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A paediatric case of central retinal artery occlusion following antibiotics and decompression surgery for orbital cellulitis

Orbital cellulitis is an ophthalmic emergency that warrants urgent management in the hospital setting [1]. This occurs more frequently in the paediatric population where it is often secondary to sinus infections. Delay in treatment could result in severe complications including...

The assessment of pupils and 
pupillary reactions

Understanding pupillary reactions is vital in understanding basic neuro-opthalmology. It is a skill required in eye casualty, clinics and perhaps most importantly, exams. To start at the beginning, the pupil is the central aperture of the iris, its size controlling...

What not to miss in neuro-ophthalmology Part 1

Neuro-ophthalmology is a complex and difficult subspecialty in ophthalmology. It has several connections to neurology, neuro-surgery, rheumatology as well as many other medical specialties. Working in an multidisciplinary team (MDT) environment is key to success in this subspecialty as mistakes...

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....

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...

Proning and the pandemic - ocular complications seen in critical care

Priyanka Sanghi and her co-authors explore the ocular complications seen in critical care units throughout the country as we treat patients through this challenging time. The SARS-Cov-2 (COVID-19) pandemic has placed the NHS and critical care services under immense strain,...

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....

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...

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...

Don’t ignore the black lesion! It might be mucormycosis

Keeping mucormycosis infection in the foreground of your differential diagnosis, especially in those more vulnerable patients, will help save their lives if recognised and managed appropriately. Mucormycosis is a fulminant infection caused by the fungi of the family Mucoraceae. It...