Thirty years ago children with Juvenile Idiopathic Arthritis (JIA) were at high risk of not only crippling physical disability, but also visual loss secondary to cataract, glaucoma and macular oedema caused by their chronic uveitis, or the steroids we used to treat it. Now, thanks to the development of targeted biological therapies, by clinical scientists like Andrew Dick, these children are living normal active lives and their risk of sight loss has been dramatically reduced.

In this episode of Eyes on Tomorrow we talk to Andrew about his career-long interest in immunology and inflammatory eye disease and the impact of translational research which has led to a better understanding of cytokine inflammatory pathways in uveitis, the subsequent development of TNF inhibitors and finally landmark trials, like the Sycamore Trial.

Andrew stresses the critical importance of working closely with paediatric rheumatologists and of involving patients, no matter how young, in the management of their disease.

He has pioneered a “zero-tolerance” approach for the long-term use of topical and systemic steroids, in patients with uveitis, facilitated by the use of biological agents and this has dramatically improved the visual prognosis for patients with uveitis.

We also touch upon his clinical approach to new cases of uveitis, his tips for optometrists when confronted by a patient with uveitis and what his passions are away from work.

Subscribers to the podcast will have access to the Bonus video episode in which Andrew discusses promising new uveitis treatments, the challenges of managing patients with Gene Therapy Associated Uveitis, his advice to potential budding clinical scientists and his thoughts on leadership.

All in all a fantastic listen for anyone who wants to learn more about inflammatory eye disease.

Subscribe at eyesontomorrow.substack.com/subscribe

Produced by Matt Hill at Rethink Audio

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Nothing provokes more anxiety in optometric practice or in an ophthalmology emergency clinic than the patient presenting with headaches and suspected optic disc swelling.

The long shadow cast by the Honey Rose case has lead to a tsunami of referrals to the Hospital Eye Service and in many cases unnecessary neuroimaging.The timely recognition of papilloedema can be life saving. Our conversation with Lorcan Butler of The Brain Tumour charity gives clinicians a clear framework for managing these patients with confidence. He emphasises the importance of taking a good history, accurately assessing the optic nerve function and knowing the OCT features that help distinguish papilloedema from pseudo disc swelling.The OCT features of PHOMS are discussed in the bonus audio and the subscribers’ newsletter features articles on OCT optic disc imaging, idiopathic intracranial hypertension and how machine modelling AI can classify and quantify papilloedema.All in all a perfect package for your Easter listening.

Globally, half of glaucoma blindness is caused by angle closure glaucoma.

To mark World Glaucoma Awareness week we are delighted to be joined on the podcast by Professor Paul Foster, who is literally and metaphorically a “giant” in the field of angle closure glaucoma! We discuss Paul’s seminal research which has revolutionised our understanding of the natural history of ACG and has reshaped both referral guidelines and the treatment of this condition.

Paul also shares his amusing experiences of arriving in Mongolia in the early 1990’s and the commotion caused amongst the locals by the appearance of this 6’7” blonde giant within their midst!

You can get full access to Eyes On Tomorrow, including:

* Bonus conversations from our guests

* PDFs of reading material linked to topics discussed in the podcast and perfect for your CPD

* Summaries of the key learnings as a regular newsletter

* Discussion with other subscribers

This month’s newsletter includes copies of the 14 year follow up of the ZAP study cohorts and the EAGLE study. There are also links to the Gonioscopy.org website, which is a superb resource for anyone who wants to improve their understanding of normal and abnormal angle architecture.

And the Bonus audio features Paul’s suggestions for how to become more confident with gonioscopy and his top tips for performing laser iridotomies, especially in heavily pigmented eyes.

All in all a perfect package of listening and learning for World Glaucoma Awareness week.

All for just £25 per year, when you subscribe at eyesontomorrow.substack.com/subscribe

Produced by Matt Hill at Rethink Audio.

You may be surprised to learn how many corneal conditions can be treated with sclerals! Brian Tompkins, one of the Godfathers of scleral contact lens practice, shares with us his passion for treating complex corneal pathology and restoring vision in patients with advanced keratoconus, corneal ectasias and a host of other ocular surface conditions.

Brian also shares his top tips for setting up a scleral contact lens practice and which new scleral fitting technologies to consider.

And no conversation with Brian would be complete without talking about his unique presentation style, combining theatrics and education, an approach Brian describes as “Edutainment”!

You can get full access to Eyes On Tomorrow, including:

* Bonus conversations from our guests

* PDFs of reading material linked to topics discussed in the podcast and perfect for your CPD

* Summaries of the key learnings as a regular newsletter

* Discussion with other subscribers

This month’s newsletter includes papers on pellucidal marginal degeneration versus keratoconus and how we differentiate between them, and guidance on building a specialist contact lens practice. Plus in our bonus podcast episode Brian discusses his membership of the Hakim group, the benefits it brought to his practice and how the move allowed him to focus on clinical work while leveraging the group's support.

All for just £25 per year, when you subscribe at eyesontomorrow.substack.com/subscribe

Produced by Matt Hill at Rethink Audio

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Improvements in biometry, the development of more refined multifocal IOLs like the Rayone Galaxy IOL, and societal changes, have led the evolution of cataract surgery into a refractive procedure.

