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Slit lamp photo with dilated epi-scleral veins. Fundus photo with retinal hemorrhages. FA with severe non perfusion, leakage from the disc, and laser scars. MRI/MRA demonstrates left distal precavernous/proximal cavernous ICA fistula into the cavernous sinus with arterialized flow. There is resulta…

Increased intracranial pressure leading to bilateral optic nerve edema. Grade 5 is considered when all vessels are partially obscured by edema.

A 7-year-old patient with fundus photos showing temporal optic nerve pallor OU. Vision was 20/400 and 20/800. Ganglion cell layer of the patients male first cousin reveals diffuse thinning.

Bilateral Optic Neuritis A 36-year-old male presented to ER with sudden loss of vision in both eyes, associated with sever periorbital pain, photophobia and pain with eye movement. Vision was NLP right eye and 20/70 left eye with a right afferent pupillary defect in the right eye. Eye movements wer…

Bilateral Papillitis A 66-year-old man presented to Bascom Palmer with complaints of blurry vision in both eyes for three days which he described as painless. Vision was 20/350 in the right and 20/200 in the left eye with evident papillitis in both eyes on exam. An MRI revealed no retrobulbar optic…

Leber Hereditary Optic Neuropathy – LHON An 18-year-old healthy man was evaluated in the eye emergency room for acute progressive painless vision loss in both eyes. First was affected a right eye and a six days later, left eye was affected too. Best-corrected visual acuity was 20/800 right eye an…

Non-Arteritic Ischemic Optic Neuropathy We report a case of a 32-year-old male who presents with a four days blurry vision in the left eye. Patient denied any associated pain or systemic symptoms. His review of system includes mild gastrointestinal discomfort 2 years prior that led to eventual remo…

Alstrom Syndrome A 5-year-old male referred to the BPEI pediatric ophthalmology clinic for second opinion regarding bilateral progressive vision loss since infancy. VA was 20/200 OU and the patient had nystagmus. He was 99% percentile for weight but had no hearing loss or polydactyl. He underwent s…

Bilateral Ischemic Optic Neuropathy Following Buttock Augmentation in an IIH Suspect A 51-year-old female was transferred from an outside facility 5 days after buttock augmentation surgery in the prone position. On examination, there was no light perception in the right eye and hand motion vision i…

Indirect Carotid Cavernous Fistula A 72-year-old female referred to Bascom Palmer Emergency room with 4 months of progressive painless diplopia and eye redness after dental procedure. Exam revealed VA 20/25 OU with bilateral abducens palsy, and arterialization of the conjunctival vessels. Review of…

Ocular Ischemic Syndrome Ocular ischemic syndrome (OIS) is a rare condition associated with severe carotid artery occlusive disease leading to ocular hypoperfusion. It typically presents at mean age of 65, there is no racial predilection, and is two times more common in men than women. It is typica…