Disseminated tuberculosis (TB) presenting with intraocular involvement is a rare condition, which can lead to profound visual loss if misdiagnosed. We report a case of a 24-year-old Nepalese male with disseminated TB who presented primarily with bilateral vision loss.

Aims To estimate the incidence of childhood uveitis not associated with juvenile idiopathic arthritis (JIA) in the United Kingdom. Methods Children under 16 years who presented with a new diagnosis of uveitis from November 2014 to October 2015 were identified prospectively through the British and Scottish Ophthalmological Surveillance Unit reporting card system. Incident questionnaires were sent to reporting ophthalmologists at presentation and 12 months. Results From 1st November 2014 to 31st October 2015, 119 cases were reported. Thirty-nine cases were excluded. The estimated minimum annual incidence of non-JIA uveitis in children younger than 16 years is 0.66 per 100,000 (95% CI 0.52-0.82). Median age at presentation was 10 years. 73% had bilateral uveitis. Median (IQR) BCVA in the worse eye was 0.3 (IQR 0.1-0.66) logMAR. The location of uveitis was: anterior 36%, intermediate 24%, posterior 6.8% and panuveitis 30%. 70% of cases were idiopathic. Most children were started on topical corticosteroids at presentation (86%, n = 51). At presentation, 31% (n = 19) were on started on systemic corticosteroids. At 1 year only 13% (n = 7) remained on corticosteroids, with the majority transitioned to steroid-sparing agents: methotrexate (30.8%, n = 16), mycophenolate (5.8%) and anti-TNF agents 5 (9.6%). At 1 year, 46% had ongoing intraocular inflammation despite treatment. The most common ocular adverse event was raised intraocular pressure (13.5%, n = 7). Conclusion Our study provides the first national population-based data of non-JIA childhood uveitis. Most children remain on treatment at 1 year, but visual acuity improves and none were eligible for sight-impairment registration.

PURPOSE:Optical coherence tomography (OCT) is a non-invasive method for diagnosis and monitoring of retinal (typically, macular) conditions. The unfamiliar nature of OCT images can present considerable challenges for some community optometrists. The purpose of this research is to develop and assess the efficacy of a novel internet resource designed to assist optometrists in using OCT for diagnosis of macular disease and patient management.METHODS:An online tool (OCTAID) has been designed to assist practitioners in the diagnosis of macular lesions detected by OCT. The effectiveness of OCTAID was evaluated in a randomised controlled trial comparing two groups of practitioners who underwent an online assessment (using clinical vignettes) based on OCT images, before (exam 1) and after (exam 2) an educational intervention. Participants' answers were validated against experts' classifications (the reference standard). OCTAID was randomly allocated as the educational intervention for one group with the control group receiving an intervention of standard OCT educational material. The participants were community optometrists.RESULTS:Random allocation resulted in 53 optometrists receiving OCTAID and 65 receiving the control intervention. Both groups performed similarly at baseline with no significant difference in mean exam 1 scores (p = 0.21). The primary outcome measure was mean improvement in exam score between the two exam modules. Participants who received OCTAID improved their exam score significantly more than those who received conventional educational materials (p = 0.005).CONCLUSION:Use of OCTAID is associated with an improvement in the combined skill of OCT scan recognition and patient management decisions.

Background/aims There is a paucity of high-level evidence to support the management of childhood uveitis, particularly for those children without juvenile idiopathic arthritis uveitis (JIA). We undertook a modified Delphi consensus exercise to identify agreement in the management of chronic anterior uveitis (CAU), the most common manifestation of childhood disease. Methods A four-round, two-panel process was undertaken between June and December 2017. Paediatric uveitis specialists identified through multiple sources, including a multicentre network (the Paediatric Ocular Inflammation Group), were invited to participate. They were asked whether they agreed with items derived from existing guidelines on the management of JIA-U when extrapolated to the population of all children with CAU. Consensus was defined as agreement greater than or equal to 75% of respondents. Results 26 of the 38 (68%) invited specialists participated with the exercise, and response rates were 100% for rounds one to three, and 92% for round four. Consensus was reached on 23 of the 44 items. Items for which consensus was not reached included management at presentation, use of systemic and periocular steroids for children with severe disease and the role of conventional steroid sparing immunosuppressants beyond methotrexate. Conclusion The areas of management uncertainty at the level of the group, as indicated by absence of consensus, reflect the areas where the evidence base is particularly poor. Our findings identify the key areas for the future research needed to ensure better outcomes for this blinding childhood ocular inflammatory disorders.

