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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....

Step-by-step guide to mastering skills with the Goldmann applanation tonometer

Ophthalmology is a highly specialised field that requires proficiency in various diagnostic skills for numerous conditions. Entrants into ophthalmology at ST1 often possess minimal to no ophthalmic experience beyond what they learned in medical school. Consequently, they may face significant...

Acanthaemoeba keratitis

In the second of this series I describe a case of Acanthaemoeba keratitis (AK) that was misdiagnosed for a prolonged period which resulted in a devastating outcome. This is one of half a dozen similar medico-legal cases I have dealt...

Hydroxychloroquine toxicity

Being the subject of litigation is stressful and upsetting. Having to look back over your previous decisions and justify the care you delivered in good faith can be difficult. Sadly, we all live with the Sword of Damocles above us...

The results of the last survey Feb21

Once again, I am grateful for the responses and read the results with interest. I am always surprised by the amount of practice variation I see. I fully accept there is art in what we do and there is no...

The blue-light hazard – is it true?

Simerdip Kaur takes a look at the latest ophthalmology-related news stories and asks which are based on facts and which are ‘fake news’. Headline: The blue-light hazard – is it true? Blue light is part of the visible optical spectrum...

Doctor prints cornea on demand!

Simerdip Kaur takes a look at the latest ophthalmology-related news stories and asks which are based on facts and which are ‘fake news’. Headline: Doctor prints cornea on demand! Dr Hideo Kodama from the Nagoya Municipal Industrial Research Institute first...

Disseminated cutaneous zoster – a masquerade

Reactivation of varicella zoster infection in the elderly commonly presents to ophthalmologists as herpes zoster ophthalmicus (HZO), affecting the Va trigeminal dermatome. In patients with impaired immunity, zoster infection occurs with increased severity and may be complicated by visceral and...

A case of late spontaneous subluxation of in-the-bag intraocular implant

An 82-year-old frail lady was referred by her optometrist with a finding of subluxated implant in the right eye. She had uneventful phacoemulcification with in-the-bag intraocular implant 17 years earlier. There is no history of having had pseudoexfoliation (PXF) or...

An unusual case of silicone oil in the anterior chamber simulating intraocular implant

Silicone oil internal tamponade has been used for over 50 years, even prior to pars plana vitrectomy [1].Over a course of time silicone oil may migrate to the anterior chamber through the pupil. This may disperse in the form of...

Fundus photography in Malawi – setting up a screening programmefor diabetic retinopathy

We present the case of a 53-year-old lady who presented to the diabetes outpatient clinic at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. She was diagnosed with type 2 diabetes mellitus six years ago, for which she takes metformin orally. She...