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This patient presented with a one day history of severe pain, reduced vision, diplopia, and proptosis. Imaging revealed a superior ophthalmic vein thrombosis. Extensive workup showed no definite underlying etiology. The patient was started on antibiotics, corticosteroids, and anticoagulation. There…

Superior Ophthalmic Vein Thrombosis with likely Cavernous Sinus Thrombosis A patient presented to the ophthalmology emergency room with a 1 day history of periorbital edema, decreased vision, pain with extraocular movements, and diplopia. Evaluation showed proptosis with significant injection and e…

Recurrent Idiopathic Neuroretinitis A patient presented with 1 day of decreased vision in 2016. Exam disclosed OS>>OD optic nerve edema with visual field defects without other findings. The patient was treated with steroids without much improvement and lost to follow up. The patient then over…

Myelin Oligodendrocyte Glycoprotein Antibody Disease A middle-aged patient was referred from an outside facility for follow up of idiopathic intracranial hypertension. On careful review, she was found to have demyelinating disease on a prior MRI. Patient underwent a repeat MRI which did not demonst…

Recurrent Benign Sixth Nerve Palsy A young patient presented with acute onset of crossed eyes and diplopia. He reported no associated vision changes in either eye. His examination revealed right eye esotropia of 6 prism diopters (PD) in primary gaze, 14 PD in right gaze, and 4 PD in left gaze. The …

A patient discovered to have infiltrative optic neuropathy secondary to pleomorphic mantle cell lymphoma. Color fundus photo of the left eye shows grade 3 optic nerve edema with associated splinter hemorrhages as well as a few, scattered dot blot hemorrhages.

Infiltrative Optic Neuropathy Secondary to Pleomorphic Mantle Cell Lymphoma A patient presented to the ophthalmology emergency room with a 2-day history of decreased vision of his left eye. Examination revealed vision of 20/25 OD and 20/50 OS, with a relative afferent pupillary defect in the left e…

Arsenic Toxicity A patient presented for slowly worsening vision over past two years. She was diagnosed with glaucoma at an outside hospital however vision continued to worsen throughout the years. She presented for second opinion. Due to her posterior exam, her diagnosis was difficult to ascertain…

Morning Glory Disc Anomaly A child presented for evaluation of chronic poor vision of her right eye. Fundus exam showed an excavated nerve with peripapillary chorioretinal pigmentation, overlying central glial tuft, radial vessels, and inferior serous retinal detachment. Findings were consistent wi…

Acute syphilitic posterior placoid chorioretinopathy (ASPPC) is a unique ocular sign of syphilis. It appears as a large, flat, yellowish lesion on the retinal pigment epithelium, typically in the macula. While not seen in every syphilis case, its presence strongly suggests ocular involvement and wa…

Pediatric Idiopathic Intracranial Hypertension (Pediatric IIH) A pediatric patient accompanied by their parent presented to BPEI ED complaining of an episode of complete loss of vision in the left eye that was initially blurry, then totally black, lasting from 20-30 seconds. The symptom was associa…