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A practical guide to anisocoria

Anisocoria means the presence of difference in the size of the right and left pupils. It is a sign of an abnormality in the efferent pathway. The first question facing the ophthalmologist is to ascertain if anisocoria is present or...

Headaches in ophthalmology (part 1)

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...

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...

The results of the last survey Apr 2020

As ever, I would like to thank all those who participated in the last edition’s survey. A lot of data was generated and I do not intend to go through each individual finding. What is staggering again is the degree...

Global health and conflict: the unseen consequences

Global eye health inequalities stem from poor access to affordable care, causing preventative vision impairment and blindness. In 2020, a study showed that 510 million people, the majority being in low-income and middle-income countries, had uncorrected near vision impairment simply...

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...

External dacryocystorhinostomy in the management of childhood epiphora

Congenital nasolacrimal duct obstruction is thought to be caused by a membranous obstruction at the distal end of the nasolacrimal duct (NLD). Rarely, associated midline deformities in soft tissue and bony structures of the face are present in patients with...

Friendly felines and a spot diagnosis

A nine-year-old girl presented to me in eye casualty with a three-week history of blurred vision in her left eye. Otherwise she was apparently well, with no past ophthalmic, medical, drug or relevant family history. Visual acuity was 6/4 right...