Abstract Background Paediatric sarcoidosis represents a spectrum of disease. Early onset sarcoidosis & Blau syndrome associated with NOD2 mutations are characterized by fever, rash, arthritis & organomegaly. Later onset sarcoidosis has wider organ involvement (lungs, kidneys, lachrymal & extra-ocular glands). Both presentations may lead to long term complications due to end-stage organ damage. Ocular sarcoidosis has a well described uveitis phenotype. We aim to describe a retrospective cohort of children with sarcoid-like uveitis & their systemic manifestations at time of study; compare cohort of patients fulfilling IWOS criteria for ocular sarcoidosis versus who did not; and describe their management in retrospective cohort. Methods We performed a retrospective case review of all children currently followed at GOSH with ocular sarcoidosis phenotype with uveitis (ophthalmologist definition based on IWOS, or diagnosis of idiopathic uveitis with raised ACE level at least once. We collected demographics & all extra-ocular involvement described in sarcoidosis. Results n = 52; 27/52 males. Median age at onset of uveitis 4.20 years (1.41-15.16). 49/52 bilateral uveitis. 27/52 (50%) <8years age at onset & 2/6 NOD 2 + belonged to this group. Median ACE 68 U/L at presentation (0-90U/L). Median maximum ACE 74 (14-420). NOD2 tested in 12 patients: 6+ , 6- . 1/6 positive patient had Blau phenotype. Ethnicity: African 12/52, asian 11/52, caucasian 14/52, unknown 15/52. Uveitis: Anterior 17/52(32.6%), Anterior+Intermediate 1/52, intermediate 5/52(9.6%) , posterior 2/52, panuveitis 25/52(48%), undocumented 2/52. ANA positive (>1:80) in 15/47 (32%). Systemic involvement (n = 52): arthritis 29%, liver 29%, lymphadenopathy 19%, renal 16%, lungs 15.3%, skin 17.3%, spleen 7.7%, glands 1.9%. Patients as per adult IWOS criteria: Definite 12/52, Presumed 6/52, Probable7/52 and Not fulfilling – 27/52. Systemic involvement in patients not fulfilling IWOS criteria (27/52) – renal 14.8%, arthritis 22.2%, hilar or peripheral lymphadenopathy 0 %, skin involvement 7.4%, lung 18.5%, splenomegaly 3.7%. Comparing IWOS fulfilling (25) with the ones who did not (27) – systemic involvement consistently less common in the ones NOT fulfilling but only reaches statistical significance difference for involvement. Lymphadenopathy and skin (p < 0.001 and p < 0.050 respectively). Suggesting that paediatric age group cannot be classified as per the adult IWOS ocular sarcoidosis criteria and needs early systemic screening. Medications used to treat uveitis and/or extra-ocular manifestations: methotrexate alone 25%, methotrexate + adalimumab 21.1%, mycophenolate mofetil 9.61%, only systemic steroids 3.8%. 9 patients- no systemic medications at any time during their disease. Conclusion Most sarcoid-like uveitis patients had at least one systemic involvement. 51.9% patients did not fulfil the IWOS ocular sarcoidosis criteria, still had systemic involvement. Hilar lymphadenopathy criteria cannot be applied to the paediatric population, peripheral more common. ACE not a sensitive biomarker to predict sarcoidosis. 17.3 % had mild phenotype & required no treatment. This study demonstrates the importance of close monitoring for systemic manifestations & highlights good clinical response to steroids, MTX, MMF and anti-TNF. Conflicts of Interest The authors declare no conflicts of interest.

