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Quiz Aug/Sep 2022

History A 58-year-old female patient was referred with a 2-year history, gradually enlarging, painless left upper lid lump. There was no bleeding or ulceration. She had no other eye symptoms and no other skin lesions. Her past medical history included:...

Quiz Oct/Nov 2022

History An Afro-Caribbean woman, aged 30, with “scleral tattooing” for cosmetic reasons (subconjunctival dye injection), presented with bilateral upper and lower eyelid oedema for one week, and she also had restricted eye movement and blurry vision in her right eye....

Quiz Jun/Jul 2024

History A one-year-old girl originally presented with a red eye, initially bilaterally and later in the left only. On examination a membrane was found on the tarsal conjunctiva of the upper eyelid (Figure 1). Figure 1: Anterior segment. Serum plasminogen...

A practical guide to anisocoria

Anisocoria means the presence of difference in the size of the right and left pupils. It is a sign of an abnormality in the efferent pathway. The first question facing the ophthalmologist is to ascertain if anisocoria is present or...

Managing cataract surgery in a patient with diabetic maculopathy

A 56-year-old type 2 diabetic with previously treated bilateral diabetic maculopathy develops a cataract requiring surgery in the right eye. He has had grid laser previously, followed intermittently by intravitreal triamcinalone, Avastin and more recently Lucentis in both eyes. His...

Internuclear ophthalmoplegia: a case study

A 44-year-old patient presents with binocular, mostly horizontal diplopia when fixating on moving objects. This has been ongoing for approximately five years. He is known to have multiple sclerosis and had an episode of optic neuritis six years prior in...

The results of the last survey Dec22

I am regularly faced with litigation whereby the claimant’s cornea has decompensated after cataract surgery. The procedure may have been complicated but sometimes it is not. The eye may have been high risk, for example, a shallow anterior chamber with...

The results of the last survey Feb23

*Please be aware that this data does not form part of a peer reviewed research study. The information therein should not be relied upon for clinical purposes but instead used as a guide for clinical practice and reflection. For the...

The results of the last survey Apr23

*Please be aware that this data does not form part of a peer reviewed research study. The information therein should not be relied upon for clinical purposes but instead used as a guide for clinical practice and reflection. My thanks...

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...

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...

Melanocytoma of the optic disc

Melanocytoma is a heavily pigmented lesion, composed of melanocytes and is a variant of melanocytic naevus. It classically occurs at the optic disc and is usually benign, static and asymptomatic. However, it can occasionally grow and invade the retina or...