Kieren Darcy, one of the UK’s leading cataract and refractive surgeons, and Director of The Vision Care Clinic in Bristol, joins us to discuss:

* IOL developments and his experience with the Rayone Galaxy IOL

* the critical importance of managing ocular surface pathology before surgery

* pitfalls to avoid when treating patients who have undergone refractive laser procedures

* the potential impact of robotics and AI on cataract surgery

Kieren also shares his tips on best refractive surgery outcomes. Including: how to educate patients about IOL options, how to choose lenses which will best meet their visual needs, how to ensure your patients have realistic expectations of their surgery. And he reminds us that “there is no such thing as a free lunch in optics”!

You can get full access to Eyes On Tomorrow, including:

* Bonus conversations from our guests

* PDFs of reading material linked to topics discussed in the podcast and perfect for your CPD

* Summaries of the key learnings as a regular newsletter

* Discussion with other subscribers

This month’s bonus episode discusses considerations and challenges around LASIK surgery, plus the benefits and drawbacks in the emerging field of robotic cataract surgery.

All for just £25 per year, when you subscribe at eyesontomorrow.substack.com/subscribe

Produced by Matt Hill at Rethink Audio.

For heaps of practical tips about how to build a dry eye practice, join us in the midst of the Quantock Hills as we spend an evening at home with Sarah Farrant, the President of the British Contact Lens Association. With her trademark infectious enthusiasm, Sarah talks about her holistic and evidence based approach to managing the dry eye disease patient, the multifaceted aetiology of this condition and why our modern lifestyles are causing its prevalence to rise inexorably.

Sarah shares her top tips about dry eye practice, how to use IPL and LLLT to best effect, and the importance of setting realistic goals for our patients at the outset of treatment.

Join us for this light-hearted festive listen.

You can get full access to Eyes On Tomorrow, including:

* Bonus conversations from our guests

* PDFs of reading material linked to topics discussed in the podcast and perfect for your CPD

* Summaries of the key learnings as a regular newsletter

* Discussion with other subscribers

This month’s bonus episode covers the role of tearful biomarkers and the link between the gut microbic and the ocular surface.

All for just £25 per year, when you subscribe at eyesontomorrow.substack.com/subscribe

Produced by Matt Hill at Rethink Audio.

Patrick Condon is the man who brought phaco to Ireland and who’s father, a contemporary of Harold Ridley in London, implanted the 1st IOL in Ireland in 1959.

He shares some fascinating insights into those pioneering days of IOLs and phaco surgery and the origins of the feud between Harold Ridley and “The Duke”, which was to shape this story.

Shrouded in secrecy, 75 years ago, Sir Harold Ridley's first IOL implantations ignited political fall-out amongst the ophthalmological establishment. They led to decades of trial and error experimentation, during which a multitude of IOL designs were implanted, often at a terrible cost to the patient.

Today we are celebrating that first implantation, back on 29th November 1949.

We are joined by Larry Benjamin one of the UKs leading cataract surgeons and surgical trainers, who takes us on a fascinating journey charting the evolution of cataract surgery from antiquity to the present day. Larry also talks about the equally bumpy evolution of phacoemulsification surgery, championed by the flamboyant Charles Kelman.

Despite the many setbacks, and often personal cost, these pioneering surgeons were undeterred and we have them to thank for helping to create one of the world’s safest and most transformational operations, which has restored the vision of millions of patients around the world.

You can get full access to Eyes On Tomorrow, including:

* Bonus conversations from our guests

* PDFs of reading material linked to topics discussed in the podcast and perfect for your CPD

* Summaries of the key learnings as a regular newsletter

* Discussion with other subscribers

All for just £25 per year, when you subscribe at eyesontomorrow.substack.com/subscribe

Produced by Matt Hill at Rethink Audio.

Spurred on by the seemingly hopeless plight of patients with AMD, professor Robyn Gymer is one of the leading lights in dry AMD research. 

Robyn explains why it was important to have developed a universally accepted classification for GA, the relationships between macular structure and function, and why early OCT signs of nascent GA can help us identify who is at risk of progression. She also explores the potential role of complement blockers and gene therapy in slowing the progression of GA.

This episode is a perfect way to get up to speed with the rapidly evolving field of GA, a condition with which 60 million people globally will suffer by 2040.

Plus Robyn regales us with a wonderful anecdote about her first Moorfields clinic with Professor Bird, when her rather direct Antipodean manner left the other British trainees open-mouthed!

You can hear more from Robyn in our subscriber episode, including the crucial role of nutrition and diet in the aetiology of AMD. 

You can get full access to Eyes On Tomorrow, including:

* Monthly bonus conversations from our guests  

* PDFs of reading material  linked to topics discussed in the podcast and perfect for your CPD

* Summaries of the key learnings as a regular newsletter

* Discussion with other subscribers

All for just £25 per year, when you subscribe at eyesontomorrow.substack.com/subscribe

Produced by Daisy Chakoo at Rethink Audio.

Over 1 billion people around the globe suffer the burden of avoidable sight impairment. 

We talk to Hunter Cherwek,  the VP of Clinical Services for ORBIS, who has dedicated his entire working life to Global Ophthalmology. Hunter tells us how ORBIS is using its Cybersight educational platform, virtual reality simulation and AI, in combination with a myriad of community based projects, such as Women-led Green Vision Centres, to tackle the burden of avoidable sight impairment.

An inspiring listen for anyone involved with eye-care, particularly today on World Sight Day.

Produced by Matt Hill at Rethink Audio.