Background Childhood uveitis is a group of heterogenous, potentially blinding inflammatory disorders. Management is complex. There is growing recognition of the importance of actively involving affected children and their families in their own care. Co-designed interventions, developed through active involvement of staff and patients, can provide effective solutions to problems identified by those affected. Objectives To use findings from a patient and family discussion group to inform the co-designed development of health care processes and interventions. Methods Five children/young people with uveitis (age ranges 8 to 17), seven parent/carers of children with uveitis and four health care professionals attended a 90 minute discussion group. Main discussion topic was the identification of areas in need of interventions or support structures. Sub-topics were determined a priori using previous PPI and existent research (REFS). They comprised: Direct health care; Impact on families; School, education and peers. Responses were collated. Consent was taken for use of direct quotes from participants. Results We outline the areas identified by children and families: Direct health care Four interconnected areas were identified: (1) Transitioning to adult services, (2) peer support (health care services being a valuable site for identifying peers), (3) communication between care structures, and (4) education for families. With regards to family education, there was identification of the need for specific services or interventions around the communication of (4a) diagnosis, (4b) treatment, (4c) likely long term outcomes/prognosis, (4d) and the child’s progress. There was also discussion on (4e) the formats used to communicate with families. Impact on families Participants discussed support around (1) family relationships, (2) the impact of systemic medication. They also discussed (3) a need for recognition of the changing nature of their lived experience as affected families over the disease course and the need for on-going psychologic support especially at presentation to help with acceptance. School, education and peers Participants discussed the need for support around: (1) the impact of treatment on school life, (2) communication with school professionals and peers, (3) impact of visual impairments, (4) managing the visibility/invisibility paradox (ie being made to feel different but also having a disorder which was not externally apparent), and (5) managing adolescence. Conclusion Through the above approach, we have identified a range of issues affecting our patients and their families. Our findings are similar to those of other groups (1, 2) These lived experiences will be used to inform the co-design of supportive services (patient leaflets, videos, website, psychology intervention) and research on the effectiveness of these interventions in improving the management of affected children and their families. References [1] Parker DM, Angeles-Han ST, Stanton AL, Holland GN. Chronic Anterior Uveitis in Children: Psychosocial Challenges for Patients and Their Families. Am J Ophthalmol. 2018 Jul; 191:xvi-xxiv [2] Silva LMP, Arantes TE, Casaroli-Marano R, Vaz T, Belfort R Jr, Muccioli C. Quality of Life and Psychological Aspects in Patients with Visual Impairment Secondary to Uveitis: A Clinical Study in a Tertiary Care Hospital in Brazil. Ocul Immunol Inflamm. 2017 Oct 11:1-9. Disclosure of Interests Sandrine Compeyrot-Lacassagne Grant/research support from: Abbvie, Christine Twoney: None declared, Harry Petrushkin: None declared, Dhanes Thomas: None declared, Emily Robinson: None declared, Lucia Kossarova: None declared, Ameenat Lola Solebo: None declared

Purpose To describe the distribution of corneal hysteresis (CH) in a large cohort and explore its associated factors and possible clinical applications. Design Cross-sectional study within the UK Biobank, a large cohort study in the United Kingdom. Participants We analyzed CH data from 93 345 eligible participants in the UK Biobank cohort, aged 40 to 69 years. Methods All analyses were performed using left eye data. Linear regression models were used to evaluate associations between CH and demographic, lifestyle, ocular, and systemic variables. Piecewise logistic regression models were used to explore the relationship between self-reported glaucoma and CH. Main Outcome Measures Corneal hysteresis (mmHg). Results The mean CH was 10.6 mmHg (10.4 mmHg in male and 10.8 mmHg in female participants). After adjusting for covariables, CH was significantly negatively associated with male sex, age, black ethnicity, self-reported glaucoma, diastolic blood pressure, and height. Corneal hysteresis was significantly positively associated with smoking, hyperopia, diabetes, systemic lupus erythematosus (SLE), greater deprivation (Townsend index), and Goldmann-correlated intraocular pressure (IOPg). Self-reported glaucoma and CH were significantly associated when CH was less than 10.1 mmHg (odds ratio, 0.86; 95% confidence interval, 0.79–0.94 per mmHg CH increase) after adjusting for covariables. When CH exceeded 10.1 mmHg, there was no significant association between CH and self-reported glaucoma. Conclusions In our analyses, CH was significantly associated with factors including age, sex, and ethnicity, which should be taken into account when interpreting CH values. In our cohort, lower CH was significantly associated with a higher prevalence of self-reported glaucoma when CH was less than 10.1 mmHg. Corneal hysteresis may serve as a biomarker aiding glaucoma case detection.

