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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...

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...

How does your practice compare?

One of the lovely things about clinical meetings and conferences is the ability to meet with your peers and ask questions of them about their practice. Often the questions are not earth shattering, for example, it could be as simple...

The results of the last survey Aug24

In the first case we were faced with a 55-year-old patient with narrow, potentially occludable drainage angles, no significant cataract, and persistently raised intraocular pressures (IOPs) of 28mmHg with early disc compromise, and normal vision in each eye. It is...

A curry a day could keep the ophthalmologist away

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: A curry a day could keep the ophthalmologist away The dietary supplement market is a multibillion-dollar...

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 single intravitreal bevacizumab in the treatment of breast carcinoma related choroidal metastasis

Case report Choroidal metastasis represents a common form of intraocular malignancies occurring in up to 10% of patients with systemic metastasis [1]. The most common primary sites of ocular metastasis are breast carcinoma in women and lung carcinoma in men,...

Cortical blindness

Cortical blindness is a rare but recognised entity. Cerebrovascular accident is a well-known risk factor. We report a case of an 84-year-old lady with bilateral cortical blindness with multiple cardiovascular risk factors. Case report An 84-year-old lady was admitted under...

Choroidal melanoma – breaking bad news

Case report A 55-year-old Caucasian female presented to her general practitioner with a three-month history of headaches and worsening blurred vision in the left eye. On further close questioning, she reported no eye pain, intermittent floaters and flashes of light...

Traumatic ‘toy’ gun injury leading to permanent vision loss

Pseudoxanthoma elasticum (PXE) is a progressive, inherited disorder of connective tissue that affects the skin, cardiovascular system and retina. Ocular manifestations of the disease are related to Bruch’s membrane, a thin elastic tissue layer located between the retinal pigment epithelium...

Usefulness of gonioscopy to investigate cause of corneal oedema after cataract surgery

A 72-year-old man with ocular hypertension presented three months after routine right phacoemulsification and toric intraocular lens (IOL) implantation with a two-week history of an irritated right eye and a sudden deterioration in right vision. His preoperative spherical equivalence was...

The madarosis mystery: unravelling the clues to a host of health issues

Eyelash madarosis is a medical condition characterised by the loss of eyelashes caused by the destruction of hair follicles. It can range from a few missing lashes to a complete absence of lashes on the eyelids. This condition can be...