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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....

Effects of ML4 on the eye

Mucolipidosis type IV (ML4) is an autosomal recessive lysosomal storage disease and is caused by variants of the MC0LN1 gene. It often presents in young individuals with eye and ocular adnexa issues. The authors present a case report and literature...

In conversation with John Forrester

What made you choose ophthalmology as a career and how did your interest in academia develop? During Medical School at Glasgow University, I was getting progressively disillusioned with the career options while my colleagues and friends all seemed to quickly...

An interview with Professor John Forrester

What made you choose ophthalmology as a career and how did your interest in academia develop? During Medical School at Glasgow University, I was getting progressively disillusioned with the career options while my colleagues and friends all seemed to quickly...

Enzymatic clearance of anterior chamber infiltrate in uveitis

Aqueous humour (AH) which fills the anterior chamber (AC) of the eye provides nutrients to the cornea and the lens. Clearance of cellular and particular matter from AH is necessary for good visual acuity. In part this is achieved by...

Cavernous sinus syndrome

Anatomically the cavernous sinus is a plexus of multiple veins that are connected and within this plexus there are several important vascular and neurological structures. These include cranial nerves III, IV, V1 (and sometimes V2), VI as well as the...

Immunoglobulin G4-related ophthalmic disease – what is it? (Part 2)

Part 2: Clinical presentation and treatment (see part 1 here) Introduction IgG4-related disease (IgG4-RD) is understood to have a vast clinicopathological spectrum; nearly every organ has had reported involvement. Similarly, IgG4-related ophthalmic disease (IgG4-ROD) is known to affect nearly every...

Don’t ignore the black lesion! It might be mucormycosis

Keeping mucormycosis infection in the foreground of your differential diagnosis, especially in those more vulnerable patients, will help save their lives if recognised and managed appropriately. Mucormycosis is a fulminant infection caused by the fungi of the family Mucoraceae. It...

Differential inhibition of EAU by CTLA4 and IL-6

Cytotoxic T lymphocyte antigen-4 (CTLA4) binds both CD80 and Cd86 and inhibits T lymphocyte activation via CD28. Il-6 is a pleiotropic cytokine that has been associated with many autoimmune conditions including uveitis. Blockade of these molecules by either CTLA4-Ig, a...

Bleomycin for conjunctival lymphangioma

This is a retrospective review of 16 eyes which underwent intralesional / sub-conjunctival injections of bleomycin sclerotherapy for conjunctival lymphatic malformations (lymphangiomas). The mean age was 18 (range three to 59 years). Four of the lesions were microcystic and 12...

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...

Medical treatment of orbital lymphatic malformations

This is a literature review of the use of Sirolimus, to treat orbital lymphatic malformations. Sirolimus is an immunosuppressant used in renal transplants, and acts by inhibiting mammalian target of rapamycin (mTOR), which in turn inhibits activation of T and...