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Feb/Mar 2017 Quiz

History A 40-year-old male patient presented with a right lower eyelid swelling with gradual enlargement for two months. On examination there was a large lesion apparently involving lid margin, part of palpebral conjunctiva and skin. No other local or systemic...

Aug/Sep 2018 Quiz

History A seven-year-old girl presented with a presumed papillomatous lesion on right inferior fornix (Figure 1). Her parents said the lesion was increasing in size for two weeks. CT scans (Figure 2) revealed a lesion occupying the right medial canthus....

Oct/Nov 2018 Quiz

History A 37-year-old male was referred from the Emergency Eye Clinic with a swollen right upper eyelid. Symptom relieved with nonsteroidal anti-inflammatory drugs (NSAIDs). The initial clinical diagnosis was dacryoadenitis. The patient presented again six weeks later with 3mm proptosis,...

Dec/Jan 2019 Quiz

History A 72-year-old male presented to his GP with a large ulcerated lesion on his right lower eyelid present for six months and enlarging in size. He had an urgent referral to a tertiary centre for specialised examination. The lesion...

Feb/Mar 2019 Quiz

History A 31-year-old female patient presented with history of gradual downward displacement of the globe over the last six months. The superotemporal mass then became palpable (Figure 1). Lateral orbitotomy was performed following CT scans (Figure 2). Figure 1. Figure...

Diagnosis and management of IV cranial nerve palsy

Aetiology: Trochlear nerve palsy can be divided into acute or congenital. Congenital trochlear nerve palsy is usually noted in childhood with development of abnormal head posture. Various pathologies can lead to acute IV nerve palsy, most commonly trauma. Other causes...

Headaches in ophthalmology (part 1)

Ophthalmologists see a large number of patients with headaches or facial pain in the ophthalmic outpatient clinics or in emergency clinics. Over two articles, I will discuss several causes of headaches, ocular manifestations and proposed management and referral options. It...

Acanthaemoeba keratitis

In the second of this series I describe a case of Acanthaemoeba keratitis (AK) that was misdiagnosed for a prolonged period which resulted in a devastating outcome. This is one of half a dozen similar medico-legal cases I have dealt...

How does your practice compare?

One of the lovely things about clinical meetings and conferences is the ability to meet with your peers and ask questions of them about their practice. Often the questions are not earth shattering, for example, it could be as simple...

Ophthalmology survey results August/September 2019

I am delighted to see another great response to the practice variance survey. I am extremely grateful to all of you who took part and would encourage those of you who didn’t to try this survey. It literally takes mere...

The results of the last survey Apr 2020

As ever, I would like to thank all those who participated in the last edition’s survey. A lot of data was generated and I do not intend to go through each individual finding. What is staggering again is the degree...

The results of the last survey Aug 2020

Once more I would like to thank those of you who took the time to complete the last edition’s survey. It was highly pertinent to what we are facing now. It is clear that our services have been markedly disrupted....