Nocardiosis is an infection caused by a soil-borne aerobic filamentous bacterium in the genus Nocardia and the order Actinomycetales. Within the genus Nocardia, N. asteroides, N. brasiliensis and N. caviae are responsible for nearly all nocardial infections in man. This article is available only as a PDF. Please click on...

Shigellosis is generally considered to be confined to the gastrointestinal tract. Septicaemic infections with Shigella species are extremely rare in adults. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Epidural abscess complicating epidural catheterisation was first reported in 1974. Two recent studies indicated a local infection incidence of epidural catheters of 4.3% to 12% and about 0.7% are reported to have central nervous system infection e.g. epidural abscess or meningitis. This article is available only as a PDF. Please...

Epidural analgesia has been shown to provide excellent pain relief following thoracotomy, abdominal and other surgery. Studies have shown improvement in specific variables with epidural analgesia; and effective postoperative pain relief is a prerequisite to attain improved postoperative outcome. This article is available only as a PDF. Please click on...

Mycobacterium haemophilum is a nontuberculous mycobacterium (NTM) that is increasingly recognised as a cause of cutaneous, joint, or pulmonary infections in immunocompromised patients and lymphadenitis in children. To date, less than 100 patients with this infection have been reported worldwide. This article is available only as a PDF. Please click...

Compared to in-hospital patients, patients treated in an intensive care unit (ICU) have the highest risk of contracting an infection. The risk correlates well with underlying and accompanying diseases and invasive monitoring. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

Lemierre’s syndrome (LS) is a condition which follows an oropharyngeal infection, often in an otherwise healthy young adult. This usually progresses to septic thrombophlebitis of the internal jugular vein (IJV), leading to metastatic abscesses mainly of the lungs, but organs such as the liver, bones, joints and kidneys can...

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Patients suffering from visual field defects caused by optic nerve or post-chiasmatic injury commonly experience many limitations in their daily activities. The generally accepted paradigm that nothing can be done leaves little hope for such patients as restoration was once considered impossible. This article is available only as a PDF....

The prevalence rates of myopia, including high myopia (spherical equivalent at least –6.0 diopters), are rising to epidemic proportions in Asia. Singapore has one of the highest rates of myopia in the world.1-3 To address this huge public health problem, the national disease control plan for prevention and control...

The review articles in this journal represent the advancing frontier of the dynamic specialty of ophthalmology. In the cacophony of advancing scientific opinion, we often forget the issue that lies at the very heart of our discipline of ophthalmology. The very question that first brings the patient to his...

Two recent court rulings1 have underlined the global trend of relying on the principles of medical ethics of autonomy or self-determination of the individual when determining whether informed consent has been given by the relevant subject. This article discusses the importance of respecting the individual person, especially in cases...

The heterogeneous group of conditions resulting in glaucomatous optic neuropathy have been treated with a combination of medical and surgical therapies. The advent of anti-glaucoma medications has reduced the requirement for surgical procedures in glaucoma. This article is available only as a PDF. Please click on "Download PDF" to view...

The possible role of nutritional supplementation in preventing or halting the progression of ocular disease is of interest to healthcare professionals and patients. Nutritional supplements are available in many forms such as vitamins A, B, C and E, carotenoids (beta-carotene, lutein, and zeaxanthin), minerals such as selenium and zinc,...

Uveitis is a general term describing inflammation of one or all parts of the uveal tract. Deleterious effects on vision, either by acute ocular inflammation or by its sequelae, such as cataracts, glaucoma and retinal vascular ischaemia, make uveitis one of the major causes of visual loss.1 Uveitis can...

The advancement flap is a modality of skin defect closure via mobilisation of tissue along a linear direction. It is one of the most versatile flaps used commonly in many surgical disciplines including ophthalmology. This technique may be used to close a variety of defects of various sizes and...

The Muller’s muscle (MM) is a sympathetically innervated upper eyelid muscle that elevates the eyelid besides the levator palpebral superioris. The MM resembles smooth muscle and originates from the levator aponeurosis about 15 mm above the superior tarsus.1 The MM is adherent to the conjunctiva but easily separable from...

Age-related macular degeneration (AMD) is a group of non-Mendellian disorders which share the common manifestation of chronic progressive degeneration of the macula involving changes in the neuro-sensory retina, retinal pigment epithelium (RPE) and/or the inner choroid in patients above 50 years of age. This article is available only as a...

Singapore has one of the fastest ageing populations in the world today. The current elderly population, defined as persons 65 years or older, comprises 7% of Singapore’s total population and is expected to multiply almost threefold to 19% by the year 2030.1 Although the current figure stands at 7%,...

There is increasing evidence that retinal and cardiovascular diseases share a “common soil”. Risk factors for cardiovascular disease, such as hypertension, diabetes, hyperlipidaemia and cigarette smoking, are known to influence the development of a range of retinal diseases, including hypertensive retinopathy, diabetic retinopathy, retinal vein and artery occlusion, retinal...

It is now a well-known fact that Singapore’s population is greying dramatically due to the ageing of the “baby boomers” – defined as those born between 1947 and 1964. In 2005, 1 in 12 Singapore residents was 65 years or older. By 2030, this is expected to escalate to...

Incisional hernias are common complications following abdominal surgery with an incidence of 2% to 20% after midline laparotomy. Umbilical fluid discharge is, however, an unusual presenting complaint and may arise from structural abnormalities persisting from birth such as a patent urachus or secondary to instrumentation. This article is available only...

Transrectal ultrasound guided prostate biopsy (TRPB) is one of the modalities in the diagnosis of prostate cancer. Its use has increased with the widespread use of serum prostate-specific antigen (PSA). It is generally a safe procedure with acceptable complication rates.1 However, when infective complications occur, it is potentially fatal.2...