Investigation and Management of Eye Disease in Primary Care

This handbook offers concise, evidence-based guidance for clinicians who diagnose and manage ocular disease outside tertiary centres. Written for general practitioners, optometrists, ophthalmic nurses and primary care eye professionals, it translates core science into practical steps for assessment, urgent decision making and initial therapy.

The book covers common sight-threatening conditions, including glaucoma, age-related macular degeneration, diabetic and hypertensive retinopathies, uveitis, cataracts and inflammatory and immune-mediated eye disease. It provides clear, illustrated pathways for history taking, focused examination and red-flag recognition, with pragmatic advice on when to treat, when to refer and how to arrange safe follow-up.

Key Practical Features

• Clinical diagnostic aids and annotated images to support decision making
• Management algorithms and treatment pearls for emergencies and routine care
• Practical procedures such as corneal scraping, microscopy and basic microbiology with guidance on appropriate antimicrobial therapy
• Therapeutic rationale covering ocular pharmacology, prescribing considerations and when to use immunomodulatory agents
• Public health and tropical perspectives on ocular infections, epidemiology and prevention of cross-infection in practice

This book bridges the gap between specialist ophthalmology texts and everyday primary care needs, equipping clinicians with the knowledge to protect vision, reduce avoidable harm and coordinate care effectively within diverse global health settings.

Dr David V Seal MD FRCOphth FRCPath Dip. Bact.(LSHTM) holds Fellowships in both ophthalmology and pathology (medical microbiology) and has practised in both. He was Senior Lecturer in the Tennent Institute of Ophthalmology, Glasgow University and NHS Consultant in Microbiology for the Public Health Laboratory, Maternal and Paediatric services for Glasgow. Previously, he worked with the Medical Research Council for microbiology and infectious diseases at the Clinical Research Centre & Northwick Park Hospital, Harrow. Prior to that, he was Consultant Medical Microbiologist at Southampton General (University) Hospital and Public Health Laboratory. He studied medicine at St. George’s Hospital, London where he started his career. He has published over 100 scientific papers and 4 books.

Prof. Uwe Pleyer was Professor of Ophthalmology at Charité Hospital, Humbolt University, Berlin, Germany. He was awarded his medical degree from the RWTH Aachen, Germany and Cornell University, New York USA.  Dr. Pleyer did a fellowship at the Jules Stein Institute, UCLA, Los Angeles. He is involved with both research aspects and clinical treatment of infectious and immune-mediated ocular diseases. He is a founding member of the International Ocular Inflammation Society, IOIS and past president of the European Association for Vision and Eye Research (EVER).

Dr Michelle Hennelly is Associate Professor and Head of Optometry and Visual Science at City St George’s, University of London, with over 30 years’ experience in clinical optometry, academic leadership, and global eye health. A registered optometrist, she holds a PhD in psychophysics and is both a Senior Fellow of the Higher Education Academy and a Fellow of the College of Optometrists. She has led on postgraduate and undergraduate programme development, including Independent Prescribing and MOptom pathways, and represents UK optometry on national and international panels. Michelle serves as a reviewer, editor, and advisor for journals, funding bodies, and global education boards, contributing to research and policy in clinical education and public eye care. Her leadership is defined by a commitment to inclusive teaching, global collaboration, and innovation in optometric education.

Professor John Lawrenson MSc (Oxon) PhD FCOptom is a Clinical Scientist and Professor of Clinical Visual Science at City St George’s, University of London. His primary research interests are in the field of ophthalmic public health, including global causes of visual impairment e.g. myopia, diabetic retinopathy, glaucoma and age-related macular degeneration. He has edited the eye and orbit sections in the last four editions of Gray's Anatomy. He is an advocate for evidence-based clinical practice, holds a master’s degree in Evidence-based Healthcare from the University of Oxford, and is a senior editor for Cochrane and authored a number of high-profile Cochrane systematic reviews in Eyes and Vision.

Bhavina Patel BSc (Hons), DipTp(IP), DipGlauc, Prof Cert MR, LV, Paeds is a postgraduate lecturer specialising in Independent Prescribing. With over two decades of experience across both the multiple and independent sectors, she combines academic expertise with active clinical practice. Bhavina is currently a Clinical Lead and Senior Triager for South-East London’s Primary Ophthalmic Solutions, where she oversees ophthalmic triage pathways and referral refinement across primary and secondary care interfaces, including services into King’s College Hospital and St Thomas’ Hospital. She holds senior roles within independent optometric practices, serving as Clinical Lead, Information Governance Lead, and part of the senior management team. Her extensive portfolio includes specialist optometrist work in glaucoma at St Thomas’ Hospital and active involvement with the Lambeth, Southwark, and Lewisham Local Optical Committee.