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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...

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....

Iris chafing from displaced single-piece acrylic IOL

A 74-year-old man had persistent 3+ cell one month following left eye cataract extraction, complicated by anterior capsular rent and zonular dialysis at 7 o’clock, with single-piece acrylic intraocular lens implantation (IOL) in the capsular bag. Figure 1: Haptic-like transillumination...

Triamcinolone (TA) deposits following subcutaneous injection to treat chalazion

Chalazia are chronic lipogranulomatous inflammations of the eyelid secondary to a blocked meibomian gland. Whilst most resolve spontaneously, certain chalazia warrant treatment. Options include incision and curettage (I&C), lesion excision, intralesional steroid injections, and botox injections [1]. I&C is usually...

Like a moth to AC flare: CMV-associated hypertensive anterior uveitis

Hypertensive anterior uveitis can present a diagnostic challenge to clinicians working in emergency eye departments. While prompt initial control of intraocular pressure (IOP) and inflammation is essential, elucidating the underlying aetiology is critical for long-term visual outcomes. When there is...

Deciphering dark retinal patches

We present a case of bilateral extensive dark without pressure (DWP) located outside the retinal vascular arcades in a young female. This retinal finding is benign but, in some instances, darkened retinal patches could be associated with potential sight-threatening conditions....

A pituitary tumour from 1927

The author shares a clinical case from Edinburgh Royal Infirmary’s archives. It is not often in the course of a clinical career that one gets the opportunity to review a patient who had been treated by a pioneer neurosurgeon some...

Ophtherminator 3 - Rise of the Machines

“Bring back life form, priority one, all other priorities are rescinded.” Film buffs will spot this as a chilling quote spoken by Ash (Ian Holm) from the classic sci-fi horror movie Alien (1979). Ash (spoiler alert) is a Hyperdyne Systems...

Deliberate darkness: The systematic weaponisation of blinding in global protests

As eyecare professionals, we spend our entire professional lives fighting to preserve light. We train to master the delicate microscopic topography of the cornea, the retina and the optic nerve, all with the objective of saving our patients from the...

White dot syndromes

It is fair to say that trainees and consultants who are not medical retina specialists are a bit scared of the so called retinal ‘white dot syndromes’. It is easy to understand why this is the case, as almost every...

“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...

More sensitive visual acuity test for age-related macular degeneration

Age-related macular degeneration (AMD) is the leading cause of blindness in the developed world. Primarily associated with ageing, genetic factors and lifestyle choices such as smoking also play a contributory role. Patients with early AMD, characterised by the development of...