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Comparison of bupivacaine injection vs. mini-tenotomy for small angle deviations

Bupivacaine hydrochloride is an aminoacyltype local anaesthetic. Injection into extraocular muscles elicits a myotoxic response destroying striated muscle fibres but sparing satellite cells, nerves and vessels. Preserved satellite cells proliferate to form new muscle fibres, causing muscle hypertrophy and greater...

“Beware of the pigment”

Using some captivating artwork, Iheukwumere Duru describes key features of pigment dispersion syndrome. Pigmentary dispersion syndrome (PDS) leads to pigmentary glaucoma (PG) in approximately 35-50% of patients with the condition [1]. PG is the leading cause of non-traumatic blindness in...

Measuring patient-reported outcomes after refractive surgery to assess patient satisfaction

Patient-reported outcomes enable surgeons to evaluate patients’ symptoms and satisfaction after laser vision correction. The great majority of patients are pleased with their outcomes from laser vision correction, whether it is with photorefractive keratectomy, laser in-situ keratomileusis (LASIK), or small...

Closed-chamber haptic re-externalisation for posteriorly displaced sclerotomy and inadequate haptic tuck in glued posterior chamber intraocular lenses

This technique (online video http://jcrsjournal.org) emphasises the importance of both symmetrical and sufficient anterior placement of sclerotomies to externalise an adequate length of the haptics, which in turn provides good centration and stability of the intra-ocular lens (IOL). The authors...

Oct/Nov 2017 Quiz

History A 73-year-old man presented with a rapidly growing left lower eyelid lump with recent bleeding. On examination there was a raised, ulcerated, firm mass occupying two thirds of his lower eyelid. The lesion bled easily and appeared connected to...

Aug/Sep 2017 Quiz

History A seven-year-old atopic boy has been treated for phlyctenulosis with mild topical steroids. However, he developed dramatic changes at the right limbus in two weeks. He also had past history of vernal keratoconjunctivitis (VKC) with poor compliance to treatment....

Apr/May 2017 Quiz

History A five-month-old baby was seen in clinic with bilateral congenital corneal opacities. The right cornea is shown in Figure 1. Figure 1. Examination revealed corneal oedema and opacities of Descemet’s membrane and endothelium with a few vesicular lesions. Corneal...

Oct/Nov 2019 Quiz

History A 62-year-old female patient was referred for rapid growth of a left periorbital soft tissue lesion with proptosis. Her past medical history included: hypertension, hyperlipidaemia and bipolar disorder. On examination: vision in the affected eye was hand movements, right...

Quiz Dec/Jan 2020

History A 69-year-old female patient was referred to the uveitis clinic from her local district general hospital with a left posterior uveitis which had been unresponsive to high dose steroids. She had no other previous ophthalmic history nor significant systems...

Quiz Feb/Mar 2024

History A 21-month-old boy presented to his local ophthalmology department with a left proptotic eye from a growing cystic lesion known to be present from birth. Notes taken on presentation were: Known left microphthalmia with chorio-retinal coloboma, contralateral eye was...

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...

Cyanoacrylate nail glue accidentally instilled into the eye instead of eye drops

Three hundred thousand cataract operations take place each year in the UK alone and each patient will receive a four week course of drops in order to cover them for any postoperative inflammation or infection. Accidental instillation of cyanoacrylate glue...