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International medical graduates in ophthalmology

IMGs in the NHS The General Medical Council (GMC) defines an international medical graduate (IMG) as someone who has obtained their primary medical qualification outside the European Economic Area (EEA) [1], meaning that an IMG is a medical doctor whose...

Dark circles and facial rejuvenation

A 45-year-old socialite lady comes for cosmetic consultation and wants a remedy for dark circles and facial ageing. How do you manage this patient? Issues of dark circles and facial ageing should be addressed separately. Facial ageing should be considered...

Systemic sarcoidosis presenting with acute myopia and angle closure

Case report A 40-year-old Asian man presented to the Emergency Department with a one day history of sudden onset visual disturbance in his right eye. He complained of image distortion and noted that objects now appeared smaller. He also described...

The challenge of chorioretinal folds in virtual eye clinics

Chorioretinal or choroidal folds are parallel striations involving the retina, retinal pigment epithelium (RPE), Bruch’s membrane, and inner choroid [1]. They can arise from compressive stress on these layers, and their presence often serves as a diagnostic marker for underlying...

Deciphering dark retinal patches

We present a case of bilateral extensive dark without pressure (DWP) located outside the retinal vascular arcades in a young female. This retinal finding is benign but, in some instances, darkened retinal patches could be associated with potential sight-threatening conditions....

Immunoglobulin G4-related ophthalmic disease – what is it? (Part 1)

Part 1: Epidemiology, classification, radiology, histopathology and associations (see Part 2 here) In this two-part series, Li Yen Goh reviews IgG4 disease and reminds us of diagnostic challenges faced. Introduction Immunoglobulin G4 (IgG4) disease is a recently recognised idiopathic systemic...

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...

Upper eyelid ulceration as a presenting sign of frontal sinus mucocele

Introduction A sinus mucocele is an epithelium-lined sac filled with mucus and desquamated epithelium. It forms secondary to inflammatory processes that occur in a sinus with an obstructed ostium. Predisposing conditions include previous trauma, surgery, tumours, anatomical abnormalities, and chronic...