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Conjunctival Amyloidosis A 48-year-old male with no PMH or POH presented to clinic with painless ptosis OD>OS noticed by his wife for several months. Visual acuity was 20/25 in each eye with unremarkable ocular vitals. Large, yellow-pink, fleshy lesions were noted on the superior bulbar conjunct…

Conjunctival Keratoacanthoma Keratoacanthoma (KA) is an epithelial tumor characterized by rapid, abundant growth and a potential for spontaneous resolution. It typically occurs on the skin in sun-exposed areas such as the face, neck, and hands. Rarely it can occur on the conjunctiva and vulvar regi…

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…

Conjunctival Melanoma A 55-year-old male who presented to Bascom Palmer for a multi-year history of a progressively enlarging painless pigmented conjunctival lesion of the right eye. He was found to have a large non-mobile pigmented lesion of the right perilimbal conjunctiva. While initially he was…

Conjunctival Squamous Cell Carcinoma with Intraorbital and Intraocular Invasion A 64-year-old male with a history of T2DM and HTN was referred for 2 weeks of severe pain and redness in the right eye. Two months earlier, he had undergone reported pterygium removal surgery in another country. At pres…

Conjunctival Squamous Cell Carcinoma, Keratoacanthoma Type A patient presented with a rapidly enlarging lesion of the nasal conjunctiva of the left eye. The past ocular history was significant only for bilateral surgical removal of cataracts with intraocular lens placement. The patient had a past m…

In this module, we will look at:




Corneal Anatomy


Refractive Errors


Dry Eye Syndrome


Corneal Infections


Immune Mediated Corneal Disease



Corneal Ectasias and Degenerations

Corneal Decompensation Corneal decompensation in the setting of glaucoma surgery is a complex entity that is poorly understood. Endothelial cell loss occurs from both the glaucoma itself and from the placement of intraocular glaucoma devices. This decline in endothelial cells occurs via direct and …

A patient with bilateral corneal edema and elevated intraocular pressure due to cosmetic iris implants. Slit lamp photos showing left worse than right corneal edema, with distortion of native iris behind the implant. High resolution ultrasound biomicroscopy showing iris implant resting in the angle…

Corneal Graft Endothelial Rejection in Association with COVID-19 Vaccine A patient with history of pseudophakic bullous keratopathy (PBK) of the right eye (OD) was self-referred to cornea service for progressively decreasing vision. He subsequently underwent uncomplicated Descemet’s membrane endo…

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…

Cosmetic Iris Implant A patient presented for bilateral blurred vision and eye pain of 3 days duration. The patient had previously undergone bilateral LASIK and cosmetic iris implantation. He was found to have decreased vision of 20/800 on the right eye and could see the 20/200 E when held at his f…

COVID-19 Related Conjunctivitis A 33-year-old female presented with 6 days of eye redness and tearing without vision changes. She had no significant past medical history and was not taking any medications. Of note, the patient was a Registered Nurse at University of Miami Hospital. She had multiple…

Crystalline Keratopathy Secondary to Mycobacteria Abscesses in Setting of Pre-Existing Herpetic Keratitis A patient with history of herpetic keratitis referred to cornea service with multifocal, white, anterior stromal deposits left eye. Examination revealed 20/20 with inferior and temporal paracen…

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…

Epithelial Downgrowth A patient with a history of bilateral corneal transplants, glaucoma drainage device, and iris cysts presented with gradually decreasing vision after surgical removal of the cyst and cataract surgery in that eye. The patient was diagnosed with epithelial downgrowth and underwen…

Epithelial Downgrowth A patient with ocular history of ruptured globe presented with a new pupillary membrane. Argon laser photocoagulation showed blanching of the iris epithelium concerning for epithelial downgrowth. A biopsy of this membrane was positive for epithelial downgrowth. It was observed…