Contact lens overuse scar This man wears contact lens. He did not follow advice with contact lens wear and developed a nasty infection of his cornea. This caused an overuse scar. He is legally blind. We will restore vision with a corneal stromal transplant. Caring for your contact lens As we have seen above improper …
OSSN amt – This man has a HUGE tumour of the eye, unresponsive to chemotherapy, causing loss of vision, threatening invasion of the eye and risking spread to brain. I undertook excision and repair, stitching the line of placenta onto the eye. The video can be seen here https://youtu.be/FLDOCEVs70E Just be mindful that the video …
Ptosis slk – This 42yo lady presented complaining of a droopy left upper eyelid, and stated she wanted surgery to lift the lid. This is what she looks like with eyes in primary position. Turns out, she has a completely separate problem causing bilateral variable ptosis. In downgaze, the superior limbic keratitis (slk) is clearly …
Proptosis eyelid rubbing ptosis This gentleman was referred in for ptosis surgery, and he does have blepharoptosis. We are trained to look for dangerous causes of ptosis, like brain tumors, but we overlook the common causes. This man is a great example… He has bulging eyes, not due to disease, but his orbital structure. This …
Blunt trauma MDALK This is a lady who was blind from keratoconus, and on whom I performed an MDALK 3 months ago. She is from overseas, and left seeing 6/18 at 2 weeks. She was very happy! A few days ago, she was hit in the eye by a ball. The image shows the outcome: …
This man presented with a 3 year history of his face changing. Note the left eye is pushed laterally, a one sided hypertelorism. Having gone on for some time, it is unlikely to be a malignant mass. Scan shows a huge ethmoidal mucocoele extending into the orbit. Like a lacrimal sac mucocoele, the sinuses can …
Eyelid papilloma This is a simple papilloma of the upper eyelid. You will see them quite often. Note how the lashes are growing through the papilloma, and there is no tissue destruction. Patients often complain of irritation or aesthetic issues when the papilloma grows beyond a certain size. Many of these can be removed by …
Chalazion sac This 79 year old male presents with a chronic discharge from his upper eyelid. There is minimal swelling, and the discharge is unresponsive to antibiotics. On eversion, a discharging mass was noted. This is how it turned out….a very unusual chalazion sac, an inpouching of epithelium into the structure of the tarsus. The …
Pseudomonas keratitis scar This young lady is 26 and presents with a typical pseudomonas keratitis scar post soft contact lens overwear. Note how well circumscribed it is, like a disc on the cornea. She sees a blurry 6/24, complains of visual confusion and is seeking to have permanent correction. These patients do very well with …
This is a presentation of atypical marginal keratitis. The infiltrate is sterile, vision is count fingers. Treated with topical intensive antibiotics for 24 hours. Day 2, steroids introduced. Day 5, antibiotics tapered and steroids increased. Day 7 antibiotics stopped and steroids continued. Vision returned to 6/0 The take home here is – Catch it early …