Fundus imaging with a fundus camera is an essential part of ophthalmic practice. A mobile phone with its in-built camera and flash can be used to obtain fundus images of reasonable quality. The mobile phone can be used as an indirect ophthalmoscope when coupled with a condensing lens. It can be used as a direct ophthalmoscope after minimal modification, wherein the fundus can be viewed without an intervening lens in young patients with dilated pupils. Employing the ubiquitous mobile phone to obtain fundus images has the potential for mass screening, enables ophthalmologists without a fundus camera to document and share findings, is a tool for telemedicine and is rather inexpensive.

Brucella spp is an uncommon class 3 pathogen isolated in laboratories serving non-endemic areas. This is a report of four recent cases of brucellosis diagnosed at five different London laboratories, and it highlights the need to maintain a high index of suspicion for brucellosis in patients with a history of travel to and/or consumption of unpasteurized foods from endemic areas. A protocol for risk categorisation is proposed, and there is a description of the strategy adopted for serological follow-up of exposed staff and use of postexposure prophylaxis.

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Purpose:To evaluate the anatomical and functional outcomes of sutureless scleral buckling for the repair of rhegmatogenous retinal detachment (RD).Design:Retrospective interventional case series.Materials and Methods:Retrospective analysis of 50 eyes of 49 patients with rhegmatogenous RD, who underwent sutureless scleral buckling from January 2009 to March 2013.Results:Primary retinal re-attachment rate of 86% was achieved with single surgery, but final anatomical success was 94% with additional interventions in the form of intravitreal gas, buckle revision, and/or pars plana vitrectomy. Best corrected logarithm of minimum angle of resolution visual acuity improved from 1.44 ± 1.01 preoperatively to 0.50 ± 0.40 at a mean follow-up of 6.7 months.Conclusion:Sutureless scleral buckling achieves excellent anatomical and functional success in majority of the patients with rhegmatogenous RD.

A 71-year-old man was admitted with a 2-day history of the hot and swollen right knee in December 2012. He had undergone a primary cemented right total knee replacement (TKR) in 2002. He also had a history of chronic lymphatic leukaemia (CLL), haemolytic anaemia and splenomegaly, and was in partial remission following chemotherapy in 2008. He underwent arthroscopic washout of right TKR on admission. Blood cultures on admission and joint fluid specimen grewHaemophilus influenzae(Hi). The isolate was identified as a non-encapsulated Hi strain by the reference laboratory. Non-encapsulated Hi strains rarely cause invasive disease. CLL with splenomegaly may have predisposed our patient to severe invasive disease. A recently licensed 10-valent pneumococcal vaccine conjugated to the immunogenic outer membrane protein D of Hi could potentially prevent invasive Hi disease. Routine vaccination should be considered in all patients with prosthetic joints and predisposing comorbidities.