A new avenue of mining published genome-wide association studies includes the joint analysis of related traits. The power of this approach depends on the genetic correlation of traits, which reflects the number of pleiotropic loci, i.e. genetic loci influencing multiple traits. Here, we applied new meta-analyses of optic nerve head (ONH) related traits implicated in primary open-angle glaucoma (POAG); intraocular pressure and central corneal thickness using Haplotype reference consortium imputations. We performed a multi-trait analysis of ONH parameters cup area, disc area and vertical cup-disc ratio. We uncover new variants; rs11158547 in PPP1R36-PLEKHG3 and rs1028727 near SERPINE3 at genome-wide significance that replicate in independent Asian cohorts imputed to 1000 Genomes. At this point, validation of these variants in POAG cohorts is hampered by the high degree of heterogeneity. Our results show that multi-trait analysis is a valid approach to identify novel pleiotropic variants for ONH.

PurposeTo describe the rationale, methods and research potential of eye and vision measures available in UK Biobank.ParticipantsUK Biobank is a large, multisite, prospective cohort study. Extensive lifestyle and health questionnaires, a range of physical measures and collection of biological specimens are collected. The scope of UK Biobank was extended midway through data collection to include assessments of other measures of health, including eyes and vision. The eye assessment at baseline included questionnaires detailing past ophthalmic and family history, measurement of visual acuity, refractive error and keratometry, intraocular pressure (IOP), corneal biomechanics, spectral domain optical coherence tomography (OCT) of the macula and a disc–macula fundus photograph. Since recruitment, UK Biobank has collected accelerometer data and begun multimodal imaging data (including brain, heart and abdominal MRI) in 100 000 participants. Dense genotypic data and a panel of 20 biochemistry measures are available, and linkage to medical health records for the full cohort has begun.Findings to dateA total of 502 665 people aged between 40 and 69 were recruited to participate in UK Biobank. Of these, 117 175 took part in baseline assessment of vision, IOP, refraction and keratometry. A subgroup of 67 321 underwent OCT and retinal photography. The introduction of eye and vision measures in UK Biobank was accompanied by intensive training, support and a data monitoring quality control process.Future plansUK Biobank is one of the largest prospective cohorts worldwide with extensive data on ophthalmic diseases and conditions. Data collection is an ongoing process and a repeat of the baseline assessment including the questionnaires, measurements and sample collection will be performed in subsets of 25 000 participants every 2–3 years. The depth and breadth of this dataset, coupled with its open-access policy, will create a powerful resource for all researchers to investigate the eye diseases in later life.

This report describes a case of unilateral pigmented paravenous retinochoroidal atrophy (PPRCA) in a patient with low-grade unilateral intermediate uveitis. A 31-year-old woman, previously diagnosed with intermediate uveitis in the right eye (OD) presented to the clinic. Best-corrected visual acuity was 20/20 OD. Fundus examination, fluorescein angiography, autofluorescence, and optical coherence tomography OD were in keeping with a phenotypic diagnosis of PPRCA. Electrophysiology showed severe photoreceptor dysfunction of both the rod and the cone systems OD. Systemic workup revealed QuantiFERON-gold positive. This is the first report of unilateral PPRCA secondary to presumed ocular tuberculosis. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:345-349.].

