Search

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 Dec/Jan 2023

History A 35-year-old female presented to the emergency eye clinic with an acutely red, painful, photophobic left eye. She was a contact lens-wearer but denied swimming, showering, or sleeping in her lenses. She resided on a farm and worked as...

Quiz Feb/Mar 2024

History A 21-month-old boy presented to his local ophthalmology department with a left proptotic eye from a growing cystic lesion known to be present from birth. Notes taken on presentation were: Known left microphthalmia with chorio-retinal coloboma, contralateral eye was...

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...

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...

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...

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...

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...

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...

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....