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Immunoglobulin G4-related ophthalmic disease – what is it? (Part 2)

Part 2: Clinical presentation and treatment (see part 1 here) Introduction IgG4-related disease (IgG4-RD) is understood to have a vast clinicopathological spectrum; nearly every organ has had reported involvement. Similarly, IgG4-related ophthalmic disease (IgG4-ROD) is known to affect nearly every...

Jun/Jul 2017 Quiz

History A 57-year-old female patient presented with gradual painless diplopia over the last six months. Examination revealed restricted upward eye movements and 4mm proptosis which did not increase with Valsalva manoeuvre. Intraocular pressure was normal, no visual defects were noted,...

Apr/May 2014 Quiz 2

History A 29-year-old woman presented to the emergency department with a two week history of floaters and patchy peripheral visual field loss in the left eye (LE). She had no relevant medical history and she was not on any current...

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...

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...

Choroidal folds

Choroidal folds are undulations of the choroid, Bruch’s membrane and pigment epithelium, with wrinkling of the overlying retina. They may be idiopathic but can also be caused by a number of different conditions. Case report A 60-year-old male patient was...

A case of retinal cavernous haemangioma – don’t let it slip through the grapevine

We present a case of a seven-year-old male who presented to the emergency eye referral clinic with red eye. He was diagnosed and treated for allergic conjunctivitis, however, on clinic review, wide field retinal imaging was performed (as has been...

Neonatal hypoxic ischaemic encephalopathy with imaging abnormalities in the occipital lobe – how to counsel the parents

Case A baby boy, with a background of intrauterine growth restriction, was born at 37 weeks and three days gestation via forceps delivery. The baby was born in poor condition, with low heart rate, poor respiratory rate, poor colour and...

My Top Five: Ophthalmology TikTok accounts, educating and entertaining both the public and trainees

In the modern world, our electronic devices have now become an extension of ourselves, with our reliance and use of them of comparable importance to an arm or a leg. The importance of electronic devices can also be seen in...

My Top Five: Ophthalmology TikTok accounts, educating and entertaining both the public and trainees

In the modern world, our electronic devices have now become an extension of ourselves, with our reliance and use of them of comparable importance to an arm or a leg. The importance of electronic devices can also be seen in...

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...