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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...

Step-by-step guide to mastering skills with the Goldmann applanation tonometer

Ophthalmology is a highly specialised field that requires proficiency in various diagnostic skills for numerous conditions. Entrants into ophthalmology at ST1 often possess minimal to no ophthalmic experience beyond what they learned in medical school. Consequently, they may face significant...

The results of the last survey Oct20

The point of this series is to find variations in practice and to raise them to you, the readership, so you can review and reflect upon them. I am aware there is not always a ‘correct’ way of doing things,...

The results of the last survey Jun23

*Please be aware that this data does not form part of a peer reviewed research study. The information therein should not be relied upon for clinical purposes but instead used as a guide for clinical practice and reflection. I continue...

The results of the last survey Aug24

In the first case we were faced with a 55-year-old patient with narrow, potentially occludable drainage angles, no significant cataract, and persistently raised intraocular pressures (IOPs) of 28mmHg with early disc compromise, and normal vision in each eye. It is...

A refractive surprise after vitrectomy and capsulectomy

Figure 1: Right posterior capsule small aperture. We report a case of a pseudophakic patient who underwent vitrectomy and posterior capsulectomy. In spite of good visual acuity and absence of floaters, he was unhappy with the visual outcome. Case report...

Refractive surprise after cataract surgery caused by posterior capsular striae

Cataract removal with intraocular lens (IOL) implantation is one of the most frequently performed surgeries in current clinical practice [1,2]. New microsurgical techniques and refined IOL power calculations allow excellent refractive outcomes. Refractive surprise following cataract surgery is uncommon [1-3]...

Macular imagery: observing the visual sensations pre- and post-Jetrea injections

A 63-year-old woman, a professional painter, was diagnosed with vitreomacular traction (VMT) in 2017. She had a history of metamorphopsia, drop in visual acuity (VA) in the left eye (6/6 in the RE; 6/18 in the LE), foveal vitreomacular traction...

Syringocystadenoma papilliferum in the right lateral canthus

Syringocystadenoma papilliferum (SP) is an exceedingly rare, benign adnexal tumour primarily affecting the skin. It is characterised by the presence of cystic structures and papillary projections. This uncommon dermatological condition is typically found in areas rich in apocrine glands, such...

An arm and a leg

“It cost me an arm and a leg.” – Mr B told me. An arm and a leg to be seen by the famous Russian eye surgeon who said that everybody can be spectacle-free. He took Mr B’s money (roughly...

On the wrong track

A 65-year-old very high myope lady presented with sudden blurred vision down to count fingers to her right eye after a short and sharp pain. She also described seeing a black swirly line and as all these symptoms were exactly...