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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%...

Typical or surprisingly uncharacteristic presentations of neuro-ophthalmic emergencies

Irrespective of geographical location or patient cohort, emergency departments are high risk locations capable of inspiring extreme anxiety and dread in patients and doctors alike. The stress multiplies when a walk-in or referred case is suspected of underlying neurological pathology....

Association of sleep problems in children with visual impairment

The intention of this study was to investigate sleep problems in children who had a wide range of visual impairments. Recruitment was via an online survey distributed through the National Federation of Blind and National Organisation for Albinism and Hypopigmentation,...

Viral uveitis

This review covers viral causes of anterior uveitis. A viral aetiology should be suspected when anterior uveitis is accompanied by ocular hypertension, diffuse stellate keratic precipitates or the presence of iris atrophy. Most common viruses associated are herpes simplex, varicella-zoster...

Acute retinal necrosis presumably caused by Epstein-Barr virus infection

Acute retinal necrosis (ARN) is an uncommon, but serious and potentially blinding condition. ARN is characterised by panuveitis, occlusive vasculopathy and progressive peripheral necrotising retinitis. The diagnosis is clinical but confirmation is sought via aqueous and vitreous sampling. Varicella zoster...

Thyroid eye disease

Thyroid eye disease (TED) is an autoimmune condition with a spectrum of signs and symptoms, usually associated with Graves’ hyperthyroidism. The diagnosis is based on history and physical examination but there are further investigations that can aid diagnosis if unclear....

Boston type I keratoprosthesis for limbal stem cell deficiency

Boston type I keratoprosthesis (KPro) long-term outcomes were compared in patients with and without limbal stem cell deficiency (LSCD) in this retrospective study. In the 11 year period 68 procedures were performed in individuals with LSCD, and 105 procedures in...

How to examine the visual system Part 2: Accommodation, pupils, fundoscopy and additional tests

Examining the visual system can be a tricky skill for medical students to master, yet it is a task that is frequently tested in examinations. This is the second of a two-part series of articles, which together aim to improve...

What not to miss in neuro-ophthalmology Part 2

As mentioned previously there are several conditions in neuro-ophthalmology that should not be missed by the general ophthalmologist as well as ophthalmology trainees. We discussed in the first part some of these conditions including third cranial nerve palsies, giant cell...

What not to miss in neuro-ophthalmology Part 1

Neuro-ophthalmology is a complex and difficult subspecialty in ophthalmology. It has several connections to neurology, neuro-surgery, rheumatology as well as many other medical specialties. Working in an multidisciplinary team (MDT) environment is key to success in this subspecialty as mistakes...

Papilloedema: an update

Some readers may have seen a recent report in the national newspapers of the case of a teenage girl with persistent severe headache associated with a fatal brain tumour having been undiagnosed despite many consultations with her medical advisers. It...

Immunoglobulin G4-related ophthalmic disease – what is it? (Part 2)

Part 2: Clinical presentation and treatment (see part 1 here) Introduction IgG4-related disease (IgG4-RD) is understood to have a vast clinicopathological spectrum; nearly every organ has had reported involvement. Similarly, IgG4-related ophthalmic disease (IgG4-ROD) is known to affect nearly every...