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Apr/May 2019 Quiz

History A 68-year-old female patient was referred from her GP with bilateral conjunctival lesions on her upper eyelids which cause local irritation and dry eyes. Her past ophthalmic history is uneventful. However, systemically she has history of high blood pressure...

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...

Quiz Oct/Nov 2022

History An Afro-Caribbean woman, aged 30, with “scleral tattooing” for cosmetic reasons (subconjunctival dye injection), presented with bilateral upper and lower eyelid oedema for one week, and she also had restricted eye movement and blurry vision in her right eye....

Quiz Dec/Jan 2023

History A 35-year-old female presented to the emergency eye clinic with an acutely red, painful, photophobic left eye. She was a contact lens-wearer but denied swimming, showering, or sleeping in her lenses. She resided on a farm and worked as...

Quiz Jun/Jul 2024

History A one-year-old girl originally presented with a red eye, initially bilaterally and later in the left only. On examination a membrane was found on the tarsal conjunctiva of the upper eyelid (Figure 1). Figure 1: Anterior segment. Serum plasminogen...

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...

Third nerve palsy

Case scenarios A 71-year-old female presented to a nearby eye emergency unit with two days history of partial ptosis in her left eye with diplopia. She saw her GP earlier that day and he asked her to go to the...

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...

Managing cataract surgery in a patient with diabetic maculopathy

A 56-year-old type 2 diabetic with previously treated bilateral diabetic maculopathy develops a cataract requiring surgery in the right eye. He has had grid laser previously, followed intermittently by intravitreal triamcinalone, Avastin and more recently Lucentis in both eyes. His...

Managing a dislocated intraocular lens

A 70-year-old male patient is referred from the optician with a history of onset of double vision and examination shows a dislocated / subluxated IOL. How will you manage this patient? If the double vision is causing serious concern to...

Ophthalmology in the COVID-19 pandemic

The novel coronavirus pandemic has affected the whole world and forced all of us to think of new ways to manage our day to day personal as well as professional life. I am not going to talk about the clinical...

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....