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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…

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…

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…

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…

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

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…

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…

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…

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…

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…

Intraocular Foreign Body A patient with past ocular history of remote trauma, unilateral retinal detachment repair, and cataract extraction presented with inferior iris pigmentation and chronic corneal edema. He complains of decreased vision, redness, and foreign body sensation. His visual acuity w…

Ocular cicatricial pemphigoid with symblepharon in both eyes.

Ocular Cicatricial Pemphigoid An elderly patient with severe ocular cicatricial pemphigoid (OCP) and immunosuppressed with mycophenolate mofetil has previously lost the right eye due to corneal perforation and choroidal hemorrhage resulting in evisceration. After 5 years of quiescence, his left eye…

Residual Ametropia, Symptomatic Higher Order Aberration A patient who presents for refractive surgery evaluation. They were noted to have no ocular pathology and was deemed a good refractive surgical candidate. Patient underwent uncomplicated bilateral laser in situ keratomileusis, however the pati…

A patient with severe limbal stem cell defiency due to extensive tumor excision undergoes ocular surface reconstruction and SLET.

Sheet form of epithelial downgrowth.

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…