Neurofibromatosis type 2 – diagnosis, features and MDT approach

NF2 is a genetic condition caused by mutation in a single gene (NF2 gene) on chromosome 22. The NF2 gene provides instructions to produce a protein called merlin, also known as schwannomin. This protein functions as a tumour suppressor, preventing...

Traumatic optic neuropathy

In neuro-ophthalmology we get asked a lot about management of patients who suffered significant trauma and presented with loss of vision secondary to presumed traumatic optic neuropathy (TON). TON happens usually in the context of significant craniofacial trauma. The incidence...

Time is vision in central retinal artery occlusion

Central retinal artery occlusion (CRAO) is a rare but devastating vascular episode that can have severe impact on vision. Treatment is very time-limited and needs to be initiated very quickly to salvage any vision. The majority of patients present to...

Idiopathic intracranial hypertension (IIH)

IIH is a medical condition where the intracranial pressure (ICP) is raised without an obvious cause. The cerebrospinal fluid (CSF) is produced in by the choroid plexus in the lateral ventricles and the roof of the third and fourth ventricles,...

Chemical injury

You are the on-call ophthalmologist. You receive a call from A&E regarding a 45-year-old man who sustained a chemical injury. He was mixing some cement, when a small amount entered his left eye. He was not wearing any protective goggles....

Cavernous sinus syndrome

Anatomically the cavernous sinus is a plexus of multiple veins that are connected and within this plexus there are several important vascular and neurological structures. These include cranial nerves III, IV, V1 (and sometimes V2), VI as well as the...

It’s not always GCA

Giant cell arteritis (GCA) is an immune mediated granulomatous inflammatory disease that affects muscular middle or large sized arteries. It is considered as a continuation of polymyalgia rheumatica (PMR) when the severity of the disease has increased. It is the...

Sexually transmitted conjunctivitis – the REALLY sticky eye

Let’s face it, patients with conjunctivitis don’t always produce the most stimulating consultations and most of the time we can manage them in auto-pilot. The prospect of delving into such a patient’s sexual history is not overly appealing, but this...

Ophthalmology in the COVID-19 pandemic

The novel coronavirus pandemic has affected the whole world and forced all of us to think of new ways to manage our day to day personal as well as professional life. I am not going to talk about the clinical...

Making sense of the orthoptic assessment

Following the Specialty Trainee article on this topic in the February/March 2020 issue, Joe Smith provides a more detailed breakdown of the orthoptic report. Orthoptists investigate, diagnose and manage a wide variety of patients with varying problems. In this article,...

Management of squint with near-distance angle disparity

These are a group of strabismus disorders where the angle of misalignment is different between near and distance. The focus of this article will be on the patients where the angle for near exceeds the distance angle by more than...

Non-organic visual loss

Patients can present to eye departments with various signs and symptoms (mostly symptoms) with no obvious organic cause. These patients can be labelled with any of a wide range of diagnoses such as functional visual loss, functional overlay, psychosomatic reaction...

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