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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...

Feb/Mar 2014 Quiz 2

History A 65-year-old lady presented with a ten year history of nonspecific visual disturbance and mild symptoms of dry eyes. Questioning revealed progressive nyctalopia. Previous medical history of note included Crohn’s disease requiring two bowel resections including small intestine. Figure...

Dec/Jan 2019 Quiz

History A 72-year-old male presented to his GP with a large ulcerated lesion on his right lower eyelid present for six months and enlarging in size. He had an urgent referral to a tertiary centre for specialised examination. The lesion...

Feb/Mar 2019 Quiz

History A 31-year-old female patient presented with history of gradual downward displacement of the globe over the last six months. The superotemporal mass then became palpable (Figure 1). Lateral orbitotomy was performed following CT scans (Figure 2). Figure 1. Figure...

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...