Epidemiological reports strongly indicate that pterygium is an ophthalmoheliosis: a sun-related eye disease. Familial occurrence of pterygium is rare but supports the concept that heredity may predispose the conjunctiva to react abnormally to atmospheric-environmental stimuli. We describe a two generation Caucasian family of five members from the United Kingdom, four of whom developed pterygia in early adulthood with autosomal dominant inheritance. The present report confirms the significance of heredity in the pathogenesis of pterygium. Understanding the genetic basis of pterygium pathogenesis is clinically relevant, particularly in the management of patients who develop recurrent and aggressive pterygia at younger ages.

There have only been a few case reports in the literature describing facial nerve palsy in the context of a glomus jugulare tumour. This case highlights that although paragangliomas are exceedingly rare causes of facial palsy, they should be included in the differential diagnosis.

While diabetic retinopathy and maculopathy are leading causes of premature visual loss in people with diabetes, other retinal and non-retinal pathology should be considered in the differential diagnosis. These include issues with both eye movement and vision, and can be split into: those which are extraocular, including orbital cellulitis and cranial nerve palsies; those in the anterior segment, including dry eyes, visual disturbances, superficial eye infections, anterior uveitis, cataracts and neovascularisation glaucoma; and those in the posterior segment of the eye, including endophthalmitis, diabetic papillopathy and ischaemic optic neuropathy. This article reviews each of these areas in respect to a person with diabetes, with the aim to highlight some of these conditions to health care staff who manage patients with diabetes. Awareness of conditions other than diabetic retinopathy should help with timely referral and treatment to limit visual disability, which can have a significant impact on daily living.

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