Topical silicone gel mistaken for a retained orbital foreign body on MRI.

MRI is now a well-regarded imaging technique, but due to its use of strong magnetic fields, some metallic objects are contraindicated. We present a case of a man in his 40s with thyroid eye disease, who underwent bilateral orbital decompression. Following surgery, he was advised to start scar massage with topical silicone gel (Dermatix).

Co-existence of metastatic uterine sarcoma and orbital sarcoidosis: A case report and literature review.

A 77-year old lady with previously treated endometrial sarcoma presented with progressive left upper lid mechanical ptosis secondary to superior orbital mass. An orbital biopsy confirmed the diagnosis of orbital sarcoidosis. Further systemic work up revealed suspicious pulmonary nodules which were found to be endometrial sarcoma metastases rather than systemic sarcoidosis on image guided biopsy.

Patients' perceptions of visual impairment associated with smoking: A cross-sectional study of a United Kingdom tertiary eye centre.

Smoking is a well-established risk factor for several eye disorders including cataracts and age-related macular degeneration. While many individuals are informed of the various adverse health effects, there is limited research into patients' awareness of the relationship between smoking and eye disease and the potential impact this might have on reducing smoking behaviour. Our findings document the low level of awareness of the risk of blindness from smoking at a tertiary eye unit in the United Kingdom and highlight the need for increased involvement from eye care professionals, alongside health campaigns to educate the public of this consequence of smoking.

Management of thyroid eye disease in the United Kingdom: A multi-centre thyroid eye disease audit.

This article aims to provide baseline data and highlight any major deficiencies in the current level of care provided for adult patients with thyroid eye disease (TED). We undertook a prospective, nonrandomized cross-sectional multicenter observational study. During a 3-month period June-August 2014, consecutive adult patients with TED who presented to nominated specialist eye clinics in the United Kingdom, completed a standardized questionnaire.

Clinical challenges of thyroid eye disease in HIV-positive patients on highly active antiretroviral therapy.

Background: Graves' disease (GD) as an immune reconstitution inflammatory syndrome during highly active antiretroviral therapy (HAART) for HIV has previously been reported. However, clinical challenges associated with HIV in the context of thyroid eye disease (TED) are not as well-characterized.

Objective: To determine the frequency of coexisting HIV and TED, describe TED presentation and course in the context of HIV, and evaluate management difficulties as well as potential solutions.

Impact of cataract surgery on sleep in patients receiving either ultraviolet-blocking or blue-filtering intraocular lens implants.

Purpose: Although visual impairment is a well-recognized consequence of cataract development, little is known about the ability of the melanopsin-based photosensitive retinal ganglion cells (pRGCs) to regulate sleep-wake timing in the presence of cataract. In this study, we replaced a cataractous natural crystalline lens with two different types of artificial intraocular lenses, a UV-blocking lens or a blue-filtering lens. We investigated the level of sleep disturbance before cataract surgery and any change in sleep due to improved light transmission following surgery and compared this in both types of intraocular lens.

Orbital compressed air and petroleum injury mimicking necrotizing fasciitis.

Background: Orbital injury secondary to petroleum-based products is rare. We report the first case, to our knowledge, of a combined compressed air and chemical orbital injury, which mimicked necrotizing fasciitis.

Case Report: A 58-year-old man was repairing his motorcycle engine when a piston inadvertently fired, discharging compressed air and petroleum-based carburetor cleaner into his left eye.

Meta-analysis of the adjunctive use of mitomycin C in primary and revision, external and endonasal dacryocystorhinostomy.

Purpose: To determine whether application of the anti-proliferation agent, mitomycin C (MMC), to the osteotomy site during dacryocystorhinostomy (DCR) surgery increases surgical success rates.

Method: We conducted a comprehensive meta-analysis of randomised controlled clinical studies relating to the adjunctive use of MMC in primary and revision, as well as external (EX-DCR) and endonasal DCR (EN-DCR).

Results: 15 studies met our inclusion criteria with a total of 850 DCR procedures.

Combined hamartoma of the retina and retinal pigment epithelium.

