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Apr/May 2018 Quiz

History A 57-year-old lady presents with a right subconjunctival lesion which has been increasing in size for three months (Figure 1). She has never had vision problems other than presbyopia. Past medical history: hypertension and asthma. On examination, she had...

Aug/Sep 2014 Quiz 1

History A 50-year-old female with a history of smoking, weight loss and cough presents to the ophthalmology clinic with a distorted pupil. Examination reveals a mass on the surface and within the iris (see Figure 1). The ophthalmologists decide to...

Jun/Jul 2014 Quiz

History An 80-year-old male had a cataract removed with intraocular lens (IOL) seven years previous. He presented with cloudy vision and it was noted that the IOL was intrinsically opaque. The IOL was replaced and sent for ophthalmic pathology assessment....

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...

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...

The results of the last survey Apr21

There was a really fascinating response to the last edition’s practice variance survey. Strictly speaking, I cheated and this was not really about practice variation, but more about your impressions about what represents negligent practice. For the first time ever,...

Paraproteinaemia: a patient with atypical corneal findings

A Bence Jones protein is a monoclonal globulin protein or immunoglobulin light chain found in the urine, with a molecular weight of 22-24 kDa [1]. Detection of Bence Jones protein may be suggestive of multiple myeloma or Waldenström’s macroglobulinemia. Multiple...

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...

Like a moth to AC flare: CMV-associated hypertensive anterior uveitis

Hypertensive anterior uveitis can present a diagnostic challenge to clinicians working in emergency eye departments. While prompt initial control of intraocular pressure (IOP) and inflammation is essential, elucidating the underlying aetiology is critical for long-term visual outcomes. When there is...