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International Primary Care Association

Clinical Focus Volume 4 N2

Volume 4 Issue 2 - 2010

With the election over we shall soon see if the victors are able to keep the NHS promises. The electorate must be punch drunk with usual list of platitudes that were wheeled out, and these were not party specific: NHS safe in our hands, we shall do more, we will maintain frontline staff, patient’s are the centre of our policies, shorter waiting lists....blah blah blah. This is boring and mostly inaccurate. Dogma rules and control from the centre is exacting, confining and restrictive. Not too far removed from the command type rule of the ex Soviet Union


It is well known that adult thyrotoxicosis can present in many guises and to different specialists, but childhood thyrotoxicosis, particularly in the pre-pubertal age group, is often overlooked as a possible diagnosis. Many children, who present to a tertiary centre for treatment, have been diagnosed ‘accidentally’. A number have seen their General Practitioner or a Paediatrician in the preceding weeks and, although concern may have been raised about the child’s symptoms, thyrotoxicosis has not been considered, as it is not traditionally thought of as a ‘paediatric’ condition.


As Normal Tension Glaucoma (NTG) comprises a significant proportion of the glaucoma workload, it is essential for general practitioners to have a thorough understanding of the nature of this disease. The diagnosis of NTG is strict and requires careful history-taking and examination to exclude differential diagnoses.


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