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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...

Unconscious bias

Swansea University invited me to an Away Day. There was a whole day of lectures planned at a hotel conference suite just outside Swansea but due to clinic commitments I only caught the afternoon session; a ‘workshop’, on how to...

The reps

Who are the reps? Every one of us knows the friendly face of the local randomprost eye drop representative or the nice man from that eye lubricant company. These company representatives travel up and down the region with a smile,...

The writing on the wall

The Prophet Daniel tells a famous tale of how the tyrannical king of Babylon held a feast for all his top lords and ladies, and as the feasting grew to fever pitch a mysterious hand appeared from nowhere that started...

Jun/Jul 2018 Quiz

History A 35-year-old woman had a long-standing left blind eye following extensive exudative retinal detachment in the past. She later developed increasing pain in her blind eye. Her medical history includes pheochromocytoma resected five years ago, and she is currently...

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 2019 Quiz

History A 62-year-old female patient was referred for rapid growth of a left periorbital soft tissue lesion with proptosis. Her past medical history included: hypertension, hyperlipidaemia and bipolar disorder. On examination: vision in the affected eye was hand movements, right...

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:...

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...

Third nerve palsy

Case scenarios A 71-year-old female presented to a nearby eye emergency unit with two days history of partial ptosis in her left eye with diplopia. She saw her GP earlier that day and he asked her to go to the...

Toxic nutritional optic neuropathy (TON)

Toxic optic neuropathy are a group of conditions manifested by reduction of visual functions secondary to damage to the anterior visual pathways from exposure to a toxin. The implicated toxin could be work-based, food or drink related, or iatrogenic medication....

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...