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Virtual COVID clinics

The clinics at Ystradgynlais Community Hospital are a little different of late. The nurses are still there, I still get tea with custard creams and the letters I dictate are still all written up by the next day. But there...

Cavernous sinus syndrome

Anatomically the cavernous sinus is a plexus of multiple veins that are connected and within this plexus there are several important vascular and neurological structures. These include cranial nerves III, IV, V1 (and sometimes V2), VI as well as the...

Supranuclear ocular motility disorders

Figure 1: Bilateral INO Introduction Complex ocular motility disorders are a diagnostic challenge. These patients come with very complex ocular motility presentations and require a careful and detailed assessment in order to find the correct diagnosis and arrange appropriate investigations....

Demyelinating optic neuropathy

Introduction Optic neuritis (ON) is an inflammatory process affecting the optic nerve. After glaucoma, it is the most common optic neuropathy affecting patients under the age of 50. The usual presentation of typical ON is unilateral subacute loss of vision...

Bovine pericardium scleral patch graft associated scleritis: Ahmed valve implant for pupillary block glaucoma

Processed bovine pericardium is a lyophilised collagen sheet used as a surgical armamentarium. It renders the material antigenically inert with minimal inflammation [1]. Sclera patch pericardium graft (Tutopatch) is a collagenous membrane derived from solvent preserved, irradiated bovine pericardium [2]...

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...

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...

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...

A unique case of macular burn from ‘toy’ laser

The first laser was created in 1960 and its name is an acronym for ‘light amplification by stimulated emission of radiation’. Laser technology has been used for medical, industrial, research and entertainment purposes in a variety of fields following extensive...

Ciliary body granuloma masquerading as a melanoma

Introduction Sarcoidosis is a multisystem granulomatous inflammatory condition which predominantly affects the pulmonary system and intrathoracic lymph nodes, followed by ocular involvement [1]. We present an interesting patient who developed acute anterior uveitis and subsequent ciliary body granuloma clinically mimicking...

Behind the eyes: Unravelling the mystery of a painless progressive proptosis

Orbital fungal infections have the potential to give rise to serious complications. While these infections typically originate in the sinuses, patients may initially exhibit ocular symptoms. As a result of the diverse and often vague clinical manifestations (especially during the...