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Melanocytoma of the optic disc

Melanocytoma is a heavily pigmented lesion, composed of melanocytes and is a variant of melanocytic naevus. It classically occurs at the optic disc and is usually benign, static and asymptomatic. However, it can occasionally grow and invade the retina or...

A case of late spontaneous subluxation of in-the-bag intraocular implant

An 82-year-old frail lady was referred by her optometrist with a finding of subluxated implant in the right eye. She had uneventful phacoemulcification with in-the-bag intraocular implant 17 years earlier. There is no history of having had pseudoexfoliation (PXF) or...

Strange Sequelae Succeeding ‘Surfer’s Eye’

Ophthalmologists in the UK are relatively infrequently faced with a patient requesting surgery for a pterygium. This condition is more common where ultraviolet exposure is greater, especially if coupled with activities associated with ocular surface irritation. For this reason, a...

Herpes zoster ophthalmicus: the essentials

Herpes zoster, also referred to as shingles, is a common infection most typically caused by the reactivation of varicella zoster virus that lies dormant (sometime for decades) in the dorsal root nerve ganglion following primary chickenpox infection [1]. In 10-20%...

Lateral canthal position after lateral orbitotomy

This is a retrospective photographic study of changes in the lateral canthal position following a lateral orbitotomy performed via a lateral canthotomy and cantholysis of both upper and lower limbs of the lateral canthal tendon. Reconstruction of the lateral canthus...

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...

Ocular manifestations of multiple sclerosis: an overview

Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system (CNS), in which there is dissemination of lesions in time (two or more clinical events) and space (multiple lesions seen on brain and spinal imaging). The pathophysiology...

Isolated trochlear (fourth cranial) nerve palsy in an Asian population

The authors report on 35 consecutive new cases of isolated fourth cranial nerve palsy seen over a period of six months in one neuro-ophthalmology clinic in Southeast Asia, with emphasis on their aetiology and management. We report on 35 patients...

My experience of the transition into a specialist orthoptist role

Michelle Dent discusses the process of transitioning into a new role and the pros and cons along the way. An opportunity arose for a permanent, full time, band 7 specialist role in the medical retina (MR) team in the Newcastle...

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....

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...

Interspecialty referrals

Referrals between the many and varied branches of ophthalmology sometimes underline how sub-specialised we have all become nowadays. The old era when everyone was an ophthalmic jack of all trades is gone, for better or for worse, and instead of...