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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...

Acute retinal necrosis presumably caused by Epstein-Barr virus infection

Acute retinal necrosis (ARN) is an uncommon, but serious and potentially blinding condition. ARN is characterised by panuveitis, occlusive vasculopathy and progressive peripheral necrotising retinitis. The diagnosis is clinical but confirmation is sought via aqueous and vitreous sampling. Varicella zoster...

Periorbital and subconjunctival emphysema - a sign of orbital rim fracture

Background Orbital emphysema is a condition where air is present in orbit or periorbital tissues [1]. It is most commonly caused by trauma leading to orbit fracture, where air from paranasal sinuses is allowed to enter the orbit. The most...

The most memorable patient encounters and what they taught me

In ophthalmology, some encounters blend quietly into the rhythm of clinic. Others stay with us, shaping how we practice and who we become as clinicians. These moments become the unexpected teachers of our training. They are subtle yet leave a...

Down with the sickness

There has been an epidemic of sick leave affecting the NHS generally and our department specifically, gradually increasing in severity over the past few years. The husband of our diabetic coordinator is a manager in the health board dealing with...