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Vitreous Hemorrhage A patient with a past medical history of hypertension presented with vision loss in the right eye for two days. His exam was notable for visual acuity of hand motions in the right eye and 20/20 in the left eye. Intraocular pressures and slit lamp exam were normal in both eyes. P…

Retinal Arteriole Occlusions Secondary to Silicone Microembolization A patient with a history of mid-brain syndrome and silicone gluteal injection 12 years prior presented to the emergency department complaining of floaters in the right eye for the past week. Exam was notable for visual acuity of 2…

Fundus photos and FA with retinal non perfusion, peripheral hemorrhages, and crystalline like retinopathy and both eyes. The OCT retina shows multiple small areas of hyperreflectivity.

Branch Retinal Artery Occlusion A patient with a past medical history of fusiform aneurysm of the right anterosuperior M2 trunk measuring 7 x 15 mm underwent a pipeline assisted coil embolization of the right middle cerebral artery M2 fusiform aneurysm, which led to almost complete obliteration of …

Type 3 Macular Neovascularization/Retinal Angiomatous Proliferation A patient presented with decrease in vision in the left eye for 3 days. Her visual acuity was 20/40 in the right eye and 20/200 in the left eye. Examination revealed drusen in the right eye and large pigment epithelial detachment, …

Endophthalmitis in the Setting of a XEN Stent A patient presented with eye pain and worsening vision 1.5 months after cataract surgery. Exam revealed purulent discharge, severe anterior chamber inflammation, and a XEN stent with nearby erosion of conjunctiva and Tenon’s down to bare sclera. Cultu…

ABCA-4 Retinal Dystrophy A patient with bilateral progressive vision loss presents to the clinic for evaluation. The patient’s initial vision was hand motion in both eyes. Fundus photos shows extensive retinal degeneration, geographic atrophy, and optic nerve pallor. ABCA-4 related retinopathies …

Lipemia Retinalis A patient with past ocular history of nonproliferative diabetic retinopathy presented for routine examination to retina clinic. Patient had no vision concerns nor any systemic symptoms on review of systems. On examination, patient found to have cream colored large calibre vessels …

Bilateral Diffuse Uveal Melanocytic Proliferation A patient with a past medical history of bladder and lung cancer s/p primary excisional therapy, chemotherapy, and a short course of immunotherapy presented with a recent episode of blurry vision in both eyes. Patient’s exam was notable for visual…

Exudative Age-Related Macular Degeneration A patient with neovascular age-related macular degeneration in both eyes has been receiving intravitreal aflibercept in her left eye every 4-5 weeks, for more than 10 years. Whenever the interval between the intravitreal injections was increased there was …

Fundus photo of Central Retinal Artery Occlusion (CRAO).

Central Retinal Artery Occlusion An elderly patient presented to the BPEI Emergency Room 3 hours after onset of painless vision loss. Past medical history included hypertension and atrial fibrillation treated with apixaban, of which the patient reported good adherence. The patient had no other sign…

A young patient presented with a 1-week history of unilateral superior visual field deficit in the left eye with a visual acuity of 20/30 with pinhole correction to 20/20, normal IOP, and without an APD. Detailed medical, surgical, family, and social history-taking revealed only patient consumption…

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…

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 …

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 …