A 53-year-old patient presented with recurrent epicleritis of the right eye for 6 months and progressive diplopia. He had a past history of orbital floor repair over 30 years. A CT scan showed a radiodense migrated orbital floor sheet implant in the maxillary sinus causing obstruction of the maxillary sinus ostium, secondary maxillary sinusitis with retrobulbar involvement. The silastic orbital implant was removed via a Caldwell Luc approach and resolution of the patient's symptoms and signs quickly ensued. We discuss this late complication of orbital floor fracture repair presenting initially as recurrent episcleritis and maxillary sinusitis with intraorbital extension. This report also emphasizes the importance of history taking.

Patients mainly justified their decision to receive Oraya treatment by expecting fewer intravitreal injections, but more research on this topic is needed to suggest new evidence-based treatment protocols for patients with wet ARMD.

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Ocular ischemic syndrome (OIS) features ocular changes occurring secondary to carotid artery occlusive disease (CAOD). We present a unique case of a 64-year-old patient who was referred to the retina clinic due to an incidental isolated finding of left optic disc neovascularization (NVD). The patient was asymptomatic with visual acuity of 6/6 unaided and with normal intraocular pressure bilaterally. Fundus fluorescein angiogram showed hyper-fluorescence on the left optic disc with no areas of capillary dropout. Carotid Doppler and CT angiogram showed significant stenosis within the left proximal internal carotid artery (ICA) and poor visualization of flow in the distal ICA. The patient was urgently referred to the vascular team, and within four months of establishing an OIS diagnosis, she had carotid endarterectomy. As a result, NVD did not show any further progression. This case highlights the importance of community retinal screening by optometrists; that OIS can be asymptomatic, the need to consider CAOD in cases of NVD; and the importance of a multidisciplinary approach.

Argon laser treatment was the mainstay of treatment for diabetic retinopathy (DR) and maculopathy up to the last decade. However, with the better understanding of pathophysiology of DR, newer medications have become available. Anti-vascular endothelial growth factors (anti-VEGF) and steroid implants for vision-threatening diabetic macular oedema have been widely adopted in clinical practice with several longer-acting drug molecules in the pipeline. In the United Kingdom, ranibizumab and aflibercept are licensed anti-VEGF drugs. Dexamethasone and fluocinolone acetonide implants are the steroids that are available. The emphasis on systemic control of diabetes and blood pressure remains very relevant even in the era of these newer drugs.