An 87-year old African-Caribbean lady presented with a two week history of severe right ocular pain, worse in the evenings. The patient had previously been diagnosed to have asymptomatic iridoschisis in 2007 and attended the diabetic retinopathy screening service annually. There was no known family history of eye disease.
Mask wearing may increase the risk of ocular infections with organisms that are not usually encountered as pathogenic. Moraxella Non-liquefaciens is normally commensal in the upper respiratory tract, non-pathogenic, and rarely found to be the causative organism in microbial keratitis. At the Ophthalmology department covering the England West Midlands North we encountered 4 patients, each with a unique Moraxella strain after the end of the second lockdown.
Pseudoexfoliation Syndrome (PEX) is a systemic disease characterised by the deposition of extracellular fibrillary material in the anterior segment of the eye. It is often identified incidentally on slit lamp examination because patients are typically asymptomatic during initial stages. It is associated with raised intraocular pressure and development of secondary glaucoma. Due to the increased disposition of PEG, patients with PEG should be routinely monitored so that early interventions could be introduced to slow down the progression of glaucomatous changes.
Acanthamoeba keratitis involves inflammation of the cornea, the thin protective transparent layer at the front of the eye, caused by the protozoa Acanthamoeba. It is rare but can be sight-threatening with an annual incidence of 1.4 per million per annum, and typically affects contact lens wearers (1).
A cataract is the opacification of the lens in the eye. Blindness secondary to cataracts is the leading cause of reversible blindness worldwide. However, this is more prevalent in the developing world due to a lack of access to surgery. In the developed world, surgery to remove a cataract, known as phacoemulsification, is the commonest surgical procedure that is carried out. The UK has an ageing population and therefore the prevalence of age-related cataracts will likely increase. Therefore for ophthalmology trainees in the UK, they must have a baseline knowledge of this condition.
Traditional iris implants that are commonly available are rigid, requiring large incisions with associated risks of scarring, astigmatism, infection and poor healing (Thiagalingam et al., 2008). Furthermore, they do not replicate the patient’s natural eye colour and are therefore less desirable from a cosmetic point of view. Custom made iris implants are now growingly available and provide an exciting alternative.
Posterior IOL dislocation is a complication of cataract surgery which can present many years after the initial procedure with an incidence rate as high as 3%. Weak zonular fibres are a major cause of IOL dislocation. Late onset dislocation is associated with progressive zonular weakening whereas zonular rupture is seen in early dislocation.
Varicella-zoster virus commonly causes shingles in the elderly population. Atypical presentations require astute knowledge of the distribution pattern of the nerve affected and a thorough history and systemic examination to allow diagnosis. We present a rare case of maxillary division shingles with ocular manifestations in a 71-year-old woman post cataract operation.