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What not to miss in neuro-ophthalmology Part 1

Neuro-ophthalmology is a complex and difficult subspecialty in ophthalmology. It has several connections to neurology, neuro-surgery, rheumatology as well as many other medical specialties. Working in an multidisciplinary team (MDT) environment is key to success in this subspecialty as mistakes...

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...

Can thou lyse this? A national study of emergency canthotomy and cantholysis

Eighty-two-year old Janet Smith woke up on the floor. Had she been unconscious? Her head hurt. It was the middle of the night, but in the darkness she suddenly wasn’t sure whether she could see out of her right eye....

Two bifocals and a trifocal

The authors compare the optical outcomes of two bifocal intraocular lenses (AcrySof ReSTOR +2.50 Diopter [D] add +3.0D add) with a trifocal lens (AT LISA tri 839MP). The optical qualities of the lenses were quantified by measuring the modulation transfer...

Neurofibromatosis type 2 – diagnosis, features and MDT approach

NF2 is a genetic condition caused by mutation in a single gene (NF2 gene) on chromosome 22. The NF2 gene provides instructions to produce a protein called merlin, also known as schwannomin. This protein functions as a tumour suppressor, preventing...

A pituitary tumour from 1927

The author shares a clinical case from Edinburgh Royal Infirmary’s archives. It is not often in the course of a clinical career that one gets the opportunity to review a patient who had been treated by a pioneer neurosurgeon some...

Image Analysis and Modelling in Ophthalmology

Recent advances have revolutionised ophthalmic imaging and helped understand the pathophysiology of ocular diseases and thus help in the diagnosis and management of ocular diseases. The authors of this book have gone through most of the available imaging techniques available...

Orbital Schwannomas

This is a large case series of orbital Schwannomas managed at a single centre over a 26-year period. Twenty Schwannomas are reported, all but one of which was managed surgically. The tumours were all benign, had an insidious onset and...

Orbital cellulitis - an overview of the diagnosis and management

Periorbital (preseptal) and orbital cellulitis are infections of the subcutaneous tissues of the eye. They are differentiated by the location of the infection. Periorbital cellulitis refers to infection of the eyelid and subcutaneous tissues anterior to the orbital septum, whereas...

Pituitary tumours: why are they so often missed?

Part 3: Clinical features, assessment and management (see also Part 2, and Part 1) As previously mentioned in this treatise [1] pituitary tumours are common, occur in all age groups and can present with anything from minimal visual symptoms to...

Ocular complications in retinal vasculitis

In this retrospective study the authors aimed to characterise the incidence rates of visual loss and ocular complications associated with retinal vasculitis (RV – annual incidence of 1-2/ 100000/ per annum). A secondary objective was to compare the visual outcomes...

Fixation disparity measurement

The authors evaluate different procedures looking at point zero, fixation disparity (FD) and motor fusion amplitude in order to calibrate the measurement of FD with Ogle’s apparatus with the overall goal to create a standardised measurement of the FD curve...