All 3 diagnostic tests are highly specific, and a positive test result is highly predictive of disease presence. IVCM is both highly sensitive and specific when performed by an experienced operator. PCR is a useful adjunct in the diagnosis of AK because of its wider availability compared with IVCM, and it may be used in combination with IVCM for microbiologic confirmation.

We describe the first two cases of percutaneous cryoablation under magnetic resonance imaging guidance. To date, this minimally invasive procedure has been used for the treatment of renal cell tumors in patients who cannot tolerate or refuse surgical nephrectomy. The two patients described showed no evidence of recurrence or complications 35 and 36 months after the procedure.

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We aim to provide a snapshot of the current surgical practice for correction of entropion and ectropion, the two most common oculoplastic procedures carried out in the UK, by surveying 135 consultant oculoplastic surgeons via the tool Survey Monkey. Forty-seven (35%) consultants responded. For entropion, 44% of surgeons opted for lateral tarsal strip (LTS) + everting sutures (ES). Other first-line choices included LTS + transcutaneous retractor plication (21%), Quickert's procedure (14%), ES (7%), and Wies procedure (5%). Important patient-related factors to consider were horizontal lid laxity and retractor dehiscence. Regarding ectropion, LTS was most commonly practiced (35%), followed by LTS + transconjunctival retractor plication (28%), wedge excision (16%), and lateral canthoplasty (5%). The patient-related factors guiding choice were horizontal lid laxity, lateral canthal tendon laxity, and punctal position under traction. Responses found a wide range of preferred surgical techniques in practice. The factors guiding surgical choice were personal audit results (92% stated important/very important), familiarity with the technique (92%), and the technique being favoured by previous trainers (76%), suggesting current practice led by expert opinion, possibly due to a lack of evidence-based literature. This highlights the variety of core oculoplastic surgical techniques practiced and underlines the need for robust trials to guide surgical choice.

No abstract

The incidence of post-operative complications following uncomplicated phacoemulsification and IOL implantation with pupillary sphincterotomy is low. The most important predisposing factors for development of a complication are ocular co-morbidities such as glaucoma, uveitis and the presence of a macular pathology.

Palinopsia is an uncommon but important neuro-ophthalmic condition. It can present with a range of visual phenomena and may be misdiagnosed as migraine or a functional disorder. The list of possible causes is long and includes structural cerebral lesions. We present a clinical case to illustrate the condition before reviewing different palinoptic subtypes and discussing how these may help clinicians to narrow the differential diagnosis.

Intracranial hypotension (ICH) is characterized by low cerebrospinal fluid pressure, postural headaches, and diffuse pachymeningeal enhancement on magnetic resonance imaging (MRI). A variety of ophthalmoparetic manifestations have been reported in the context of the ICH. The authors describe an unusual case of a 64-year-old woman who presented with rapid onset of headaches, bilateral upper-lid ptosis, and blurring of vision within 4 days after sustaining a trivial head injury. She was noted to have bilateral symmetrical ophthalmoplegia and ptosis-simulating chronic progressive external ophthalmoplegia. MRI revealed characteristic features of ICH. Subsequent autologous epidural patch therapy led to resolution of the headache and imaging findings; however, her ptosis and motility disorder persisted. Despite existing therapeutic measures for ICH, irreversible cranial nerve damage may ensue due to significant cerebral decent or ischemic injury.