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Strabismus in thyroid eye disease

Pathogenesis Thyroid eye disease (TED) is an auto-immune condition, in the initial phase there is lymphocytic infiltration and oedema of the extraocular muscles with deposition of glycosaminoglycans and hyaluronic acid and adipogenesis, which can lead to an increase in the...

The management of chronic central serous chorioretinopathy

Central serous chorioretinopathy (CSCR) is a common retinal disease characterised by one or more serous neurosensory detachments. Patients present with acute onset blurring of vision, metamorphopsia and / or central scotomas. The condition is six times more common in men...

Ultrasound biomicroscopy (part 2): primary angle closure

Patients with primary angle closure or primary angle closure glaucoma [PAC(G)] comprise a significant subgroup affecting around 10% of glaucoma patients amongst Caucasians. Assessment of the patient with angle closure, or narrow angles, requires gonioscopy. However, whilst identifying the presence...

How to diagnose and treat Acanthamoeba keratitis

Corneal ulceration caused by Acanthamoeba is on the rise, and recent publications indicate an outbreak in the UK over the last few years [1]. Since Acanthamoeba keratitis often presents with atypical features, diagnosis from slit-lamp examination alone can often be...

Cataract surgery supervision

Senior trainees supervising other more junior trainees’ cataract surgery is a skill which needs to be taught and developed with care. It is beneficial for senior trainees as it provides an opportunity to develop supervision techniques prior to consultancy and...

Sixth nerve palsy versus decompensating distance esophoria

Orthoptists see a wide range of conditions that can range from reduced binocular single vision (BSV) that may be solved with exercises, to more extreme neurogenic cases requiring further intervention. Because of this variety, it is important to be able...

Congenital cranial dysinnervation disorders (CCDDs)

The term congenital cranial dysinnervation disorder (CCDD) was introduced by Gutowski et al. in 2003 to describe strabismus conditions that result from developmental error in innervation of some of the extraocular muscles. Examples of these conditions include Duane’s syndrome and...

Poppers retinopathy: What is it and how do we treat it?

Poppers retinopathy is a relatively unknown phenomenon which afflicts users of poppers but should be considered as a differential in sudden-onset or sub-acute visual acuity loss – particularly in patients with a history of recreational drug use. Raising awareness of...