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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 developing world

After the second year of medical school, I spent my summer vacation working as a volunteer for a small Italian non-government organisation (NGO), named HEALTH-AID. As part of my volunteering experience, I joined a team of European doctors, medical students...

EU: is it time to leave and embrace the world?

Should the United Kingdom remain a member of the European Union (EU) or leave? It’s a big decision involving some complex issues, and there’s no doubt the EU will continue to change. Ipsos MORI’s monthly EU voting intention poll published...

The invisible touch: a VISION 2020 LINK with Indonesia

Indonesia’s population, the world’s fourth largest, is spread across 6,000 inhabited islands. Whilst some areas (e.g. Kalimantan, Papua) are relatively sparsely populated, Java is the world’s most densely populated island, with twice the population of the UK in half the...

Cluster of cyclic esotropia cases

This study reports a series of five patients with cyclic esotropia presenting within a period of 19 months in 2015-16 in one institute. Brain MRI scans were abnormal in two patients (twins) with abnormal white matter signal in the frontal...

Headache: the clue is in the eyes

A worrying cause of headache is raised intracranial pressure (ICP). Papilloedema is a vital clue for accurate diagnosis and performing fundoscopy is essential in detecting this sign. The authors review the use of fundoscopy in their own district general hospital....

DTI/MRI results in amblyopia

Diffusion tensor imaging (DTI) is an MRI technique that can evaluate white matter integrity and neuronal connectivity. Normal brain maturation and myelination are associated with reduced water diffusion and increased diffusion anisotropy. The authors aimed to evaluate the anterior optic...

Ophthalmology

The textbook is a large, single volume that ideally needs to be desk or table-supported, as its sheer weight makes it virtually impossible to rest comfortably on ones lap. The book is compiled by its two lead authors and editors...

Pituitary tumours: why are they so often missed?

Part 3: Clinical features, assessment and management (see also Part 2, and Part 1) As previously mentioned in this treatise [1] pituitary tumours are common, occur in all age groups and can present with anything from minimal visual symptoms to...

Third nerve palsy following cataract surgery with sub-Tenon’s anaesthesia

Figure 1: Photograph showing partial ptosis of the right eye two months after surgery (photo by R McLeod). An 83-year-old lady had routine right eye cataract surgery under uncomplicated sub-Tenon’s anaesthesia. She presented two weeks later, explaining that following the...

Unilateral central scotoma following dengue fever

Case report A 16-year-old Caucasian male was referred to the eye casualty at Nottingham University Hospitals NHS Trust by the infectious diseases unit in September 2013. He gave a history of photophobia, pain on eye movements and central blurred vision...

Principles of management

Whatever section of pathology is to blame and wherever it strikes, the aim of treatment is always the same. Find the cause if you can. Establish the effects of the cause. Halt the pathological process if you can. Reverse its...