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Multifocal Uveal Melanoma in Setting of Oculodermal Melanocytosis A healthy young patient with prior history of myopia OU presents with sudden-onset decreased vision in the right eye. On presentation, patient’s exam was notable for visual acuity of HM in the right eye and 20/20 in the left eye. I…

Proliferative Diabetic Retinopathy A patient presented to Bascom Palmer Emergency Room for vitreous hemorrhage in left eye. Patient subsequently underwent multiple sessions of panretinal photocoagulation followed by one injection in each eye. The patient was followed for six months and then lost to…

Retinitis Pigmentosa (RHO Pro347Leu Mutation) with Intermediate Uveitis Our patient was referred for asymptomatic bilateral cystoid macular edema (CME) found on a routine eye exam. Initial visual acuity was 20/30 in both eyes with normal intraocular pressure. Posterior segment exam revealed 2+ vitr…

Punctate Inner Choroidopathy A patient presented to the Bascom Palmer emergency room complaining of seeing a fixed gray spot out of the right eye for two weeks. Past history was unremarkable. Vision was 20/70 OD and 20/30 OS. Intraocular pressure and pupils were normal. The anterior exam was normal…

Pentosan Polysulfate Associated Maculopathy A patient presents with a history of difficulty reading and progressive blurry vision in both eyes prior to her presentation. Patient has a significant history of interstitial cystitis with long term use of Pentosan Polysulfate Sodium for 20 years. Her ex…

Peripheral Exudative Hemorrhagic Chorioretinopathy An elderly patient presented to the emergency room with 2 days of progressive floaters and vision loss in the right eye. His visual acuity was 20/80 in the right eye and 20/25 in the left eye. His intraocular pressure was normal in both eyes. Fundu…

Penetrating Open Globe Injury with Retained Intraocular Foreign Body, Left Eye A patient presented with acute decreased vision in the left eye after motor vehicle accident. The patient stated in the accident his car spun out and airbags deployed. Upon presentation, visual acuity was 20/25 in the ri…

Multiple Evanescent White Dot Syndrome (MEWDS) An otherwise healthy young patient without significant medical or ocular history presents with 3 days of acute-onset decreased vision in the right eye. On presentation, patient’s exam was notable for visual acuity of 20/50 in the right eye and 20/20 …

Endogenous Endophthalmitis A middle-aged patient presented to the ophthalmology emergency department with 1-day of blurred vision in his left eye. He reported fevers the week prior. Examination of the left eye was remarkable for a subretinal abscess with hemorrhage, vasculitis, and a preretinal hyp…

This photo demonstrates a large amelanotic yellow/white lesion that appears elevated in the temporal macula with adjacent vasculitis and multifocal hemorrhage. CT scan showed a large hypoattenuating lesion within the right lobe of the liver concerning for a liver abscess. The cultures grew Klebsiel…

A patient presented with night vision loss. The fundus photos showed is RPE hyperplasia and surrounding pigmentary changes. OCT here is diffuse photoreceptor disruption that spares the fovea in addition to area of RPE attenuation along with clumps of RPE deposits

Radiation Retinopathy A patient with past medical history of CNS lymphoma treated with chemotherapy but refractory and necessitating radiation therapy later presented to ophthalmology with slight decrease in vision. On examination, found to have cotton wool spots in both eyes. Fluorescein angiogram…

Retinal Detachment in Proliferative Sickle Cell Retinopathy A middle-aged patient presented with decreased vision in her right eye. She had a history of proliferative sickle cell retinopathy. She is blind in the left eye from a prior failed retinal detachment repair. Her vision in the right eye was…

Vitelliform Maculopathy A middle-aged patient with a remote history of prostate cancer in remission presented as a referral for evaluation of retinal lesions. He denied any complaints initially. He was noted to have orangeish vitelliform lesions deposited around his vascular arcades. Workup for oth…

Choroideremia with Secondary Choroidal Neovascularization A patient with no past medical history presented to the emergency department complaining of floaters in the right eye. Exam was notable for visual acuity of 20/70 in the right eye and 20/30 in the left eye. Intraocular pressures were 14 and …

A patient presented with a central scotoma in the right eye. Fundus examination revealed midperipheral chorioretinal atrophy in both eyes (Fig A). Fundus autofluorescence demonstrated areas of confluent midperipheral hypoautofluorescence (Fig B). Optical coherence tomography demonstrated choroidal …

Acute Macular Neuroretinopathy A young patient presents with acute onset of blurry vision and scotoma. Visual acuity is 20/25 in both eyes. Exam reveals hypopigmented patches in the macula of both eyes, as well as a flame hemorrhage in the left. Imaging reveals disruption of the outer plexiform, ou…

Acute Zonal Occult Outer Retinopathy (AZOOR) A patient with a history of photopsias in the left eye for approximately 20 years comes for evaluation due to photopsias now involving both eyes. Concomitantly, the patient also notices scotomas in both eyes. Infectious, immune, and degenerative retinopa…

Bardet-Biedl Syndrome A young adult presented with progressive decrease in the visual acuity of both eyes. Past medical history included idiopathic intracranial hypertension suspect, obesity, learning disabilities, anxiety, polydactyly (status post excision of an extra toe). Family history includes…