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Diagnosis and management of IV cranial nerve palsy

1 October 2017 | Neuro-Ophthalmology
Aetiology: Trochlear nerve palsy can be divided into acute or congenital. Congenital trochlear nerve palsy is usually noted in childhood with development of abnormal head posture. Various pathologies can lead to acute IV nerve palsy, most commonly trauma. Other causes...

Third nerve palsy

1 August 2017 | Ophthalmology, Neuro-Ophthalmology
Case scenarios A 71-year-old female presented to a nearby eye emergency unit with two days history of partial ptosis in her left eye with diplopia. She saw her GP earlier that day and he asked her to go to the...

The madarosis mystery: unravelling the clues to a host of health issues

4 October 2023 | | Cornea / External Eye Disease
Eyelash madarosis is a medical condition characterised by the loss of eyelashes caused by the destruction of hair follicles. It can range from a few missing lashes to a complete absence of lashes on the eyelids. This condition can be...

A missed opportunity

1 February 2019 | AMD, Cataract and Refractive, Cornea / External Eye Disease, Emergency Ophthalmology, Genetics, Glaucoma, Imaging, Neuro-Ophthalmology, Ocular Pathology and Oncology, Oculoplastics, Optometry, Ophthalmology, Orbit, Paediatric Ophthalmology / Strabismus, Retina / Uvea / Vitreous
Back in 2000 Sir Liam Donaldson wrote a piece of work commissioned by the then Secretary of State for Health entitled “An Organisation with a Memory”. We are now 18 years on and still some of the recommendations from them...

Chronic dacryocystitis?

1 February 2018 | | Ophthalmology
Lacrimal drainage system tumours are rare and lymphomas account for less than 10% of these tumours [1]. Most patients presenting with lymphoma infiltration of the lacrimal drainage system have a history of previously diagnosed lymphoma elsewhere. We report a case...

Do steroids prevent progression to proliferative diabetic retinopathy (PDR)?

1 February 2017 | | Retina / Uvea / Vitreous
There is continuing debate on the merits of pan-retinal photocoagulation (PRP) for severe pre-proliferative and proliferative DR versus the newer therapies that inhibit vascular endothelial growth factor (VEGF). This has been hotly debated [1] following the publication of findings from...

Broadening of treatment options for potentially blinding retinal conditions

2 August 2022 | | Ophthalmology
Rod McNeil provides an update on a promising bispecific antibody recently approved for treatment of neovascular age-related macular degeneration (nAMD) and diabetic macular oedema (DMO) and considers emerging developments in biosimilars to established anti-vascular endothelial growth factor (anti-VEGF) therapies, including...

Brexit, for richer, for poorer: prospects for post-withdrawal Britain

1 July 2017 | | Cataract and Refractive, Cornea / External Eye Disease, Glaucoma, Imaging, Neuro-Ophthalmology, Ocular Pathology and Oncology, Oculoplastics, Ophthalmology, Optometry, Orbit, Genetics, Paediatric Ophthalmology / Strabismus, Retina / Uvea / Vitreous, AMD, Emergency Ophthalmology
The people of the United Kingdom voted by 52% to 48% to leave the European Union (EU) in June 2016, a referendum decision intended by a slim majority to restore national self-determination and achieve what many believed to be a...

Cavernous sinus syndrome

4 February 2021 | | Ophthalmology, Neuro-Ophthalmology
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...

The management of chronic uveitis

1 October 2015 | | Retina / Uvea / Vitreous
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...

Recurrent unilateral preseptal cellulitis secondary to herpes simplex virus infection

3 April 2023 | | Ophthalmology
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

1 April 2019 | | Ophthalmology, Neuro-Ophthalmology
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....