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A practical guide to anisocoria

Anisocoria means the presence of difference in the size of the right and left pupils. It is a sign of an abnormality in the efferent pathway. The first question facing the ophthalmologist is to ascertain if anisocoria is present or...

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...

Light in darkness – manual small incision cataract surgery in India

Cataract has been documented to be the most significant cause of bilateral blindness in India, where vision <20/200 in the better eye on presentation is defined as blindness [1,2]. Estimation of blindness in India by the World Health Organization (WHO)...

The treachery of images – making sense of OCT imaging

In 1929 Belgian surrealist Rene Magritte produced his painting La Trahison des Images. It depicted an old fashioned pipe for smoking tobacco and underneath were the words “ceci n’est pas une pipe”, this is not a pipe. You may wonder...

Cavernous sinus syndrome

Anatomically the cavernous sinus is a plexus of multiple veins that are connected and within this plexus there are several important vascular and neurological structures. These include cranial nerves III, IV, V1 (and sometimes V2), VI as well as the...

Microcatheter in the vertebral artery as a cause of branched retinal artery occlusion?

A 19-year-old male presented to eye casualty with a seven-day history of a ‘blurred patch’ in the left eye. The patient denied any other visual symptoms including flashes or floaters and there had been no change in visual symptoms in...

Recurrent unilateral preseptal cellulitis secondary to herpes simplex virus infection

Introduction Periorbital (sometimes called preseptal cellulitis) is a common condition which on its own is not normally an ophthalmic or surgical emergency, however it has the potential to cause severe and serious morbidity in cases where the infection has crossed...

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....