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Aneurysmal Bone Cyst A patient with a 2-week history of proptosis and vision changes in the right eye is transferred from an outside hospital. Neuroimaging revealed a large intraorbital and intracranial expansile lesion with multilobulated cystic spaces, surrounded by a thin cortical shell with per…

NUT Carcinoma A patient presented with several weeks of right eye proptosis. On initial examination, his visual acuity in the right eye was 20/400, and a relative afferent pupillary defect was noted. He had 4 mm relative proptosis on the right and restricted motility in all gaze directions. CT orbi…

Orbital Lympathic Dominant Lymphatic Venous Malformation A patient with a past ocular history of orbital lymphatic-venous malformation with left upper eyelid swelling and proptosis at childhood who underwent sclerosing therapy presents 7 years later with newly developed left upper eyelid swelling, …

Pleomorphic Adenoma A patient with a past ocular history of presumed thyroid eye disease presented with left eye discomfort and left upper eyelid swelling for two days. She endorsed double vision but denied any blurry vision. Her exam was notable for visual acuity of 20/20 in the right eye and 20/2…

Myelinated retinal nerve fiber layer

Nasolacrimal Fungal Granuloma A 40-year-old man with a past medical history significant only for hyperthyroidism, and no past ocular history, presented with “several months” of left sided proptosis associated with bloody tears, left eye pain, and unilateral blurry vision. He denied trauma, feve…

Adult Onset Xanthogranuloma A 48-year-old male presented with intermittent bilateral eyelid swelling for 5 years and progressively enlarging well-demarcated yellow eyelid lesions. On exam, patient had chemosis, and reduced up gaze in the right eye, prompting orbital imaging with MRI which demonstra…

Retinal Capillary Hemangioblastoma in Von-Hippel Lindau Syndrome A 40-year-old male with family history of renal cell carcinoma and history of neurosurgical excision of cerebellar hemangioblastoma presents for routine ophthalmic examination. Vision is 20/20 in both eyes. Fundus examination reveals …

Basal Cell Carcinoma A 73-year-old female presented to clinic with a large ulcerated lesion involving the forehead, glabella, upper eyelids and extending towards the medial canthi bilaterally. The lesion had been present and growing for over 19 years, but the patient was reluctant to seek medical c…

Congenital Zika Syndrome A 20 m/o female presented to an eye clinic in Colombia for a follow-up eye exam. Ocular examination revealed a normal anterior segment exam, but fundus photos displayed focal pigment mottling in the macula bilaterally. These ocular findings were attributed to ocular involve…