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Glaucoma Surgery Glaucoma and Cataract Surgeon and Surgical Glaucoma "Fixer-Upper" at Moorfields, London

05/10/2026

In recent years, I've heard an increasingly frequent claim that silicone oil can obstruct drainage tubes. I don't think I've ever seen that happen unless there is a complete anterior chamber silicone oil fill.

28/09/2026

In my training days, aqueous misdirection, or malignant glaucoma, as we always called it, was very poorly diagnosed and often labelled as pupil block. Nowdays, it seems like the opposite often happens. However, in this case, you can see that the diagnosis is not always crystal clear, which is why the diagnosis of aqueous misdirection should generally not be made until there is a functioning PI.

26/09/2026

This Paul Glaucoma Implant in a teenage patient with Axenfeld-Rieger Syndrome was functioning but retracted, was repositioned and retracted again. In this situation, with high PAS, there is much more space in the sulcus than the AC, providing significant extra tube lengh and avoiding the cornea. The sulcus is therefore an ideal place for placement in this situation.

22/09/2026

Cogan-Reese Syndrome is the least of the three common clinical variants of the irido-corneal (ICE) syndrome and the main differential diagnosis is iris melanoma.

19/08/2026

Tisseel fibrin glue is useful for gluing on donor patches and as an adjunct to conjunctival closure, but comes in a somewhat messy proprietary dispensing system. This video demonstrates a simple method of preparing Tisseel for ocular surgery so that it can be applied to the eye more precisely.

17/08/2026

Definitive glaucoma surgery in an eye with an extremely tight orbit can be a slow process requiring more than one procedure, but can get there in the end. A Paul Glaucoma Implant in a one-eyed patient with severe primary angle closure, a very tight orbit and almost no conjunctiva.

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28/07/2026

Occasionally patients present with hypotony months or years after a trabeculectomy in eyes with no visible bleb, often after a later phaco.

This is a simple diagnostic test to clarify the role of the trabeculectomy in this situation.

12/07/2026

This patient has uncontrolled glaucoma on 4 drugs, 5 years after lacrimal gland excision and radiotherapy for adenoid cystic carcinoma.

Can any glaucoma procedure work well enough to get the patient of the glaucoma medication that is destroying the ocular surface and at the same time control the intraocular pressure definitively?

16/06/2026

The management of secondary angle closure in nanophthalmos is possibly the greatest clinical challenge a glaucoma specialist might face in their clinical career. The case illustrated in this video is not an atypical presentation.

06/06/2026

Another interesting clinical case. In this one-eyed aniridic patient with a subluxed Morcher aniridic IOL a non-funtional Ahmed Valve and a Paul Glaucoma Implant obstructed with capsule, after a vitrectomy and tube unblocking, how would you fix the IOL?

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50-52 New Cavendish Street
London
W1G8TL

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Monday 9am - 12pm
Tuesday 9am - 12pm
Wednesday 9am - 12pm
Thursday 9am - 12pm
Friday 9am - 12pm

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