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Active thyroid eye disease with pretibial myxedema A patient with a 10-year history of hyperthyroidism treated with levothyroxine and liothyronine developed one month of intermittent double vision, redness, and foreign body sensation. His exam was notable for vision 20/20 in the right eye and 20/30…

Uveal melanoma arising in ocular melanocytosis A patient was referred to Bascom Palmer Eye Institute for evaluation due to new onset blurry vision and a dark inferotemporal lesion extending out of the right eye for one month. Her ocular and surgical history includes non-exudative age-related macula…

Ghost Cell Glaucoma A patient with history of T2DM and HTN presented to an emergency department with 2 days of eye pain. The patient endorsed a history of CEIOL in both eyes several years prior and recent history of vitreous hemorrhage for which he had been receiving intravitreal injections. Upon p…

ICE syndrome with secondary angle closure glaucoma A patient presented to the Emergency Department with one day of right eye pain and blurry vision. She was noted to have decreased visual acuity in the right eye of 20/400 with highly elevated intraocular pressure at 50. Visual acuity and intraocula…

Sebaceous Cell Carcinoma A patient presents to the Bascom Palmer emergency room with complaints of bloody tearing. Exam demonstrates a large, erythematous epithelial mass on the left upper eyelid palpebral surface. Biopsy of the lesion demonstrates a poorly differentiated carcinoma demonstrating po…

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 …

Bilateral inferior rectus muscle aplasia, severe hypertropia, deprivation amblyopia An infant was referred to BPEI for strabismus/oculoplastic evaluation. They were born prematurely at 32 weeks of gestation with a previous surgical history notable for superior rectus tenotomy. The patient presented…

[Diagnosis] An infant with history of preterm birth presented to the Bascom Palmer emergency room with a rapidly progressive left upper lid mass. Evaluation showed non-axial proptosis and a large superonasal, vascular mass deep in the left orbital rim. MRI brain and orbits with and without contrast…

Autosomal dominant cone-rod dystrophy caused by a mutation in the cone-rod homeobox (CRX) gene A patient presented with decreased vision, photophobia and glare affecting both eyes within the past year. Their past medical history included sleep apnea and anxiety/depression treated with hydroxyzine a…

PDE6-associated Retinitis Pigmentosa  A patient with a family history of vision loss presented with a 2 year history of progressive vision loss in both eyes. Patient’s exam was notable for visual acuity of 20/40 in the right eye and 20/30 in the left eye. Intraocular pressure was 20 and 21 i…

PDE6-associated Retinitis Pigmentosa A patient with a family history of vision loss presented with a 2 year history of progressive vision loss in both eyes. Patient’s exam was notable for visual acuity of 20/40 in the right eye and 20/30 in the left eye. Intraocular pressure was 20 and 21 in the …

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…

Invasive Cutaneous Melanoma of the Eyelid A patient presented to clinic for a long-standing history of a left lower eyelid/ cheek lesion with more recent growth. He had a history of multiple previously resected basal cell carcinomas of the face, neck and scalp. Initial examination was notable a lef…

Kabuki Syndrome Associated Euryblepharon and Ptosis Repair with Post Operative Hematoma A teenager with a history of Kabuki Syndrome presents to the ophthalmology clinic for evaluation of bilateral ptosis and eye rubbing, and epiphora. Best corrected visual acuity is 20/40 bilaterally, intraocular …

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…

Nocardia Bacterial Keratitis A patient presented to the Bascom Palmer Emergency Room with 2 weeks of red painful eye. On exam, he was found to have a patchy white stromal infiltrate suspicious for bacterial or fungal keratitis. Fortified antibiotics were started, and a culture was drawn. Ultimately…

Primary Localized Conjunctival Amyloidosis A patient with a few years of intermittent left eye redness and left eyelid drooping. He has no significant past ocular or past medical history. Exam reveals intact visual acuity, normal pupils, intraocular pressure, extraocular motility, and confrontation…

Conjunctival Melanoma Treated with Systemic Checkpoint Inhibitors A patient with past medical history of basal cell carcinoma and metastatic scalp melanoma presents with an enlarging pigmented lesion of his left conjunctiva. His vision was intact in both eyes with normal intraocular pressures. Exam…

Infectious Necrotizing Scleritis A patient with no past medical history and a past ocular history of five prior pterygium removal surgeries (three in the right eye and two in the left eye, most recently seven years ago in the right eye), presented to the Bascom Palmer Emergency Room for pain and ir…

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…