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The only thing to fear is fear itself

There is a song by the Amateur Transplants called ‘Finals Fantasy’ which describes in humorous detail how stressful clinical exams can be. Having not done any viva or objectively structured clinical examination (OSCE) style exams for many years indeed I...

Oct/Nov 2017 Quiz

History A 73-year-old man presented with a rapidly growing left lower eyelid lump with recent bleeding. On examination there was a raised, ulcerated, firm mass occupying two thirds of his lower eyelid. The lesion bled easily and appeared connected to...

Apr/May 2017 Quiz

History A five-month-old baby was seen in clinic with bilateral congenital corneal opacities. The right cornea is shown in Figure 1. Figure 1. Examination revealed corneal oedema and opacities of Descemet’s membrane and endothelium with a few vesicular lesions. Corneal...

Feb/Mar 2018 Quiz

History A 48-year-old farmer with gradual worsening vision in her only eye was referred by her optician. She had recently moved to the UK and required an interpreter during consultation. She seemed to have had vision problems since childhood. Although...

Oct/Nov 2016 Quiz

History A 67-year-old female patient had chronic left canaliculitis becoming painful and more recently complicated by left lower blepharitis. Examination revealed a small fleshy lump on the medial aspect of the left lower eyelid. There was also swelling of the...

Apr/May 2018 Quiz

History A 57-year-old lady presents with a right subconjunctival lesion which has been increasing in size for three months (Figure 1). She has never had vision problems other than presbyopia. Past medical history: hypertension and asthma. On examination, she had...

Aug/Sep 2014 Quiz 1

History A 50-year-old female with a history of smoking, weight loss and cough presents to the ophthalmology clinic with a distorted pupil. Examination reveals a mass on the surface and within the iris (see Figure 1). The ophthalmologists decide to...

Apr/May 2019 Quiz

History A 68-year-old female patient was referred from her GP with bilateral conjunctival lesions on her upper eyelids which cause local irritation and dry eyes. Her past ophthalmic history is uneventful. However, systemically she has history of high blood pressure...

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...

Cyanoacrylate nail glue accidentally instilled into the eye instead of eye drops

Three hundred thousand cataract operations take place each year in the UK alone and each patient will receive a four week course of drops in order to cover them for any postoperative inflammation or infection. Accidental instillation of cyanoacrylate glue...

Paraproteinaemia: a patient with atypical corneal findings

A Bence Jones protein is a monoclonal globulin protein or immunoglobulin light chain found in the urine, with a molecular weight of 22-24 kDa [1]. Detection of Bence Jones protein may be suggestive of multiple myeloma or Waldenström’s macroglobulinemia. Multiple...

A case of retinal cavernous haemangioma – don’t let it slip through the grapevine

We present a case of a seven-year-old male who presented to the emergency eye referral clinic with red eye. He was diagnosed and treated for allergic conjunctivitis, however, on clinic review, wide field retinal imaging was performed (as has been...