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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...

It’s not always GCA

Giant cell arteritis (GCA) is an immune mediated granulomatous inflammatory disease that affects muscular middle or large sized arteries. It is considered as a continuation of polymyalgia rheumatica (PMR) when the severity of the disease has increased. It is the...

Feb/Mar 2015 Quiz 1

A 79-year-old male presented to the ophthalmic emergency department with a three week history of left eye pain. He also reported visual deterioration in the left eye over the same period. He suffered from degenerative myopia, with his spectacle prescription...

Macula re-attachment following intravitreal ranibizumab in rhegmatogenous retinal detachment

Ranibizumab (Lucentis) is a vascular endothelial growth factor inhibitor (anti-VEGF) used for treatment of choroidal neovascular membrane [1]. We report a case where macula off inferior rhegmatogenous retinal detachment was misdiagnosed as wet age-related macular degeneration (AMD) and three intravitreal...

Systemic sarcoidosis presenting with acute myopia and angle closure

Case report A 40-year-old Asian man presented to the Emergency Department with a one day history of sudden onset visual disturbance in his right eye. He complained of image distortion and noted that objects now appeared smaller. He also described...

Fusarium keratitis in a patient with alcohol dependence

Treatment of fungal keratitis secondary to the Fusarium species remains a challenge. Although relatively more common in warmer climates, this corneal infection is rare in the UK. Most cases have been reported in farmers and are often preceded by trauma....

End stage glaucoma management

A 48-year-old female has had multiple drug treatment for glaucoma and is still losing field of vision. How do you manage this over time? This patient is at high-risk for going blind and should be managed aggressively to protect remaining...

Demyelinating optic neuropathy

Introduction Optic neuritis (ON) is an inflammatory process affecting the optic nerve. After glaucoma, it is the most common optic neuropathy affecting patients under the age of 50. The usual presentation of typical ON is unilateral subacute loss of vision...

Human factors in the operating room

The importance of minimising human error in surgery is well established. This was initially sparked by lessons learned from the aviation industry in the 1970s after several fatal flight accidents [1]. This became a catalyst for a movement on training...