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Orbital airgun pellet injuries: A paediatric case pair

Airgun injuries to the eye and orbit can be visually devastating. The pellet need not impact the globe directly to cause visual loss, as the cone shaped orbit may funnel the projectile into the orbital apex and optic nerve. We...

End stage glaucoma management

A 48-year-old female has had multiple drug treatment for glaucoma and is still losing field of vision. How do you manage this over time? This patient is at high-risk for going blind and should be managed aggressively to protect remaining...

It’s not always GCA

Giant cell arteritis (GCA) is an immune mediated granulomatous inflammatory disease that affects muscular middle or large sized arteries. It is considered as a continuation of polymyalgia rheumatica (PMR) when the severity of the disease has increased. It is the...

Traumatic optic neuropathy

In neuro-ophthalmology we get asked a lot about management of patients who suffered significant trauma and presented with loss of vision secondary to presumed traumatic optic neuropathy (TON). TON happens usually in the context of significant craniofacial trauma. The incidence...

Myopia-related strabismus – heavy eye syndrome

Introduction Myopia can be associated with any type of strabismus, but high myopia has increased frequency of esotropia and vertical heterotropia. The incidence and severity of the strabismus increases with the degree of myopia and age of the patient. Classification...

What's trending Jun/Jul 2023

A round-up of the eye-related hot topics that have been trending on social media over the last few weeks. #whoopigoldberg #presbyopia #bionic Whoopi Goldberg made a name for herself in blockbusters such as the Oscar-winning Ghost and Sister Act. She...

Microcatheter in the vertebral artery as a cause of branched retinal artery occlusion?

A 19-year-old male presented to eye casualty with a seven-day history of a ‘blurred patch’ in the left eye. The patient denied any other visual symptoms including flashes or floaters and there had been no change in visual symptoms in...

Trans-sinus endoscopic removal of retrobulbar air gun pellet within the orbital apex

Injuries to the eye have been widely reported in medical literature due to a variety of mechanisms causing significant morbidity and occasional unexpected mortality for the patient [1]. It is often wrongly assumed that air gun pellets lack this potential....

Oculogyric crisis with B12 deficiency

An oculogyric crisis (OGC) is a dystonic movement disorder of the eyes which can last from seconds to hours. Although there is no published diagnostic criteria for OGC, typically the onset is acute, and it is characterised by conjugate upward...

Transferring imaging from primary to secondary care (part 2)

Transferring clinical imaging from high street optometrists to secondary care is an increasingly requested option, especially in the context of the COVID-19 pandemic. A wide variety of solutions exist to allow this, each with their own merits and shortcomings. In...

Optic nerve swelling – your survival guide (part 2)

In this second article we will discuss bilateral optic nerve swelling, its aetiology, various investigations and possible treatments. We will also discuss various protocols used in the management of suspected optic nerve swelling cases. (Part one of this topic available...

Papilloedema: an update

Some readers may have seen a recent report in the national newspapers of the case of a teenage girl with persistent severe headache associated with a fatal brain tumour having been undiagnosed despite many consultations with her medical advisers. It...