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Aug/Sep 2014 Quiz 1

History A 50-year-old female with a history of smoking, weight loss and cough presents to the ophthalmology clinic with a distorted pupil. Examination reveals a mass on the surface and within the iris (see Figure 1). The ophthalmologists decide to...

Quiz Aug/Sep 2022

History A 58-year-old female patient was referred with a 2-year history, gradually enlarging, painless left upper lid lump. There was no bleeding or ulceration. She had no other eye symptoms and no other skin lesions. Her past medical history included:...

Quiz Oct/Nov 2024

History An 83-year-old female was previously treated by surgical excision and plaque brachytherapy for her left conjunctival lesion. She presented to her ophthalmologist with a recurrence some years later and underwent a lid sparing orbital exenteration, which was sent to...

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...

Paraproteinaemia: a patient with atypical corneal findings

A Bence Jones protein is a monoclonal globulin protein or immunoglobulin light chain found in the urine, with a molecular weight of 22-24 kDa [1]. Detection of Bence Jones protein may be suggestive of multiple myeloma or Waldenström’s macroglobulinemia. Multiple...

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...

An unusual presentation of sarcoidosis

*Equally contributing co-first authors. Case report A 45-year-old man presented to his local optometrist with a three-week history of severe intermittent left eye pain with associated blurred vision and tenderness around his left temple. Two days prior, he developed weakness...

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...

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...