Applanation tonometry in the pandemic era: Are facial masks an obstacle to a correct intraocular pressure measurement?

Current recommendations in the UK advise on wearing any facial covering to prevent the spread of the coronavirus [1]. Whilst this is vital for patient and hospital staff safety, it has led to several changes in the approach to a...

Recurrent corneal erosions secondary to isotretinoin use

Isotretinoin (13–cis-retinoic acid) is the first line treatment for moderate to severe nodulocystic or papulopustular acne [1,2]. Although it is a safe medication, it has several adverse side-effects, including ophthalmic manifestations, as shown in Table 1 [3]. These side-effects need...

Anaesthetic drops abuse

A 67-year-old retired female nurse presented with persistent, bilateral, non-healing (>6 weeks) corneal ulcers and stromal ring infiltrates (Figures 1 and 2). The epithelial defects were the result of chemical burns caused by her contact lenses which had been stored...

Trabeculectomy with erroneous Mitomycin-C concentration – a near miss

Trabeculectomy is the most commonly performed surgical procedure for glaucoma in the United Kingdom and worldwide. Modifications to the technique have been made since its introduction in 1963, perhaps the most significant being the adjunctive use of mitomycin-C (MMC), which...

Choroidal melanoma – breaking bad news

Case report A 55-year-old Caucasian female presented to her general practitioner with a three-month history of headaches and worsening blurred vision in the left eye. On further close questioning, she reported no eye pain, intermittent floaters and flashes of light...

A step-by-step approach to the diagnosis and management of Sands of Sahara Syndrome

Sands of Sahara syndrome (diffuse lamellar keratitis) is a rare postoperative complication of Laser in situ keratomileusis (LASIK). Its estimated prevalence is reported to be 2-4% among LASIK cases [1], despite that, it is more likely to be encountered by...

Retinal arteriovenous malformation

A 24-year-old Caucasian girl reported to the eye clinic with the complaint of painless decreased vision in her right eye. She had no history of infectious disease, trauma, systemic malignancy or other systemic complaint. Her best corrected visual acuity was...

Chronic dacryocystitis?

Lacrimal drainage system tumours are rare and lymphomas account for less than 10% of these tumours [1]. Most patients presenting with lymphoma infiltration of the lacrimal drainage system have a history of previously diagnosed lymphoma elsewhere. We report a case...

A case of late spontaneous subluxation of in-the-bag intraocular implant

An 82-year-old frail lady was referred by her optometrist with a finding of subluxated implant in the right eye. She had uneventful phacoemulcification with in-the-bag intraocular implant 17 years earlier. There is no history of having had pseudoexfoliation (PXF) or...

Disseminated cutaneous zoster – a masquerade

Reactivation of varicella zoster infection in the elderly commonly presents to ophthalmologists as herpes zoster ophthalmicus (HZO), affecting the Va trigeminal dermatome. In patients with impaired immunity, zoster infection occurs with increased severity and may be complicated by visceral and...

An unusual case of silicone oil in the anterior chamber simulating intraocular implant

Silicone oil internal tamponade has been used for over 50 years, even prior to pars plana vitrectomy [1].Over a course of time silicone oil may migrate to the anterior chamber through the pupil. This may disperse in the form of...

Fundus photography in Malawi – setting up a screening programmefor diabetic retinopathy

We present the case of a 53-year-old lady who presented to the diabetes outpatient clinic at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. She was diagnosed with type 2 diabetes mellitus six years ago, for which she takes metformin orally. She...