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Pilot trial of Fluoxetine for post-stroke homonymous hemianopia

The authors present a pilot randomised placebo controlled double blind trial assessing 20mg fluoxetine once daily for 90 days versus placebo in stroke survivors with isolated homonymous hemianopia. Exclusion criteria were extensive in terms of pre-existing ophthalmic or neurologic disease,...

Topography based keratoconus progression after corneal collagen cross-linking

Case 1 describes a 35-year-old man with progressive keratoconus (PK). His best corrected visual acuity (BCVA) was right 20/80 (-5.25/-7.75 x 85) and left 20/20 (+4.75/-5.00 x 90). His Ks were right 36.32/48.02 D and 41.15/46.41 D. Right central cornea...

The first on-call

You’ve made into ophthalmic specialist training and before you know it, it’s your first on-call shift. You are expected to provide the specialist on-call service out of hours and there is a new wave of responsibility, with, let’s be honest,...

Narrative literature review for intermittent exotropia

This is a narrative literature review on prevalence, terminology, risk factors, natural history and clinical characteristics for intermittent exotropia. A Medline search was conducted with no date restrictions up to September 2020 and collating English language studies. Prevalence was reported...

The final step

Not long after securing my fellowship in London I was successful at interview for a consultant post at Singleton Hospital, Swansea. The interview took place before I had actually started in London and besides the basic things that are asked...

A rare neonatal presentation of bilateral dacryocele and choanal atresia

Following a routine pregnancy, a newly delivered baby boy, born at term, was found to have increased work of breathing, stridor and a left medial canthal swelling. The baby required 100% oxygen via a face mask to maintain oxygen saturations....

The management of chronic uveitis

A 40-year-old company executive is referred from another unit with recurrent anterior and posterior uveitis for 12 months and the inflammatory markers are raised. Review of systems This is a case of chronic uveitis which needs a thorough workup and...

Bosch-Boonstro-Schaaff optic atrophy syndrome (BBSOAS) NR2F1 mutation

An experienced ophthalmologist can make an anatomical diagnosis of childhood visual impairment based upon the surgical sieve, i.e., congenital and acquired. But an ophthalmologist cannot work in isolation to make an aetiological diagnosis – one would require the help of...

Embryology in clinical practice

The fascinating world of embryology is both beautiful and practical. It is a home video of our evolutionary history through the ages from the single cell through to the life aquatic, the development of gut, limbs and brain, and most...

Cortical blindness

Cortical blindness is a rare but recognised entity. Cerebrovascular accident is a well-known risk factor. We report a case of an 84-year-old lady with bilateral cortical blindness with multiple cardiovascular risk factors. Case report An 84-year-old lady was admitted under...

Neurofibromatosis type 2 – diagnosis, features and MDT approach

NF2 is a genetic condition caused by mutation in a single gene (NF2 gene) on chromosome 22. The NF2 gene provides instructions to produce a protein called merlin, also known as schwannomin. This protein functions as a tumour suppressor, preventing...

Herpes zoster ophthalmicus: the essentials

Herpes zoster, also referred to as shingles, is a common infection most typically caused by the reactivation of varicella zoster virus that lies dormant (sometime for decades) in the dorsal root nerve ganglion following primary chickenpox infection [1]. In 10-20%...