Corneal and External Diseases

Stickler Syndrome This presentation describes a teenage patient who presented with bilateral retinal detachments. He has a strong family history of Stickler Syndrome. Additionally, there is a family history of multiple types of cancers, specifically GI cancers. The patient underwent an exam under a…

Smooth Muscle Hamartoma Our patient presented due to a one-year history of a slowly growing conjunctival lesion. A large, red, non-tender lesion of the right bulbar conjunctiva was identified on examination. It did not improve after several weeks of medical management with steroids. He had no previ…

Silent Brain Syndrome A 34-year-old male presents for corneal evaluation with progressive decline in vision in both eyes associated with pain, redness and discharge. The patient’s past medical history is notable for a cerebellar cyst that was removed at age 21 and placement of a ventricular-atria…

Severe Ocular Chemical Injury A 41-year-old male international patient presented to BPEI 2 months after the initial injury with persistent redness and decreased vision. Clinical exam revealed scleral melt and ischemia and the patient was started on medical treatment and scheduled for urgent tenopla…

Sebaceous Carcinoma Presenting with Corneal Ulcer and Descemetocele An 87-year-old male was referred for second opinion due to nonhealing corneal ulcer of his right eye. He had a past medical history significant for basal cell carcinoma, arthritis, hypertension, hypothyroid, CABG, and carotid stent…

Scleral-Invasive Ocular Surface Squamous Neoplasia An 83-year-old male with history of skin cancer and tobacco use was referred to BPEI for evaluation of a subconjunctival mass which was previously biopsied. On presentation, a large firm subconjunctival mass with prominent feeder vessels was seen. …

Recurrent Pterygium We present a 71-year-old male patient with multiple pterygium resection surgeries on the left eye and one on the right eye. Referred to BPEI with progressive horizontal diplopia on lateral gaze for seven months. On ocular examination revealed 20/60 vision in the left eye, restri…

Pythium Insidiosum Keratitis An 83-year-old otherwise healthy female was referred to the BPEI ER for a progressive corneal ulcer. Exam in the left eye was notable for hand motions vision, normal IOP, and severe corneal ulcer associated with hypopyon and scleral extension. B-scan ultrasonography of …

Pseudophakic Bullous Keratopathy with Prior Descemet Membrane Tears due to Forceps Trauma A patient with a history of forceps trauma at birth and amblyopia of the left eye who presents with persistent corneal edema 1 year after uncomplicated cataract surgery. Initial visual acuity was 20/200, intra…

Post-transplant Interface Infectious Keratitis A patient with past ocular history of pseudoexfoliation syndrome, left eye Descemet’s Stripping Endothelial Keratoplasty (DSEK) and left eye scleral fixated intraocular lens after complicated left eye cataract surgery presented to the emergency room …

Post-Refractive Corneal Haze A patient presented to the Bascom Palmer Eye Institute with bilateral anterior stromal corneal haze after photorefractive keratectomy for high myopia in both eyes 5 years ago. His vision was 20/200 in both eyes, in the setting of significant irregular astigmatism induce…

Peters Anomaly Type 1 A 2-week-old girl presented with bilateral Type I Peters anomaly consisting of bilateral dense central corneal opacities and iridocorneal adhesions. Upon presentation patient had elevated IOP in both eyes (OU) (38 mmHg in the right eye (OD) and 40 mmHg in the left eye (OS)), w…

Peripheral crescentic ulceration and thinning along limbus from 0600 to 1200 with superior neovascularization associated with pain. Treatment was initially with lubrication, antibiotic, systemic steroids, vitamin C, and doxycycline. Ultimately, the patient needed conjunctival recession with AMT pla…

Peripheral Ulcerative Keratitis A patient with well-controlled HIV on antiretroviral therapy presented to the emergency department with five months of left eye pain, redness, discharge, and blurry vision. Visual acuity in the left eye was found to be 20/60 and slit lamp examination was remarkable f…

Inferior peripheral corneal thinning due to systemic inflammatory disease. Surgery was with conjunctival recession and amniotic membrane placement.

Penetrating Ocular Fishhook Injury A patient with a history of stroke, hypertension, and pseudophakia of both eyes, presented with eye trauma while fishing without protective eyewear. While reeling in, his fishhook flew out of the water and hit him in the right eye. On presentation, his right eye v…

Patient presents with unilateral blurred vision, foreign body sensation and redness. Picture on the right shows gelatinous pinguecula at limbal location 4 clock hour, corneal surface with significant PEE. Picture on the left is HR-OCT that shows thickened and hyperreflective epithelium with abrupt …