eradicate the disease, although extensive research is being carried out. Introduction  Eczema is a skin condition brought on by IgE (immunoglobulin E), a protein that is produced when you have an allergic reaction. Your immune system responds by producing IgE, which travels to cells and releases chemicals that cause an allergic reaction, seen on the nose, lungs, throat or the skin. The allergic reaction is usually red, bumpy, itchy, skin (if external). If it is an internal reaction, your airways can get obstructed, so breathing is difficult. Obstructive breathing is due to the IgE’s effect on the lungs. This is why eczema and asthma are often linked. In as...

Gemisha Cheemungtoo  Disneyworld. It is often referred to as the happiest place on Earth. According to a few American researchers, it could be of particular enjoyment for patients with kidney stones, too.    For most people, renal calculi, also known colloquially as kidney stones, may not be an obvious condition. The majority of stones are too small to cause symptoms so if a diagnosis is made, it is likely to be an incidental finding on a CT scan. Although a common urological problem, only 1 in 11 people will experience symptoms associated with renal stones in their lifetimes, such as flank pain, nausea, vomiting or blood in the urine. These symptoms usually arise if a large enough stone causes a blockage within the urinary tract.    The treatment for kidney stones depends on the severity of presentation. A small painless stone could pass out naturally with the urine, but larger stones might need to be split into smaller fragments first. Outside of the known and...