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Avoiding investigations through history taking and examinations to differentiate serious from comparably benign aetiology

*Joint first authors. Introduction Anisocoria can be a sign of neurological deficit, necessitating numerous investigations [1]. This case report explores how expensive and time-consuming investigations can be avoided by thorough history taking and examination to differentiate serious from comparably benign...

Choroidal melanoma – breaking bad news

Case report A 55-year-old Caucasian female presented to her general practitioner with a three-month history of headaches and worsening blurred vision in the left eye. On further close questioning, she reported no eye pain, intermittent floaters and flashes of light...

Upper eyelid ulceration as a presenting sign of frontal sinus mucocele

Introduction A sinus mucocele is an epithelium-lined sac filled with mucus and desquamated epithelium. It forms secondary to inflammatory processes that occur in a sinus with an obstructed ostium. Predisposing conditions include previous trauma, surgery, tumours, anatomical abnormalities, and chronic...

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...

Brain tumours in adults: the essentials for an ophthalmologist

The author provides a review of the common intracranial tumours in adults (other than pituitaries) which may present to an ophthalmologist. Primary malignant brain tumours comprise 3% of adult cancers but with an ageing population such tumours are becoming more...

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...

Unilateral central scotoma following dengue fever

Case report A 16-year-old Caucasian male was referred to the eye casualty at Nottingham University Hospitals NHS Trust by the infectious diseases unit in September 2013. He gave a history of photophobia, pain on eye movements and central blurred vision...

The Last House Officer

The Last House Officer by Gwyn Williams takes us on a hilarious journey from first surgical house job to (accidental) ophthalmology trainee. Things don't always seem to work out too well for Owen Morgan. Blindsided into a hasty marriage to...

What's trending Dec/Jan 2022

A round-up of the eye-related hot topics that have been trending on social media over the last few weeks. #eyetrackingtechnology #assitivetechnology #gaming Modern eye trackers often rely on electronic specialist hardware that continuously scan the the pupil and reflections from...

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...

Lockdown and eye health – a case of accommodative spasm

A 25-year-old male presented to the eye casualty with a one-day history of sudden onset worsening vision. More specifically, he noted his vision was more blurred than usual and this was more exaggerated for near-work than for distance-work. He was...

A case of Miller Fisher Syndrome and bilateral asymmetric globe retraction

Miller Fisher syndrome (MFS) is a rare, acquired nerve disease that is considered to be a variant of Guillain-Barré syndrome. It was first recognised by James Collier in 1932 as a clinical triad of ataxia, areflexia and ophthalmoplegia. Later, it...