Archive for Case Histories

Pre-Registration FAQs. 1: Ocular Disease and Investigative Techniques

Published October 6th, 2008 by Jane Macnaughton.

At this time of the year, pre-registration trainees are once again completing their Assessments.
Following the popular ‘Ask the Examiner’ threads over the past two years, we have compiled all of the questions and answers as FAQs and regrouped them all according to subject.
Our contributors have included Bill Harvey, Peter Chapman, Joy Myint, Dr Christine Astin, […]

Sophie’s Retinoblastoma

Published January 22nd, 2008 by Jane Macnaughton.

It’s a classic text book of diagnosis. Little Sophie Ripley’s retinoblastoma was picked up in a family photograph.As reported in several news stories today, parents Tracey and David from Sheffield, were looking at a wedding snap when they noticed Sophie’s eyes were different colours and that the left one appeared to be ‘black.’
The discovery of […]

Case History 7: Acanthamoeba Keratitis, From My Perspective

Published November 7th, 2007 by Paige Reichardt.

I have been asked to share my perspective from the patient’s point of view regarding the management of Acanthamoeba Keratitis and to share my thoughts on how to improve communications and advice to patients.  What follows is my view from the inside, looking out.
I had worn contact lens for 48 years and loved them.  I […]

Clinical Conundrums: Case history 6 The latent hypermetrope

Published October 22nd, 2007 by Jane Macnaughton.

As a locum I occasionally come across previous practitioner’s work which raises an eyebrow. However, I came across this young man recently:
Age 10, routine review, asymptomatic.
Previous practitioner reports: +0.50 R&L. No Rx given. 
Today the findings were –
RV   6/5   +1.50 =   6/5
LV   6/5   +1.50 =   6/5 
I believe that the level of plus has been previously undetected […]

Post card from Barbados: Horner’s or Gardener’s Syndrome?

Published October 14th, 2007 by David Cummins.

A fifty year old Caucasian lady called me in the middle of a busy clinic, in a panic. For the last 5 days, one of her pupils appeared much smaller than the other, the eye had been a little red and her vision in the eye seemed different.

Image reproduced from Clinical Ophthalmology (J Kanski) with […]

Sub clinical or Sub Standard?

Published October 5th, 2007 by Peter Chapman.

Maybe I just attract problems into my clinics. Maybe there is a sign on my door saying..
“problems…then step this way�
In the last 2 weeks, I have seen 5 patients who suffer with Myasthenia Gravis. One patient looked at me shocked when I said I knew what it was as his neurologist had only seen 1 […]

Clinical Conundrums: Case History 5- Branch Vein Occlusion

Published August 13th, 2007 by Jane Macnaughton.

This 50 year old lady had recently returned from competing in a triathlon.  Clearly very fit, she was blissfully unaware of a surprisingly high blood cholesterol level.  Needless to say, the loss of vision in the right eye was very swift which prompted her to visit the local eye department.
Three months on she visited us.  […]

ADHD. What came first – the chicken or the egg?

Published July 31st, 2007 by Jane Macnaughton.

I am not an authority on specific learning difficulties in children, but I saw this young man recently and began to wonder how his prescription related to the diagnosis of ADHD:
Background:
Age 6, and not performing well at school (Year 1).  He appears to have a very short attention span and is exceedingly boisterous. His parents […]

Clinical Conundrums: Case History 4 - Charles Bonnet Syndrome

Published June 2nd, 2007 by Caroline King.

I first came across Charles Bonnet Syndrome as a symptom in association with age related macular degeneration but it wasn’t until I worked as a specialist low vision optometrist that I realized how common and significant a problem it was.
I was performing low vision assessments, when one day a 78 year old lady presented to […]

Clinical Conundrums: Case History 3 - Differential Prism

Published March 20th, 2007 by Peter Chapman.

A 78-year-old patient presented for refraction following a cataract extraction on the Right Eye. A nice easy start after lunch I thought.  During history and symptoms she explained there may have been some complications during the surgery but was unsure exactly what those complications had been.
Refractive Status, Pre-operative:

R +6.00/-0.50 x 75                6/18             Add +2.75 
L +5.50/-1.25 x […]