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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 Feb/Mar 2024

History A 21-month-old boy presented to his local ophthalmology department with a left proptotic eye from a growing cystic lesion known to be present from birth. Notes taken on presentation were: Known left microphthalmia with chorio-retinal coloboma, contralateral eye was...

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...

Acute uveitis from late migration of soft lens matter 10 years post cataract surgery

A 58-year-old Caucasian male presented to the emergency eye clinic with a two-day history of a painful, red left eye and blurred vision. His past ocular history included uncomplicated left phacoemulsification cataract surgery in 2010 and left retinal detachment repair...

Iris chafing from displaced single-piece acrylic IOL

A 74-year-old man had persistent 3+ cell one month following left eye cataract extraction, complicated by anterior capsular rent and zonular dialysis at 7 o’clock, with single-piece acrylic intraocular lens implantation (IOL) in the capsular bag. Figure 1: Haptic-like transillumination...

A rare neonatal presentation of bilateral dacryocele and choanal atresia

Following a routine pregnancy, a newly delivered baby boy, born at term, was found to have increased work of breathing, stridor and a left medial canthal swelling. The baby required 100% oxygen via a face mask to maintain oxygen saturations....

Usefulness of gonioscopy to investigate cause of corneal oedema after cataract surgery

A 72-year-old man with ocular hypertension presented three months after routine right phacoemulsification and toric intraocular lens (IOL) implantation with a two-week history of an irritated right eye and a sudden deterioration in right vision. His preoperative spherical equivalence was...

Smart speakers: for patients and practitioners

Many readers will have experience of using smart speakers, such as the Amazon Echo or the Google Home. These popular devices are inexpensive and powerful. In brief, smart speakers listen for a spoken trigger word, followed by verbal commands. Commands...

The COVID-19 ‘frontlines’: a foundation doctor’s perspective

Staring through the fragmented stained glass of the Virgin Mary and her assorted angels, I reflected on the strangeness of the workplace I now found myself working in and the irony of a workforce now working together more enthusiastically than...

Strabismus and ocular motility, demystified

I am a former orthoptist, now trained in medicine and working as a foundation doctor. In my previous work, I was frequently approached by ophthalmology trainees eager for guidance with strabismus and ocular motility. Drawing on my clinical experience, I...

Supranuclear ocular motility disorders

Figure 1: Bilateral INO Introduction Complex ocular motility disorders are a diagnostic challenge. These patients come with very complex ocular motility presentations and require a careful and detailed assessment in order to find the correct diagnosis and arrange appropriate investigations....

Myopia-related strabismus – heavy eye syndrome

Introduction Myopia can be associated with any type of strabismus, but high myopia has increased frequency of esotropia and vertical heterotropia. The incidence and severity of the strabismus increases with the degree of myopia and age of the patient. Classification...