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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...

Internuclear ophthalmoplegia: a case study

A 44-year-old patient presents with binocular, mostly horizontal diplopia when fixating on moving objects. This has been ongoing for approximately five years. He is known to have multiple sclerosis and had an episode of optic neuritis six years prior in...

Cataract surgery in uveitis patients

Cataract formation is a common complication of uveitis, causing up to 40% of vision loss in these patients. Cataract results from inflammation +/- corticosteroid therapy and is usually posterior subcapsular, but a small proportion have a rapid increase in nuclear...

Unilateral central scotoma following dengue fever

Case report A 16-year-old Caucasian male was referred to the eye casualty at Nottingham University Hospitals NHS Trust by the infectious diseases unit in September 2013. He gave a history of photophobia, pain on eye movements and central blurred vision...

Apr/May 2014 Quiz 2

History A 29-year-old woman presented to the emergency department with a two week history of floaters and patchy peripheral visual field loss in the left eye (LE). She had no relevant medical history and she was not on any current...

Acute dacryoadenitis secondary to COVID-19

Acute dacryoadenitis is defined as the rapid onset of discomfort and swelling of the lacrimal gland, classically giving rise to an S-shaped ptosis [1]. Dacryoadenitis is the most common cause of a painful mass in the lacrimal gland in young...

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...

Demyelinating optic neuropathy

Introduction Optic neuritis (ON) is an inflammatory process affecting the optic nerve. After glaucoma, it is the most common optic neuropathy affecting patients under the age of 50. The usual presentation of typical ON is unilateral subacute loss of vision...

Ciliary body granuloma masquerading as a melanoma

Introduction Sarcoidosis is a multisystem granulomatous inflammatory condition which predominantly affects the pulmonary system and intrathoracic lymph nodes, followed by ocular involvement [1]. We present an interesting patient who developed acute anterior uveitis and subsequent ciliary body granuloma clinically mimicking...

Typical or surprisingly uncharacteristic presentations of neuro-ophthalmic emergencies

Irrespective of geographical location or patient cohort, emergency departments are high risk locations capable of inspiring extreme anxiety and dread in patients and doctors alike. The stress multiplies when a walk-in or referred case is suspected of underlying neurological pathology....

Aqueous misdirection: a case series of unexpected surgical complications

Aqueous misdirection (AM), also known as malignant glaucoma, is a form of secondary glaucoma that typically presents with shallowing of the anterior chamber (AC), raised intraocular pressure (IOP), and reduced visual acuity (VA) in the presence of patent peripheral iridotomies...

Lessons from an unusual case of syphilis

The rise of syphilis transmission rates over the past two decades has been one of public health’s great puzzles. In the UK, the situation has reached epidemic levels, with a 126% increase between 2013 and 2018 [1]. We present a...