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Acute dellen formation post trauma

Corneal dellen are saucer-like thinnings, usually of the peripheral cornea [1]. Dellen formation is thought to be related to localised tear film instability [2], specifically the absence of the mucin component of the tear film. Without the mucin layer, dry...

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...

Severe conjunctival cicatrisation secondary to chronic glaucoma therapy

The timing of glaucoma filteration surgery during the course of chronic progressive glaucoma remains a contentious issue amongst glaucoma specialists. The vast majority support the use of maximal medical treatment initially to achieve the target pressure. Surgical procedures are only...

Birdshot chorioretinopathy: an important differential

Birdshot chorioretinopathy (BSCR) is a relatively uncommon cause of posterior uveitis which often has a relapsing and remitting course [1,2]. We present a case which demonstrates how remission can be obtained for several years using cyclosporine. Case report A 44-year-old...

The challenge of chorioretinal folds in virtual eye clinics

Chorioretinal or choroidal folds are parallel striations involving the retina, retinal pigment epithelium (RPE), Bruch’s membrane, and inner choroid [1]. They can arise from compressive stress on these layers, and their presence often serves as a diagnostic marker for underlying...

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...

Trans-sinus endoscopic removal of retrobulbar air gun pellet within the orbital apex

Injuries to the eye have been widely reported in medical literature due to a variety of mechanisms causing significant morbidity and occasional unexpected mortality for the patient [1]. It is often wrongly assumed that air gun pellets lack this potential....

Presumed DALK stromal graft rejection following Covid-19 infection

Case report A 45-year-old healthy male patient with a past ocular history of keratoconus and right deep-anterior lamellar keratoplasty (DALK) graft performed 10 months prior, presented to our eye casualty clinic with a two-day history of right photophobia and epiphora....

Innovation update: key advances in eyecare transformation in the last year

Vishal Shah and his co-authors reflect on examples of innovation in eyecare delivery published in the last year and the implications for the future of eyecare services. The “new normal” is an overused phrase to describe extraordinary measures that have...

How good does my vision have to be to drive this thing? Visual standards for various occupations

We can all picture that moment in clinic: you are about to tell someone that they’re no longer legally able to drive, ready to deploy our ‘breaking bad news’ techniques. For some patients this may have been expected, or they...

Sclerochoroidal calcification masquerading as ocular malignancy

Case 1 A 68-year-old Caucasian gentleman was urgently referred to eye casualty by his optometrist after seeing an unusual incidental finding of protruding lesions from the retina, suspecting choroidal melanoma. He was asymptomatic and this was his first eye test...

“Herr Doktor, I can’t see but I am driving”

This 56-year-old lady was quite puzzling. With her own glasses and the pinhole she merely managed to see the 1.3 and 1.0 logMAR lines with her right and left eye, respectively (I am currently working in Germany again, so goodbye...