Consultant Ophthalmologist
A 55-year-old man is referred for ophthalmology review during an inpatient admission with a blood pressure of 260/150 mmHg, acute kidney injury, and severely impaired cardiac function. Fundoscopy and OCT reveal the full picture of severe hypertensive retinopathy - a case that illustrates how the retina can be a window to life-threatening systemic disease.
Read case →A 65-year-old man with tuberous sclerosis complex is referred after an optometrist finds a striking hyperreflective inner retinal lesion on OCT with nothing visible on fundoscopy. The differential includes cotton wool spots given his diabetes, hypertension, and renal transplant - but the history, bilateral involvement, and stability on serial photographs point firmly to retinal astrocytic hamartomas.
Read case →A 64-year-old woman is referred with an abnormal right macular OCT. The findings are diagnostic of torpedo maculopathy - a rare congenital RPE anomaly. An incidental longstanding peripheral retinal tear is also identified in the left eye, requiring no treatment.
Read case →A 27-year-old man is referred after his first OCT reveals an area of apparent RPE absence inferonasal to the right optic disc. The appearance is typical of a conforming focal choroidal excavation - a rare but benign idiopathic finding. Remote diagnosis allowed reassurance without a hospital visit.
Read case →An 87-year-old woman is referred urgently with a working diagnosis of vitelliform macular dystrophy and dot and blot haemorrhages. OCT and careful fundus interpretation point instead to a single unifying diagnosis: an old superotemporal BRVO with secondary ERM and an acquired vitelliform lesion at the fovea.
Read case →A 52-year-old asymptomatic man is referred after his first macular OCT reveals a raised area temporal to the fovea. The imaging is typical of a choroidal macrovessel - a benign anomalous dilated choroidal vessel that can mimic more sinister pathology. Confident remote interpretation allowed reassurance without a hospital visit.
Read case →A 40-year-old woman wakes from elective endovascular coiling of a paraophthalmic ICA aneurysm with no perception of light in the left eye. Serial OCT over three months illustrates the acute and chronic phases of central retinal artery occlusion, with apparent cilioretinal artery sparing but NPL vision raising the possibility of concurrent ischaemic optic neuropathy.
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