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Differentials: Retinal detachment Retinal breaks/ tears Posterior vitreous detachment Retinal dialysis (can often be related to trauma) Vitreous haemorrhage Macular oedema (1) Risk factors Advanced age Myopia (short sightedness) Trauma to the eye Family history of retinal tears or detachment Prior eye surgery Lattice degeneration (1) Basic examination tests that can be performed in the A&E department: Visual acuity using a Snellen chart Pupil check for Relative Afferent Pupillary Defect (RAPD) this will often be normal Visual fields to confrontation if the patient is describing a shadow in their vision this will be confirmed with this test Findings on examination: Shafers sign tobacco dust these are pigment cells that come from the RPE of the retina

Directed by rising star Shingo Natsume, who gained notoriety for his work on Space Dandy and then the hit One Punch Man, this adaptation of Natsume Onos ( House of Five Leave, Ristorante Paradiso ) fantasy drama is the most high-profile debut of the season

The study discovered that cytisinicline binds to nicotine receptors in each patients brain cells

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It was a bit of an ordeal but an ordeal I could live with