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Aniridia and Secondary Glaucoma A patient presented with bilateral uncontrolled intraocular pressure (IOP) on maximum medical therapy. Clinical exam was limited by corneal scarring of both eyes but visual acuity was 20/350 OD and 20/250 OS. Intraocular pressure was 27 OD and 29 OS. She had long-sta…

Downbeat Nystagmus A patient was referred with double vision and oscillopsia. He reported to have nystagmus and oscillopsia for a few years, and recently mild worsening. He denies head trauma, weakness, numbness, changes in his vision, transient visual loss, or headache. Patient has trouble reading…

Subperiosteal Orbital Hematoma A patient with a history of chronic pansinusitis and absence of midline nasal cavity structures due to chronic inhalational cocaine usage, presents with acute onset left-sided proptosis. She was found to have a non-traumatic, spontaneous subperiosteal orbital hematoma…

Vogt-Koyanagi-Harada A patient with acute onset bilateral blurry vision presented with bilateral multifocal serous detachments in the absence of other intraocular inflammatory findings. The patient had a past medical history notable for treated chlamydia and gonorrhea. The use of immunosuppressive …

Brown Syndrome A patient was diagnosed with thyroid eye disease (TED) 2 years before presenting to our clinic. He complained of horizontal and vertical diplopia. The diplopia was constant and affected distance vision only. The patient was previously treated with teprotumumab. His exam was notable f…

Nanophthalmos with Angle Closure Glaucoma A patient presented with uncontrolled intraocular pressure (IOP) on maximum medical therapy and had bilateral laser iridotomy. The patient was diagnosed with angle-closure glaucoma. Biometry measurements were consistent with nanophthalmos. The right eye und…

Lipemia Retinalis A patient with past ocular history of nonproliferative diabetic retinopathy presented for routine examination to retina clinic. Patient had no vision concerns nor any systemic symptoms on review of systems. On examination, patient found to have cream colored large calibre vessels …

Primary Congenital Glaucoma A young child with no past ocular history presents with vision loss for 2 months. Her exam was notable for visual acuity of 20/250 in the affected eye with intraocular pressures of 38, relative afferent pupillary defect. Slit lamp findings were notable for subtle bupthal…

Patient with Brown Syndrome with images and videos showing for esotropia which was worse in left gaze, hypotropia of left eye worse in right gaze and upgaze accompanied by limited elevation OS in adduction and incyclotorsion left eye, and restriction of extraocular movement of both eyes.

ABCA-4 Retinal Dystrophy A patient with bilateral progressive vision loss presents to the clinic for evaluation. The patient’s initial vision was hand motion in both eyes. Fundus photos shows extensive retinal degeneration, geographic atrophy, and optic nerve pallor. ABCA-4 related retinopathies …

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…

Bartonella Neuroretinitis A patient presented with subacute painless decreased vision in the left eye. On examination, she had evidence of stellate macular exudates in the left eye, as well as optic disc edema in the right eye. Imaging including fluorescein angiography and OCT of the macula and ret…

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…

This patient presented with left-sided CN 5, 6, 7, and 8 palsies leading to multiple emergency visits for corneal erosions and infectious corneal ulcers. Prior treatment was with amniotic membrane discs, superficial keratectomy with EDTA, botox tarsorrhaphy, and a surgical ertractor reinsertion wit…

Neurotrophic Keratitis A patient presented to the Bascom Palmer Eye Institute’s emergency room with acute on chronic left eye pain. The history was notable for a left petroclival chondrosarcoma that had been resected with post-operative, left-sided cranial nerve 5, 6, 7 and 8 palsies. The patient…