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Nontuberculous Mycobacteria Keratitis A patient five months after bilateral simultaneous cataract surgery in another country presents to the BPEI emergency room with bilateral decreased vision and extreme right eye pain for the last 2 weeks. Their exam was notable for visual acuity of hand motion i…

Choroidal Folds Related to Multiple Myeloma Recurrence A patient with a prior diagnosis of Fuchs endothelial dystrophy and a past medical history including renal amyloidosis previously treated with chemotherapy presented to the outpatient ophthalmology clinic for routine follow-up. Examination disc…

Non-Infectious Scleritis A monocular patient admitted for pyoderma gangrenosum flare complained of decreased vision and left eye pain. Four years prior she had scleritis OD which requiring scleral reinforcement surgery after which the patient was lost to follow up, developed endophthalmitis and eve…

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…

Slit lamp photos of non-infectious necrotizing scleritis at presentation, week 4, 7, 9.5, and 12 of treatment with systemic corticosteroids and rituximab.

Conjunctival Lymphoma A patient presented to the Bascom Palmer Emergency Room with a complaint of a drooping right eyelid that had been slowly progressive over 9 months. Her vision was 20/25 OD and 20/20 OS. Intraocular pressures were 17 OD and 15 OS. External exam was notable for mild right eye pt…

Dystrophic Epidermolysis Bullosa A child presented to BPEI in 2013 with symblepharon and limbal stem cell deficiency in both eyes. His visual acuity (VA) was 20/40 in his right eye and 20/80 in the left. He came back one year later in 2014 with an advanced inferior symblepharon, covering the visual…

Microsporidial Keratitis A patient with chronic nonresponse keratitis presented to Bascom Palmer with a 2 year history of progressive eye pain and blurry vision in the left eye. He was initially diagnosed with herpes stromal keratitis of the left eye and was treated for >1 year with steroids and…

Fuchs Endothelial Dystrophy A patient presents for cataract surgery evaluation with bilateral guttata and specular microscopy consistent with Fuchs endothelial dystrophy. Preoperative vision was 20/40 in the right eye with pachymetry of 595. Cataract surgery was uncomplicated, however postoperative…

Multi-Drug Resistant Pseudomonas Keratitis Pseudomonas aeruginosa is a gram-negative rod that is both an aerobic and facultative anaerobic organism. It is commonly spread through contact with exposed water, medical equipment, or human contact. As an opportunistic infection, it causes mild disease i…

This patient presented with left-sided CN 5, 6, 7, and 8 palsies leading to multiple emergency visits for corneal erosions and infectious corneal ulcers. Prior treatment was with amniotic membrane discs, superficial keratectomy with EDTA, botox tarsorrhaphy, and a surgical ertractor reinsertion wit…

Neurotrophic Keratitis A patient presented to the Bascom Palmer Eye Institute’s emergency room with acute on chronic left eye pain. The history was notable for a left petroclival chondrosarcoma that had been resected with post-operative, left-sided cranial nerve 5, 6, 7 and 8 palsies. The patient…

Terrien Marginal Degeneration Our patient presented with progressive decreased vision in the left eye and was found to have significant thinning of the inferior cornea associated with corneal neovascularization and lipid deposition, which was worse in the left than the right eye. Inflammatory lab w…

A patient presented with blurred vision in the left eye. Examination showed corneal neovascularization and lipid deposition inferiorly. Anterior segment OCT revealed significant corneal stromal thinning with descemetocele. Treatment was with a with an optical penetrating keratoplasty with corrected…

Traumatic Iris Tear A patient presented to the ER with traumatic cataract, blown pupil, and hyphema. During follow up, noted to have a cyclodialysis cleft with subsequent closure and elevation in intra-ocular pressure. The patient failed medical management of the elevated pressure. The patient requ…

Alternaria Keratitis A patient with a history of a failed DMEK who required a DSAEK, was referred to the BPEI's cornea department after a 1-month history of culture-confirmed Alternaria keratitis that developed after the DSAEK. The ulcer progressed despite topical and systemic antifungal treatment.…

Bilateral Limbal Stem Cell Deficiency Ocular burns are ophthalmic emergencies that can lead to severe long-lasting visual morbidity and disability. The prognosis for visual recovery is largely determined by the degree of ocular tissue damage on initial presentation, especially the extent of limbal …

Congenital Hereditary Endothelial Dystrophy A young patient presented with progressive “eye color changes” noted for at least 2 years. Her parents also noted increasing photophobia and her eyes turning inwards for extended periods of time. Her exam was notable for best corrected visual acuity o…

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…