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Headaches in ophthalmology (part 1)

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...

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...

Feb/Mar 2019 Quiz

History A 31-year-old female patient presented with history of gradual downward displacement of the globe over the last six months. The superotemporal mass then became palpable (Figure 1). Lateral orbitotomy was performed following CT scans (Figure 2). Figure 1. Figure...

Oct/Nov 2018 Quiz

History A 37-year-old male was referred from the Emergency Eye Clinic with a swollen right upper eyelid. Symptom relieved with nonsteroidal anti-inflammatory drugs (NSAIDs). The initial clinical diagnosis was dacryoadenitis. The patient presented again six weeks later with 3mm proptosis,...

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....

Apr/May 2017 Quiz

History A five-month-old baby was seen in clinic with bilateral congenital corneal opacities. The right cornea is shown in Figure 1. Figure 1. Examination revealed corneal oedema and opacities of Descemet’s membrane and endothelium with a few vesicular lesions. Corneal...

Feb/Mar 2017 Quiz

History A 40-year-old male patient presented with a right lower eyelid swelling with gradual enlargement for two months. On examination there was a large lesion apparently involving lid margin, part of palpebral conjunctiva and skin. No other local or systemic...

Phaco nightmares

I am interested in the stressful nature of cataract surgery from the surgeon rather than the patient’s perspective. It is an issue that has quite literally kept me awake at night. Part of getting to grips with a problem is...

Expenses

“How do I apply for expenses?” I asked one of the secretaries. The Royal Gwent Hospital was so far from home that I had been forced to rent one of their spartan on-site rooms in order to avoid a crippling...