We report two cases of combined hamatoma of the retina and retinal pigment epithelium (CHR-RPE), illustrated with ultrasonography, optical coherence tomography, fundus fluorescein angiography and indocyanine green angiography images. CHR-RPE could clinically mimic several other retinal conditions. Failure to distinguish it from serious malignancies such as choroidal melanoma or retinoblastoma has led to unnecessary enucleation in the past.

Brow ptosis: are we measuring the right thing? The impact of surgery and the correlation of objective and subjective measures with postoperative improvement in quality-of-life.

Introduction: To assess the effect of brow ptosis on visual function and quality-of-life (QoL), and to determine what measures are associated with post-surgical change in functional status.

Methods: Prospective longitudinal study. Fifteen consecutive patients undergoing brow-lift surgery from February 2009 to August 2010.

Long-term visual and retinopathy outcomes in a predominately type 2 diabetic patient population undergoing early vitrectomy and endolaser for severe vitreous haemorrhage.

Purpose: To evaluate the long-term visual outcome of type 2 diabetic patients receiving early vitrectomy and endolaser for severe vitreous haemorrhage (VH).

Materials And Methods: Retrospective case note review of 88 eyes (69 type 2 diabetics and 19 type 1 diabetics) of 80 patients who underwent vitrectomy and endolaser within 6 months of VH. Post-operative and most recent VA, in addition to long-term retinopathy grading, were analysed.

A surgical option for antipodean strabismus: four horizontal muscle resection.

The authors report a case of symptomatic antipodean strabismus caused by a combination of mechanical restriction of eye movement secondary to thyroid eye disease, longstanding intermittent divergence, and convergence weakness, which was alleviated by simultaneous resection of all four horizontal recti muscles.

Symptomatic dynamic vitreomacular traction during accommodation and head-down posture preceding definitive vitreomacular traction syndrome.

Purpose: To report a case of progressive vitreomacular traction, definitive optical coherence tomography evidence of established vitreomacular traction, and subsequent spontaneous resolution with posterior vitreous detachment occurrence.

Methods: Case report and literature review. This study involved a patient presenting to the Retina Clinic at Stoke Mandeville Hospital.

Laser epithelial keratomileusis for the correction of hyperopia using a 7.0-mm optical zone with the Schwind ESIRIS laser.

Purpose: To investigate the efficacy of laser epithelial keratomileusis (LASEK) for the correction of hyperopia using a 7.0-mm optical zone and a 9.0-mm total ablation zone diameter with the Schwind ESIRIS flying-spot laser.

Schwartz-Jampel syndrome: surgical management of the myotonia-induced blepharospasm and acquired ptosis after failure with botulinum toxin A injections.

A 6-year-old boy with Schwartz-Jampel syndrome and severe myotonia-induced blepharospasm and ptosis did not respond to botulinum toxin A injections in the orbicularis muscle. The clinical diagnosis was further supported by electromyography. Surgical management using a combination of techniques in one operation produced a satisfactory result for both function and appearance.

Aqualase for cataract extraction.

Purpose: To report our experience of using Aqualase technology for cataract extraction.

Methods: In total, 33 patients (20 females; mean age 71.4 years) underwent cataract surgery using Aqualase through a 3.

Reliability of ophthalmic accident and emergency referrals: a new role for the emergency nurse practitioner?

Background And Objectives: Annual attendances at the accident and emergency (A&E) department of St Bartholomew's and The Royal London NHS Trust exceed 100,000 people of which 6% are ophthalmic. This study evaluated the accuracy of eye referrals from A&E senior house officers (SHOs) and emergency nurse practitioners (ENPs) and the impact any inaccuracies may have had on out of hours work.

Methods: Over a four week period a record of all referrals from the A&E department was made.

Cerebral malaria versus bacterial meningitis in children with impaired consciousness.

Cerebral malaria (CM) and acute bacterial meningitis (ABM) are the two common causes of impaired consciousness in children presenting to hospital in sub-Sahara Africa. Since the clinical features of the two diseases may be very similar, treatment is often guided by the initial laboratory findings. However, no detailed studies have examined the extent to which the laboratory findings in these two diseases may overlap.