Pediatric DermatologyVolume 34, Issue 5 p. 612-613 Photoquiz White Eyelashes and Red Eyes in a 7-Year-Old Boy Isabella Plumptre B.A., Isabella Plumptre B.A. orcid.org/0000-0002-2226-5136 Faculty of Medicine, Imperial College London, London, United KingdomSearch for more papers by this authorSatyamaanasa Polubothu M.D., Satyamaanasa Polubothu M.D. Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, United Kingdom Paediatric Dermatology, Great Ormond Street Hospital for Children, National Health Service Foundation Trust, London, United KingdomSearch for more papers by this authorDhanes Thomas M.D., Dhanes Thomas M.D. Moorfields Eye Hospital, National Health Service Foundation Trust, London United KingdomSearch for more papers by this authorVeronica Kinsler M.D., Ph.D., Corresponding Author Veronica Kinsler M.D., Ph.D. v.kinsler@ucl.ac.uk Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, United Kingdom Paediatric Dermatology, Great Ormond Street Hospital for Children, National Health Service Foundation Trust, London, United KingdomAddress correspondence to Veronica Kinsler, Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK, or e-mail: v.kinsler@ucl.ac.uk.Search for more papers by this author Isabella Plumptre B.A., Isabella Plumptre B.A. orcid.org/0000-0002-2226-5136 Faculty of Medicine, Imperial College London, London, United KingdomSearch for more papers by this authorSatyamaanasa Polubothu M.D., Satyamaanasa Polubothu M.D. Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, United Kingdom Paediatric Dermatology, Great Ormond Street Hospital for Children, National Health Service Foundation Trust, London, United KingdomSearch for more papers by this authorDhanes Thomas M.D., Dhanes Thomas M.D. Moorfields Eye Hospital, National Health Service Foundation Trust, London United KingdomSearch for more papers by this authorVeronica Kinsler M.D., Ph.D., Corresponding Author Veronica Kinsler M.D., Ph.D. v.kinsler@ucl.ac.uk Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, United Kingdom Paediatric Dermatology, Great Ormond Street Hospital for Children, National Health Service Foundation Trust, London, United KingdomAddress correspondence to Veronica Kinsler, Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK, or e-mail: v.kinsler@ucl.ac.uk.Search for more papers by this author First published: 08 September 2017 https://doi.org/10.1111/pde.13213Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume34, Issue5September/October 2017Pages 612-613 RelatedInformation

Purpose To describe an approach to the use of optical coherence tomography (OCT) imaging in large, population-based studies, including methods for OCT image acquisition, storage, and the remote, rapid, automated analysis of retinal thickness. Methods In UK Biobank, OCT images were acquired between 2009 and 2010 using a commercially available “spectral domain” OCT device (3D OCT-1000, Topcon). Images were obtained using a raster scan protocol, 6 mm x 6 mm in area, and consisting of 128 B-scans. OCT image sets were stored on UK Biobank servers in a central repository, adjacent to high performance computers. Rapid, automated analysis of retinal thickness was performed using custom image segmentation software developed by the Topcon Advanced Biomedical Imaging Laboratory (TABIL). This software employs dual-scale gradient information to allow for automated segmentation of nine intraretinal boundaries in a rapid fashion. Results 67,321 participants (134,642 eyes) in UK Biobank underwent OCT imaging of both eyes as part of the ocular module. 134,611 images were successfully processed with 31 images failing segmentation analysis due to corrupted OCT files or withdrawal of subject consent for UKBB study participation. Average time taken to call up an image from the database and complete segmentation analysis was approximately 120 seconds per data set per login, and analysis of the entire dataset was completed in approximately 28 days. Conclusions We report an approach to the rapid, automated measurement of retinal thickness from nearly 140,000 OCT image sets from the UK Biobank. In the near future, these measurements will be publically available for utilization by researchers around the world, and thus for correlation with the wealth of other data collected in UK Biobank. The automated analysis approaches we describe may be of utility for future large population-based epidemiological studies, clinical trials, and screening programs that employ OCT imaging.

Possession of the HLA-DRB1*1501 Allele and Visual Outcome in Idiopathic Intermediate Uveitis Idiopathic intermediate uveitis (IIU) is a potentially sightthreatening inflammatory disease characterized by breakdown of the blood-retina barrier with consequent leukocytic infiltration of the vitreous and retina. Poor visual outcome has been associated with cystoid macular edema, poor vision at presentation, and male sex.1 The human leukocyte antigen (HLA) allele DRB1*1501 has long been associated with multiple sclerosis (MS). Tang et al2 prospectively analyzed 18 patients and found that HLA-DRB1*1501 conferred increased risk of developing IIU associated with MS in some patients. The purposes of this study were to prospectively evaluate the association between the HLA-DRB1*1501 allele and IIU in patients and to determine whether HLA-DRB1*1501 might be a separate independent risk factor for visual loss.

