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Headache: the clue is in the eyes

A worrying cause of headache is raised intracranial pressure (ICP). Papilloedema is a vital clue for accurate diagnosis and performing fundoscopy is essential in detecting this sign. The authors review the use of fundoscopy in their own district general hospital....

The refractive index in the eye lens – implications for clinical practice and optical design

The eye may appear to be a comparatively simple organ and yet its optical system is complex and continues to be a source of investigation and research. The major optical elements are considered to be the cornea and the lens...

Pituitary tumours: why are they so often missed?

Part 2: Clinical varieties, anatomical considerations and case report (see also Part 1 and Part 3) For ophthalmologists there are four types of pituitary tumour to be considered, three of which are named according to the hormone secreted, along with...

Caring for adults with an ocular tumour

Detection If you screen for an intraocular tumour, dilate the pupil. If the patient is driving, use phenylephrine only. If the patient declines, document this in the casenotes. Don’t forget to look for sentinel vessels, which would indicate a ciliary...

Dans le Noir

There is a restaurant in London where dinner is served in the dark. Not dim light or occasional infrequent light, but absolute pitch black darkness. Apparently the aim is twofold; to better appreciate the quality of the food as the...

Higher risk of poor functional outcome in the presence of visual deficits post-stroke

The authors present a retrospective case review with the aim of reporting the disability outcomes of individuals 90-days post stroke with and without visual deficits. The Houston Methodist Hospital Outcomes-based Prospective Endpoints in Stroke (HOPES) Registry was used as the...

Bovine pericardium scleral patch graft associated scleritis: Ahmed valve implant for pupillary block glaucoma

Processed bovine pericardium is a lyophilised collagen sheet used as a surgical armamentarium. It renders the material antigenically inert with minimal inflammation [1]. Sclera patch pericardium graft (Tutopatch) is a collagenous membrane derived from solvent preserved, irradiated bovine pericardium [2]...

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...

Jun/Jul 2017 Quiz

History A 57-year-old female patient presented with gradual painless diplopia over the last six months. Examination revealed restricted upward eye movements and 4mm proptosis which did not increase with Valsalva manoeuvre. Intraocular pressure was normal, no visual defects were noted,...

Diagnosis and management of IV cranial nerve palsy

Aetiology: Trochlear nerve palsy can be divided into acute or congenital. Congenital trochlear nerve palsy is usually noted in childhood with development of abnormal head posture. Various pathologies can lead to acute IV nerve palsy, most commonly trauma. Other causes...

Apr/May 2014 Quiz 2

History A 29-year-old woman presented to the emergency department with a two week history of floaters and patchy peripheral visual field loss in the left eye (LE). She had no relevant medical history and she was not on any current...

Neonatal hypoxic ischaemic encephalopathy with imaging abnormalities in the occipital lobe – how to counsel the parents

Case A baby boy, with a background of intrauterine growth restriction, was born at 37 weeks and three days gestation via forceps delivery. The baby was born in poor condition, with low heart rate, poor respiratory rate, poor colour and...