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Transient thickening of the macular retinal nerve fibre layer in acute optic neuritis

Acute optic neuritis (ON) causes axonal degeneration, which can be quantified from the blood by neurofilament protein (Nf) levels. Within about three months, atrophy of the retinal nerve fibre layer (RNFL) follows. However, it remains challenging to explain why there...

Management of large hypertropia due to lost inferior rectus

This case report outlines the management strategy for a 37-year-old male who suffered a penetrating left orbital injury with rupture of the inferior rectus muscle, optic nerve avulsion and vertical deviation of about 90PD. On orbit exploration, the inferior rectus...

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...

Surgical strategies to manage incomitant strabismus in adults

Incomitant vertical and / or horizontal strabismus is a challenging presentation. Patients are usually symptomatic as the onset is either sudden so they haven’t developed any coping mechanisms or very complex so that any coping mechanisms will not cover all...

Visual disturbance heralding stroke: are we seeing the signs in time?

Isolated visual symptoms may be an early presenting feature of stroke, and timely recognition of such atypical cases is important because treatment for stroke has a limited time-window of efficacy. Stroke occurs in approximately 150,000 people per year in the...

Watch your back: Ergonomics and Ophthalmology

Aadil Hussain discusses an ophthalmologist’s risk of musculoskeletal injury and highlights the importance of ergonomics education, to ensure a pain-free career. Chronic and disabling musculoskeletal injury has been identified in the field of ophthalmology with increasing prevalence. The ophthalmologist is...

Orbital cellulitis outcomes for children

This paper discusses the clinical profile and multidisciplinary team (MDT) management outcomes in children treated for paediatric orbital cellulitis. This was a prospective study of 40 children with a mean age of 7.5 years (4-12). Unilateral orbital cellulitis cases had...

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...

Ophtherminator 3 - Rise of the Machines

“Bring back life form, priority one, all other priorities are rescinded.” Film buffs will spot this as a chilling quote spoken by Ash (Ian Holm) from the classic sci-fi horror movie Alien (1979). Ash (spoiler alert) is a Hyperdyne Systems...

Ophthalmology

The textbook is a large, single volume that ideally needs to be desk or table-supported, as its sheer weight makes it virtually impossible to rest comfortably on ones lap. The book is compiled by its two lead authors and editors...

Innovation update: key advances in eyecare transformation in the last year

Vishal Shah and his co-authors reflect on examples of innovation in eyecare delivery published in the last year and the implications for the future of eyecare services. The “new normal” is an overused phrase to describe extraordinary measures that have...

Take this waltz

My last weekend on-call was the busiest I can remember for a very long time. We were just completely swamped with patients. The weather was not too good that Saturday and it felt like every second inhabitant of our ocean...