Lockdown and eye health – a case of accommodative spasm

A 25-year-old male presented to the eye casualty with a one-day history of sudden onset worsening vision. More specifically, he noted his vision was more blurred than usual and this was more exaggerated for near-work than for distance-work. He was...

Traumatic ‘toy’ gun injury leading to permanent vision loss

Pseudoxanthoma elasticum (PXE) is a progressive, inherited disorder of connective tissue that affects the skin, cardiovascular system and retina. Ocular manifestations of the disease are related to Bruch’s membrane, a thin elastic tissue layer located between the retinal pigment epithelium...

Is this a retinal detachment?

Despite the help of allied health professionals in triaging and managing acute ophthalmic emergencies, eye casualty remains overburdened. Trainees at the beginning of their training often struggle to manage such busy clinics with varied presentations. We present a case that...

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...