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Aug/Sep 2014 Quiz 2

History A 27-year-old man presented to the emergency department with blurred vision and central scotoma in the right eye (RE) over the previous weeks. He had no relevant medical history and he was not on any current medication. However, he...

Managing a patient with ptosis

A 50-year-old male patient is referred from the Accident & Emergency department with a history of ptosis. How will you manage this patient? Mr Bertie Fernando Clinical management Clinical management starts with a sound clinical history. Current history The history...

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...

Systemic sarcoidosis presenting with acute myopia and angle closure

Case report A 40-year-old Asian man presented to the Emergency Department with a one day history of sudden onset visual disturbance in his right eye. He complained of image distortion and noted that objects now appeared smaller. He also described...

An unusual case of acute retinal necrosis

Case report A 40-year-old Caucasian male presented with a four-day history of redness and progressive painless reduction of vision in the left eye. His visual acuities were 6/4 in the right and 6/36 in the left. The left eye showed...

A step-by-step approach to the diagnosis and management of Sands of Sahara Syndrome

Sands of Sahara syndrome (diffuse lamellar keratitis) is a rare postoperative complication of Laser in situ keratomileusis (LASIK). Its estimated prevalence is reported to be 2-4% among LASIK cases [1], despite that, it is more likely to be encountered by...

Photophobia: an unusual symptom of a pituitary macroadenoma

Introduction Photophobia, defined as ‘an abnormal intolerance to light’, is commonly associated with a range of both ocular and neurological pathologies such as dry eye, blepharospasm, corneal pathologies, cataracts, uveitis, retinal dystrophies, optic neuritis, migraine, meningitis, and traumatic brain injury...

Oculogyric crisis with B12 deficiency

An oculogyric crisis (OGC) is a dystonic movement disorder of the eyes which can last from seconds to hours. Although there is no published diagnostic criteria for OGC, typically the onset is acute, and it is characterised by conjugate upward...

The approach to angle-closure glaucoma

Further to my last article in Eye News (print issue) describing the diagnostic approaches to various clinical scenarios in glaucoma, the approach to angle-closure glaucoma (ACG), a situation terrifying for patient and registrar alike, will be discussed. Please refer to...