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Aug/Sep 2015 Quiz 1

History A 60-year-old woman was referred to ophthalmology with a suspected left eye choroidal naevus. Visual acuity was unaffected in both eyes and she was asymptomatic. Ocular history and medical history were unremarkable. Questions Figure 1: Fundus photograph. 1. What...

Traumatic ‘toy’ gun injury leading to permanent vision loss

Pseudoxanthoma elasticum (PXE) is a progressive, inherited disorder of connective tissue that affects the skin, cardiovascular system and retina. Ocular manifestations of the disease are related to Bruch’s membrane, a thin elastic tissue layer located between the retinal pigment epithelium...

Ocular toxicity secondary to deferoxamine

Patients with myelodysplastic syndromes can develop transfusion-related iron overload as they become dependent on recurrent blood transfusions [1]. Iron chelation therapy is indicated for the treatment of iron overload and one established example of this is deferoxamine. However, deferoxamine ocular...

25 years of OCT

David Huang first described optical coherence tomography (OCT) in 1991, in his seminal paper on the subject in Science. This method developed the work of others on ophthalmic interferometry, which essentially showed that measuring reflected light could be used to...

More sensitive visual acuity test for age-related macular degeneration

Age-related macular degeneration (AMD) is the leading cause of blindness in the developed world. Primarily associated with ageing, genetic factors and lifestyle choices such as smoking also play a contributory role. Patients with early AMD, characterised by the development of...

Effect of minor trauma in eyes with previously undiagnosed angioid streaks

Angioid streaks (AS) may be associated with pseudoxanthoma elasticum (PXE), Paget’s disease, haemoglobulinopathies, Ehlers-Danlos Syndrome or abetalipoproteinaemia. Histopathology showed retinal pigment epithelium (RPE) and choriocapillaris loss, elastic fibre degeneration, calcium deposition, active choroidal neovascular membrane (CNVM) and vascular endothelial growth...

Conventional vs. accelerated cross-linking

The Dresden protocol of 3mW/cm2 irradiance for 30 minutes has been extensively studied and has shown advantageous clinical and topographical results. However, this protocol is time-consuming and therefore accelerated CXL using higher irradiance to shorten treatment duration has emerged. The...

High-fluence collagen cross-linking

The authors treat seven eyes with progressive keratoconus with a high energy (18mW) for five minutes delivering a total energy similar to that suggested by the original Dresden protocol (3mW for 30mins). All eyes had a thickness >400µm following epithelial...

Where along the vergence pathway is affected by Parkinson’s Disease?

The authors outlined three hypothesis for the effect Parkinson’s Disease has on blur- and disparity-driven vergence with reference to location within the vergence system that is affected to be tested in this prospective study. The study recruited 14 participants with...

Outcomes of corneal cross-linking in paediatric patients compared to fellow untreated eyes

This retrospective cohort study evaluated long-term visual, refractive, topographic and safety outcomes of corneal cross-linking (CXL) in patients younger than 18-years-old with keratoconus. The study included all consecutive paediatric patients who underwent epithelium-off CXL treatment for keratoconus at the study...

Caring for adults with an ocular tumour

Detection If you screen for an intraocular tumour, dilate the pupil. If the patient is driving, use phenylephrine only. If the patient declines, document this in the casenotes. Don’t forget to look for sentinel vessels, which would indicate a ciliary...

Discussing treatment modalities for bilateral wet AMD

A 65-year-old lady with bilateral wet AMD and vision of 6/24 comes with an internet search about current therapies. How do you explain the various treatment modalities available? There are two NICE approved treatments for wet age-related macular degeneration (AMD)....