'Can you touch your toes?' spondyloarthropathies and acute anterior uveitis for primary eyecare practitioners.

The rheumatological diseases known as spondyloarthropathies (SpAs) are reviewed with respect to the current classifications of SpAs and from the perspective of ophthalmic practitioners. The focus is on the most common spondyloarthropathy, ankylosing spondylitis (AS), and the key symptoms, such as inflammatory back pain. The association with HLA-B27 and acute anterior uveitis (AAU) and the major clinical considerations for primary eye care practitioners are reviewed.

'My pupil has gone black!' Subluxation of a total cataractous lens.

A patient with a history of longstanding opaque cataract and a white pupil reported a return to a black pupil, which was the result of lens subluxation. The case was complicated by optic nerve coloboma of the Morning Glory syndrome type and a total retinal detachment.

Branch retinal artery occlusion during a migraine attack.

A 60-year-old male with a history of migraine presented with evidence of branch retinal arterial occlusion that developed at the time of an attack of retinal migraine. The diagnosis of branch arterial occlusion secondary to migraine was made after exclusion of numerous possible medical conditions. The possible role of vasospasm in this condition is discussed.

Acute anterior uveitis in primary care.

Acute anterior uveitis is an important ocular disease of considerable interest to therapeutically and non-therapeutically qualified optometrists. This review examines the role of optometrists in the primary care setting and gives guidelines for appropriate care of patients with anterior uveitis. Diagnosis and differentiation from other forms of anterior segment inflammation are the initial requirement.

Dual macroaneurysms on the same retinal arteriole.

A case of two macroaneurysms on the same retinal arteriole is presented. After observation of these lesions for some weeks, an increased threat to the macula from oedema led to laser photocoagulation. Although treatment did not hasten resolution, the patient has remained asymptomatic.

Hemianopic visual field loss as the first clinical evidence of occipital arteriovenous malformation.

A 43-year-old patient presenting with a highly congruous homonymous hemianopia was shown by neuro-imaging to have a very large arteriovenous malformation of the brain. The significance of finding this visual field defect, its unusual cause and the absence of symptoms other than longstanding migraine with aura are discussed.

Diabetes mellitus: a brief history, epidemiology, definition and classification.

Diabetes mellitus is a systemic disease of great significance to optometrists. This review includes a brief history of the key discoveries in the understanding of diabetes from ancient times and a summary of the present knowledge of diabetes with respect to prevalence, epidemiology and major complications. The currently accepted classification of diabetes mellitus includes the major categories of type 1 and type 2 diabetes, specific diabetes types and gestational diabetes.

Normal tension glaucoma: diagnostic features and comparisons with primary open angle glaucoma.

BACKGROUND: A significant proportion of patients diagnosed under the broad classification of open angle glaucoma actually has normal tension glaucoma (NTG). It has many clinical features that overlap with primary open angle glaucoma (POAG), yet there is a question of whether it has a different aetiology in which intraocular pressure plays less of a role. METHODS: The epidemiology and clinical features of normal tension glaucoma are reviewed with particular reference to possible differences from primary open angle glaucoma, which might permit differentiation.

Curious cilia cases.

Eyelashes can be observed in unusual anatomical locations after falling out of their hair follicles. Loose lashes can inadvertently enter a lacrimal punctum or with more difficulty, a Meibomian gland orifice They may even penetrate through anterior surface layers such as the conjunctiva or skin of the lid. There may be some diagnostic problems, occasionally questions of management and in rare instances, some risk of morbidity.

Perspectives on migraine: prevalence and visual symptoms.

About 20 per cent of women and 10 per cent of men experience migraine at some time in their lives, of whom about one half to two thirds will have had a migraine attack in the previous 12 months. Prevalences of this order have been found in a survey of patients in an Australian optometric practice. Between one third and one half of migraineurs experience sensory or motor aura.