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Disseminated cutaneous zoster – a masquerade

Reactivation of varicella zoster infection in the elderly commonly presents to ophthalmologists as herpes zoster ophthalmicus (HZO), affecting the Va trigeminal dermatome. In patients with impaired immunity, zoster infection occurs with increased severity and may be complicated by visceral and...

Apr/May 2018 Quiz

History A 57-year-old lady presents with a right subconjunctival lesion which has been increasing in size for three months (Figure 1). She has never had vision problems other than presbyopia. Past medical history: hypertension and asthma. On examination, she had...

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...

Oct/Nov 2017 Quiz

History A 73-year-old man presented with a rapidly growing left lower eyelid lump with recent bleeding. On examination there was a raised, ulcerated, firm mass occupying two thirds of his lower eyelid. The lesion bled easily and appeared connected to...

Immunoglobulin G4-related ophthalmic disease – what is it? (Part 1)

Part 1: Epidemiology, classification, radiology, histopathology and associations (see Part 2 here) In this two-part series, Li Yen Goh reviews IgG4 disease and reminds us of diagnostic challenges faced. Introduction Immunoglobulin G4 (IgG4) disease is a recently recognised idiopathic systemic...

Lacrimal drainage system malignancies

This retrospective case series looks at the rare cases of lacrimal drainage system malignancies. The authors have identified 14 patients in 24 years, at a tertiary referral centre in the Indian subcontinent. Many previous publications have found squamous cell carcinoma...

Extraocular muscle BT after ocular pathology

Management is described for 13 patients who received inferior rectus botulinum toxin (BT) injection for vertical strabismus due to orbital pathology. Patients were aged 19-86 years, eight were female and seven were right eye injections. Orbital pathology included six with...

Uveitis in the elderly

This study from Turkey evaluated the causes and clinical characteristics of uveitis in elderly patients. Data from 90 eyes of 68 patients aged 60 years and older were reviewed. Anterior uveitis was present in 75% (33% of these had keratouveitis),...

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...

Aug/Sep 2018 Quiz

History A seven-year-old girl presented with a presumed papillomatous lesion on right inferior fornix (Figure 1). Her parents said the lesion was increasing in size for two weeks. CT scans (Figure 2) revealed a lesion occupying the right medial canthus....

Aug/Sep 2017 Quiz

History A seven-year-old atopic boy has been treated for phlyctenulosis with mild topical steroids. However, he developed dramatic changes at the right limbus in two weeks. He also had past history of vernal keratoconjunctivitis (VKC) with poor compliance to treatment....

IgG4 related orbital disease

This retrospective study was done to determine the prevalence of IgG4 related orbital disease (IgG4ROD) in patients who previously had biopsies for suspected idiopathic orbital inflammatory disease (IOID) and / or orbital lymphoproliferative disease (OLD). The charts and slides of...