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Oct/Nov 2019 Quiz

History A 62-year-old female patient was referred for rapid growth of a left periorbital soft tissue lesion with proptosis. Her past medical history included: hypertension, hyperlipidaemia and bipolar disorder. On examination: vision in the affected eye was hand movements, right...

Quiz Dec/Jan 2020

History A 69-year-old female patient was referred to the uveitis clinic from her local district general hospital with a left posterior uveitis which had been unresponsive to high dose steroids. She had no other previous ophthalmic history nor significant systems...

Quiz Feb/Mar 2024

History A 21-month-old boy presented to his local ophthalmology department with a left proptotic eye from a growing cystic lesion known to be present from birth. Notes taken on presentation were: Known left microphthalmia with chorio-retinal coloboma, contralateral eye was...

Quiz Oct/Nov 2024

History An 83-year-old female was previously treated by surgical excision and plaque brachytherapy for her left conjunctival lesion. She presented to her ophthalmologist with a recurrence some years later and underwent a lid sparing orbital exenteration, which was sent to...

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...

The results of the last survey Oct21

This edition’s survey questions moved away from the deep and ethically charged questions of the recent surveys and focussed on simple and straightforward issues. This is really where the surveys began in exploring the minor practice variations which we have...

The results of the last survey Dec22

I am regularly faced with litigation whereby the claimant’s cornea has decompensated after cataract surgery. The procedure may have been complicated but sometimes it is not. The eye may have been high risk, for example, a shallow anterior chamber with...

A single intravitreal bevacizumab in the treatment of breast carcinoma related choroidal metastasis

Case report Choroidal metastasis represents a common form of intraocular malignancies occurring in up to 10% of patients with systemic metastasis [1]. The most common primary sites of ocular metastasis are breast carcinoma in women and lung carcinoma in men,...

Acute uveitis from late migration of soft lens matter 10 years post cataract surgery

A 58-year-old Caucasian male presented to the emergency eye clinic with a two-day history of a painful, red left eye and blurred vision. His past ocular history included uncomplicated left phacoemulsification cataract surgery in 2010 and left retinal detachment repair...

Iris chafing from displaced single-piece acrylic IOL

A 74-year-old man had persistent 3+ cell one month following left eye cataract extraction, complicated by anterior capsular rent and zonular dialysis at 7 o’clock, with single-piece acrylic intraocular lens implantation (IOL) in the capsular bag. Figure 1: Haptic-like transillumination...

Usefulness of gonioscopy to investigate cause of corneal oedema after cataract surgery

A 72-year-old man with ocular hypertension presented three months after routine right phacoemulsification and toric intraocular lens (IOL) implantation with a two-week history of an irritated right eye and a sudden deterioration in right vision. His preoperative spherical equivalence was...