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Oct/Nov 2014 Quiz

History 12-year-old cattle herder in Bangladesh. Loss of vision right eye – over 2/12 to no perception of light (NPL). B-scan showed choroidal thickening. Suspected to be choroidal ‘tumour’. Enucleated. Figure 1. Figure 2. Figure 3. Figure 4. Figure 5....

Feb/Mar 2014 Quiz 2

History A 65-year-old lady presented with a ten year history of nonspecific visual disturbance and mild symptoms of dry eyes. Questioning revealed progressive nyctalopia. Previous medical history of note included Crohn’s disease requiring two bowel resections including small intestine. Figure...

A practical guide to anisocoria

Anisocoria means the presence of difference in the size of the right and left pupils. It is a sign of an abnormality in the efferent pathway. The first question facing the ophthalmologist is to ascertain if anisocoria is present or...

Headaches in ophthalmology (part 1)

Ophthalmologists see a large number of patients with headaches or facial pain in the ophthalmic outpatient clinics or in emergency clinics. Over two articles, I will discuss several causes of headaches, ocular manifestations and proposed management and referral options. It...

Acute retinal necrosis presumably caused by Epstein-Barr virus infection

Acute retinal necrosis (ARN) is an uncommon, but serious and potentially blinding condition. ARN is characterised by panuveitis, occlusive vasculopathy and progressive peripheral necrotising retinitis. The diagnosis is clinical but confirmation is sought via aqueous and vitreous sampling. Varicella zoster...

Retinal arteriovenous malformation

A 24-year-old Caucasian girl reported to the eye clinic with the complaint of painless decreased vision in her right eye. She had no history of infectious disease, trauma, systemic malignancy or other systemic complaint. Her best corrected visual acuity was...

Ocular Dirofilariasis: a diagnosis on the rise?

Dirofilaria repens is one of 40 species of Dirofilaria. It is a zoonotic filarial nematode that commonly impacts dogs, however, human infection can occur through affected organs like skin, lung and eyes [1]. Although, there have been case reports of...

Cytomegalovirus retinitis post intravitreal triamcinolone in an immunocompetent patient with juvenile glaucoma

Figure 1: Fundus photograph shows active CMV retinitis four weeks after IVTA in the right eye. Figure 2: Fundus photograph of the left eye with no CMV retinitis; atrophic disc as a result of juvenile glaucoma. Case report A 29-year-old...

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...

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....

The paediatric cataract: an overview of the diagnosis and management

In this second article (see first article here), Samuel Aryee and Rhys Dumont Jones review the challenges involved in managing this condition. Examination and diagnosis Cataracts in children can appear in a variety of forms, each presenting in a different...

Strange Sequelae Succeeding ‘Surfer’s Eye’

Ophthalmologists in the UK are relatively infrequently faced with a patient requesting surgery for a pterygium. This condition is more common where ultraviolet exposure is greater, especially if coupled with activities associated with ocular surface irritation. For this reason, a...