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A closed angle seldom comes alone

Case report An 89-year-old lady with dementia was referred to me out of hours by her GP with a few days history of an angry looking left eye for suspected elevated intraocular pressure (IOP). I discovered that this lady first...

In vivo confocal microscopy, principles and use in keratitis Part 1: Principles

In 1968 Maurice introduced the concept of high powered specular microscopy, it was in that very year that the first scanning confocal microscope was proposed. Marvin Minsky developed the first confocal microscope in 1955 named the ‘double focusing scanning microscope’....

Emerging developments in dry eye

An estimated 344 million people worldwide suffer from dry eye [1]. This chronic syndrome is characterised by a vicious cycle of tear film hyperosmolarity, tear instability and corneal stress, leading to increased friction, inflammation, ocular surface damage and decreased visual...

Headaches in ophthalmology (part 2)

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...

Correlation between aqueous flare and macular microvascular status in diabetes mellitus

The authors report a cross-sectional study which was conducted to investigate the correlation between aqueous flare and macular microvascular status, assessed by optic coherence tomography angiography (OCTA) in diabetes mellitus. Fifty-two diabetic patients with non-proliferative retinopathy, 44 diabetic patients without...

Fifteen-year results of phakic artisan IOL for hyperopia correction

This retrospective review of a cohort of 61 eyes from 32 patients offers long-term results for phakic Artisan (Ophtec BV) iris-fixated phakic IOL (IF-pIOL). The mean age at surgery was 41.6 years with a range of 25-59 years. Refractive outcomes...

The use of adalimumab for relapse in patients with Vogt-Koyanagi-Harada disease

In this retrospective, multi-centre, cohort study, the efficacy and safety of Adalimumab (ADA) treatment for the exacerbation or recurrence of Vogt-Koyanagi-Harada (VKH) patients was assessed by investigating the medical records of patients who had received ADA treatment for more than...

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...

Blinking blepharitis has a lot to answer for…

Never ignore the small things’…someone once said. There is no doubt blepharitis is one of the most common eye conditions encountered daily, but with the typical pressures of a busy outpatient department, the management of more obvious, sight-threatening conditions necessarily...

Cavernous sinus syndrome

Anatomically the cavernous sinus is a plexus of multiple veins that are connected and within this plexus there are several important vascular and neurological structures. These include cranial nerves III, IV, V1 (and sometimes V2), VI as well as the...

A step-by-step approach to the diagnosis and management of Sands of Sahara Syndrome

Sands of Sahara syndrome (diffuse lamellar keratitis) is a rare postoperative complication of Laser in situ keratomileusis (LASIK). Its estimated prevalence is reported to be 2-4% among LASIK cases [1], despite that, it is more likely to be encountered by...

Ciliary body granuloma masquerading as a melanoma

Introduction Sarcoidosis is a multisystem granulomatous inflammatory condition which predominantly affects the pulmonary system and intrathoracic lymph nodes, followed by ocular involvement [1]. We present an interesting patient who developed acute anterior uveitis and subsequent ciliary body granuloma clinically mimicking...