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Toxic nutritional optic neuropathy (TON)

Toxic optic neuropathy are a group of conditions manifested by reduction of visual functions secondary to damage to the anterior visual pathways from exposure to a toxin. The implicated toxin could be work-based, food or drink related, or iatrogenic medication....

Ocular Dirofilariasis: a diagnosis on the rise?

Dirofilaria repens is one of 40 species of Dirofilaria. It is a zoonotic filarial nematode that commonly impacts dogs, however, human infection can occur through affected organs like skin, lung and eyes [1]. Although, there have been case reports of...

Acanthaemoeba keratitis

In the second of this series I describe a case of Acanthaemoeba keratitis (AK) that was misdiagnosed for a prolonged period which resulted in a devastating outcome. This is one of half a dozen similar medico-legal cases I have dealt...

Strange Sequelae Succeeding ‘Surfer’s Eye’

Ophthalmologists in the UK are relatively infrequently faced with a patient requesting surgery for a pterygium. This condition is more common where ultraviolet exposure is greater, especially if coupled with activities associated with ocular surface irritation. For this reason, a...

Friendly felines and a spot diagnosis

A nine-year-old girl presented to me in eye casualty with a three-week history of blurred vision in her left eye. Otherwise she was apparently well, with no past ophthalmic, medical, drug or relevant family history. Visual acuity was 6/4 right...

External dacryocystorhinostomy in the management of childhood epiphora

Congenital nasolacrimal duct obstruction is thought to be caused by a membranous obstruction at the distal end of the nasolacrimal duct (NLD). Rarely, associated midline deformities in soft tissue and bony structures of the face are present in patients with...

On the wrong track

A 65-year-old very high myope lady presented with sudden blurred vision down to count fingers to her right eye after a short and sharp pain. She also described seeing a black swirly line and as all these symptoms were exactly...

Managing a dislocated intraocular lens

A 70-year-old male patient is referred from the optician with a history of onset of double vision and examination shows a dislocated / subluxated IOL. How will you manage this patient? If the double vision is causing serious concern to...

Orbital cellulitis - an overview of the diagnosis and management

Periorbital (preseptal) and orbital cellulitis are infections of the subcutaneous tissues of the eye. They are differentiated by the location of the infection. Periorbital cellulitis refers to infection of the eyelid and subcutaneous tissues anterior to the orbital septum, whereas...

Idiopathic intracranial hypertension (IIH)

IIH is a medical condition where the intracranial pressure (ICP) is raised without an obvious cause. The cerebrospinal fluid (CSF) is produced in by the choroid plexus in the lateral ventricles and the roof of the third and fourth ventricles,...

Sixth nerve palsy versus decompensating distance esophoria

Orthoptists see a wide range of conditions that can range from reduced binocular single vision (BSV) that may be solved with exercises, to more extreme neurogenic cases requiring further intervention. Because of this variety, it is important to be able...