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Headaches in ophthalmology (part 2)

Ophthalmologists see a large number of patients with headaches or facial pain in the ophthalmic outpatient clinics or in emergency clinics. Over two articles, I will discuss several causes of headaches, ocular manifestations and proposed management and referral options. It...

What not to miss in neuro-ophthalmology Part 2

As mentioned previously there are several conditions in neuro-ophthalmology that should not be missed by the general ophthalmologist as well as ophthalmology trainees. We discussed in the first part some of these conditions including third cranial nerve palsies, giant cell...

A glossary

After a week on call grading what feels like 13 billion referrals I decided it might be useful to come up with a glossary that might help other people in some way to decipher the true meaning behind every repetitive...

Using contrast acuity and rapid number naming in Huntington’s disease

This study aimed to evaluate afferent and efferent visual function in Huntington’s disease (HD). HD is often portrayed by abnormal saccadic eye movements and afferent visual pathway involvement however these are poorly characterised and difficult to quantify at the bedside....

A paediatric case of central retinal artery occlusion following antibiotics and decompression surgery for orbital cellulitis

Orbital cellulitis is an ophthalmic emergency that warrants urgent management in the hospital setting [1]. This occurs more frequently in the paediatric population where it is often secondary to sinus infections. Delay in treatment could result in severe complications including...

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 electrophysiology

A 34-year-old woman, who is a CEO in a multinational firm, has been losing vision over the last 12 months. She has seen her opticians, who initially tried different glasses but could not improve things. Clinical examination is unremarkable. How...

Ophthalmology history and examination – a guide for medical students

*First author Students have very little exposure to ophthalmology during their years at medical school. Teaching consists of a handful of lectures followed by a short placement in which students are expected to practise histories and examinations on patients with...

A novel computerised portable pupillometer detects and quantifies relative afferent pupillary defect

We have all had referrals from A&E telling us that a patient can’t see out of one eye. Sleepily we may ask “Is there an relative afferent pupillary defect (RAPD)?” to evaluate the seriousness of the presentation. The response is...

Typical or surprisingly uncharacteristic presentations of neuro-ophthalmic emergencies

Irrespective of geographical location or patient cohort, emergency departments are high risk locations capable of inspiring extreme anxiety and dread in patients and doctors alike. The stress multiplies when a walk-in or referred case is suspected of underlying neurological pathology....

How to examine the visual system Part 2: Accommodation, pupils, fundoscopy and additional tests

Examining the visual system can be a tricky skill for medical students to master, yet it is a task that is frequently tested in examinations. This is the second of a two-part series of articles, which together aim to improve...

Lessons from an unusual case of syphilis

The rise of syphilis transmission rates over the past two decades has been one of public health’s great puzzles. In the UK, the situation has reached epidemic levels, with a 126% increase between 2013 and 2018 [1]. We present a...