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Post RK Hyperopia A patient with a history of 16-cut radial keratotomy presented with significant hyperopia, an epiretinal membrane, and cataract in the right eye. Corneal topography was notable for significant central flattening and irregular astigmatism in both eyes. He underwent cataract surgery…

Acquired Corneal Subepithelial Hypertrophy A patient presented to the Bascom Palmer Eye Institute with decreasing vision in her right eye several months after having a penetrating keratoplasty for ruptured radial keratotomy incisions. Her exam was notable for visual acuity of 20/60 in the right eye…

Acute Retinal Necrosis A monocular patient with no past ocular history in the left eye presented with several days of decreased vision in the left eye. On examination he was found to have panuveitis, and there was concern for necrotizing retinitis. He was treated empirically for presumed acute reti…

A patient with acquired corneal subepithelial hypertrophy (ACSH) following history of penetrating keratoplasty. Slit lamp photo of the right eye is most notable for a temporal area of white, crescent-shaped, elevated corneal opacity.

Enophthalmos Due to Metastatic Orbital Breast Carcinoma A patient presented to the ER with subconjunctival hemorrhage but incidentally noted to have enophthalmos with mild extraocular movement restriction in the contralateral eye. Further history revealed breast cancer history that was treated 18 y…

Sebaceous Carcinoma, Concern for Muir-Torre Syndrome Our patient presented with a greater than one year history of a non-resolving right eyelid mass that began to hemorrhage due to accidental trauma. Exam was remarkable for and extensive multi-lobar ulcerated mass found along the right lower lid al…

Central Serous Chorioretinopathy We present the case of a patient with decreased vision in the right eye. The patient immigrated to the United States in 2015, and discovered his decreased vision during an eye exam for a driver’s license. He was diagnosed with Wet AMD and had received 5-6 doses of…

Nyctalopia Due to Vitamin A Deficiency A patient with a past medical history of liver cirrhosis, presented to the neuro-ophthalmology clinic with blurry vision in both eyes and nyctalopia that started around a year ago. Ophthalmological exam was notable for a visual acuity of 20/40 in both eyes, re…

Age-Related Macular Degeneration We present an elderly patient with new onset visual distortions in the right eye. Vision is 20/30 OD, 20/20 OS. She is diagnosed with exudative Age-related Macular Degeneration (AMD) in the right eye and non-exudative AMD in the left eye. Swept Source OCT Angiograph…

Infectious Scleritis An elderly patient presented to BPEI with 7 days of decreased vision and pain in the left eye. Visual acuity was hand motion and exam revealed a localized area of scleral necrosis and suppuration. B scan showed a very small and shallow ciliochoroidal detachment. Cultures of the…

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, …

Keratoacanthoma

A pediatric patient with leukemic infiltrate of the optic nerve in both eyes.

CMV Retinitis, Right Eye A patient with no past ocular history presented with right eye pain, redness, photophobia, decreased vision for a week. His exam was notable for visual acuity 20/50 in the right eye and 20/20 in the left eye. Intra-ocular pressure was 20 and 17 mmHg. The slit-lamp exam was …

Leukemic Optic Neuropathy Leukemic optic neuropathy is a rare entity that is characterized as optic nerve dysfunction resulting from direct infiltration of neoplastic leukocytes. It is an indicator of central nervous system involvement, and it is a neuro-ophthalmic and oncologic emergency that warr…

Bilateral Mycobacterium Tuberculosis-Associated Necrotizing Kerato Sclerouveitis Complicated by Bilateral Corneoscleral Perforation and Uveal Prolapse A patient presented from the Bahamas with 5-month history of redness, worsening eye pain, and 5 days of decreasing vision with enlarging “red spot…

Intraosseous Hemangioma An otherwise healthy patient presented to the Emergency Room for evaluation of a left orbital rim lesion, found incidentally by an eyebrow technician. On exam, there was a firm bony mass along the superior orbital rim. Eye exam was otherwise unremarkable. CT scan of the orbi…

Juvenile Myasthenia Gravis A child previously healthy, presented to the ED with his mother for new onset right upper eyelid ptosis of few weeks duration. History was significant for variability in eye alignment over the past few months. Exam was notable for right upper eyelid ptosis with MRD1 of -2…

Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy A patient with no family history of retinal disease presented to the Bascom Palmer emergency room with 4 days of floaters in her right eye. Her VA was 20/30 and her intraocular pressure was normal. She was found to have vitreous hemorrha…