We recently reported that 73.8% of subjects diagnosed with Vogt–Koyanaga–Harada (VKH) disease experienced recurrences (Errera et al. 2011). Based on our experience, we believed that finding an exudative retinal detachment (ERD) that responded to corticosteroids or other medical treatment more than 1 year after onset is low. To better evaluate late posterior recurrences, we reviewed the records of a large series of 45 patients with VKH disease from four tertiary centres. The median follow-up duration was 34 months since initial presentation. Late posterior segment relapses were defined as posterior segment manifestations of inflammation occurring later than 52 weeks after first presentation of VKH (Garcia-Valenzuela et al. 2000; Sachdev et al. 2008; Dolz-Marco et al. 2011). The study adhered to the tenets of the Declaration of Helsinki. Relapsing ERDs were noted within 10 months after presentation in 16 (84%) of 19 subjects who experienced such reactivation, with only four experiencing late ERDs, one of whom also had early relapses. Report of four subjects with late ERDs relapses at a median of 19 months (16–25 months). By examination and optical coherence tomography (OCT), subretinal fluid was limited localized areas of submacular ERDs in all late posterior segment relapses (Fig. 1). Intravenous pulse therapy was used within the first month for three of the four subjects who experienced a late posterior reactivation. In the fourth subject, the diagnosis of VKH disease was made 3 months after the first inflammatory signs, which caused a delay in the initiation of the correct treatment. This latter subject had treatment with corticosteroids for only 1 month, while the other three subjects received an initial duration of systemic corticosteroids for at least 6 months. In all four subjects, immunosuppressive therapy (infliximab, cyclosporin or interferon) was initiated after the first relapse because response to therapy with corticosteroid at acceptable long-term doses was insufficient. All four subjects had been on immunomodulatory agents (cyclophosphamide, infliximab and azathioprine), but these agents had been stopped 5 to 13 months prior to the relapse. In one subject, the relapse occurred while he was taking 25 mg/day of prednisone. He had responded to reintroduction of high-dose corticotherapy for an episode 6 months previously, and he was on tapering of therapy. The second subject was receiving both prednisone and cyclophosphamide. The third was on infliximab and low-dose oral corticosteroids at the time of relapse. In the experience at our institutions there were 4 late relapses (ERDs) of 45 subjects with an incidence rate of 12 cases per 1000 VKH affected person-years. Late relapses as ERDs occurred in patients receiving early intravenous pulse corticosteroids, and all four had been on other corticosteroid-sparing immunomodulatory therapy at some point. One possible explanation is that the need for more aggressive treatment in our patients with late relapses of VKH may be a marker of more severe disease. Early corticosteroid-sparing immunomodulatory therapy might be useful as first-line therapy to reduce the development of complications (Abu El-Asrar et al. 2013). Although it is difficult to conclude because we do not have enough statistical power (tests of Kaplan-Meier), we observed that subjects who had a longer duration of high dose corticosteroids (>3 months) at presentation of the disease were more likely to present posterior segment reactivation than those with shorter duration of corticosteroids therapy (This comparison raises the issue of resistance to corticosteroids treatment (and/or resistance to immunosuppressive therapies), of various therapeutics. We found, however, that late ERDs are limited to local submacular ERDs in our patients; larger ERDs do seem to be very rare. And if found, alternative diagnoses such as idiopathic chorioretinopathy (CSC) or rhegmatogenous detachment need to be considered. Conversely to what has been reported in CSC, no pigment epithelial detachment was seen on OCT in our cases. In all four subjects, ERD resolved following an increase or reinitiation of corticosteroids therapy which is another argument for excluding CSC. ‘Chronic’ or ‘recurrences’ are terms referring to subjects being off treatment or having discontinued the treatment (SUN terminology); however, in our series, among patients experiencing an ERD relapse, few of them may still be on treatment. We used the term ‘relapse’ instead.

Flashing lights (photopsia) and floaters are common visual phenomena and patients frequently present to hospital with these symptoms. This article provides a guide for the non-specialist to the different pathologies that may result in photopsia and floaters.