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Oct/Nov 2015 Quiz

History A 16-year-old female presents with bilateral ocular irritation. The patient has a history of seasonal rhinitis and eczema and complains of itchy eyes, especially during the summer months. Examination shows bilateral mucoid discharge, conjunctival injection and eversion of both...

Intravitreal afibercept and ranibizumab for PCV

This is a retrospective, interventional series comprising 98 eyes with polypidal choroidal vasculopathy (PCV) with the aim of comparing treatments with afibercept and ranibizumab, highlighting any differences in their efficacy. Case notes and imaging (FFA / ICG / OCT) were...

Stereotactic radiotherapy for polypoidal choroidal vasculopathy

Polypoidal choroidal vasculopathy (PCV) is a variant of neovascular AMD. It is a disease of choroidal vasculature characterised by abnormal branching vascular network with aneurysmal dilatations (polyps). Features of PCV include pigment epithelial detachments (PED), subretinal fluid (SRF) accumulation and...

Severe conjunctival cicatrisation secondary to chronic glaucoma therapy

The timing of glaucoma filteration surgery during the course of chronic progressive glaucoma remains a contentious issue amongst glaucoma specialists. The vast majority support the use of maximal medical treatment initially to achieve the target pressure. Surgical procedures are only...

New solutions in the prevention and treatment of Acanthamoeba keratitis

The global increase in Acanthamoeba keratitis infections has emphasised the inefficiencies of current treatment and preventative methods, here researchers from the West of Scotland detail a promising new series of compounds that may stem the tide. News headlines detailing horror...

Principles of contact lens fitting in keratoconus

Keratoconus is an ectatic condition of the cornea characterised by progressive conical distortion with irregular astigmatism, myopia and apical protrusion. Most cases progress slowly resulting in varying degrees of myopic astigmatism. Management of keratoconus includes spectacles, soft contact lenses, a...

Discussing treatment modalities for bilateral wet AMD

A 65-year-old lady with bilateral wet AMD and vision of 6/24 comes with an internet search about current therapies. How do you explain the various treatment modalities available? There are two NICE approved treatments for wet age-related macular degeneration (AMD)....

Traumatic injuries from foam Nerf bullets

Background Three patients are presented in this case report: an adult and two children which were subjected to ocular injuries from Nerf gun bullets. Generally, Nerf guns are considered safer than airsoft guns. While there are many papers on airsoft...

Feb/Mar 2018 Quiz

History A 48-year-old farmer with gradual worsening vision in her only eye was referred by her optician. She had recently moved to the UK and required an interpreter during consultation. She seemed to have had vision problems since childhood. Although...

Aug/Sep 2014 Quiz 1

History A 50-year-old female with a history of smoking, weight loss and cough presents to the ophthalmology clinic with a distorted pupil. Examination reveals a mass on the surface and within the iris (see Figure 1). The ophthalmologists decide to...

Feb/Mar 2014 Quiz 2

History A 65-year-old lady presented with a ten year history of nonspecific visual disturbance and mild symptoms of dry eyes. Questioning revealed progressive nyctalopia. Previous medical history of note included Crohn’s disease requiring two bowel resections including small intestine. Figure...

Cyanoacrylate nail glue accidentally instilled into the eye instead of eye drops

Three hundred thousand cataract operations take place each year in the UK alone and each patient will receive a four week course of drops in order to cover them for any postoperative inflammation or infection. Accidental instillation of cyanoacrylate glue...