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Bartonella Retinitis A patient presented to the emergency department with 2 days of floaters and pain with ocular movements. He endorsed exposure to stray cats and being scratched by a kitten. Best-corrected visual acuity was 20/20 in both eyes. Anterior segment exam was unremarkable and posterior …

Idiopathic Intracranial Hypertension A patient presented with two weeks of vision loss alongside a year-long complaint of left-sided neck stiffness and headaches. Past medical history was remarkable for end-stage renal disease on peritoneal hemodialysis. Examination was notable for blood pressure o…

Miller Fisher Syndrome A patient with no significant PMH presented with acute onset of diplopia associated with loss of balance 2 weeks after having an influenza infection. On examination: a bilateral limitation in adduction with end gaze nystagmus in the abducted eye was noted. Also, dilated and n…

Bleb Leak A patient with past ocular history of trabeculectomy for juvenile open angle glaucoma and DSAEK for Fuch’s endothelial corneal dystrophy presented to the emergency room with left eye blurred vision and redness. The patient was diagnosed with acute graft rejection. The patient was starte…

Phacomorphic Glaucoma and Anterior Lens Capsule Rupture After Laser Peripheral Iridotomy Patient with a history of multiple retinal detachments status post repair and brunescent cataract was seen at outside eye clinic with elevated intraocular pressure, eye pain and decreased vision. Vision was rep…

Neuromyleitis Optica A child presented to the ER with blurry vision and eye pain. Exam disclosed unilateral optic nerve edema and decreased color vision; subsequent MRI disclosed optic neuritis. Lab testing demonstrated +Aqp4 antibodies, and the patient subsequently developed longitudinally extensi…

Pachyphakia, Microcornea, and Angle Closure A patient presented for right eyelid drooping and redness. The patient had a remote history of retinopathy of prematurity (ROP) which had been treated with extensive retinal laser ablation as a neonate. The patient was found to have pachyphakia, microcorn…

White Cataract with Pre-existing Posterior Capsule Rupture from Intravitreal Injection A patient who underwent an intravitreal anti-vascular endothelial growth factor injection developed a white cataract after his procedure. Careful examination and ultrasonography revealed a white cataract with a p…

A patient who had been previously treated with retinal photocoagulation for severe retinopathy of prematurity. Ultrasound biomicroscopy revealed nearly spherical, thickened lens with complete angle closure. Fundus photography with diffuse chorioretinal scars consistent with previous photocoagulatio…

Idiopathic Intracranial Hypertension A patient with slow and progressive, painless, visual decline OD for two weeks presents to BPEI ED. She also notes moderate intensity full-day headaches and TVOs in the same time period. She saw an outside provider and was referred to BPEI ED for optic nerve hea…

Nuclear 3rd CN Palsy with Vertical Gaze Palsy A patient with significant vasculopathy risk factors (DM, HTN, dyslipidemia), had a stroke affecting the right thalamus, midbrain, and right cerebellum due to basilar artery occlusion. He had a successful mechanical thrombectomy with a stent retriever a…

IRVAN (Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis) A patient presented to the BPEI Emergency Room with a red painful eye and blurred vision. At the time of presentation she was diagnosed with elevated intraocular pressure in the setting of neovascularization of the optic nerve, ir…

Radiation Optic Neuropathy A patient with a history of proton beam therapy for a chordoma near the clivus presented with 1 week of blurry vision in the left eye. On presentation, patient’s exam was notable for a visual acuity of 20/25 in the right eye and 20/50 in the left eye. Intraocular pressu…

Terson's Syndrome A patient with no known past ocular history was referred for evaluation of bilateral retinal detachments. Prior to his presentation, the patient was admitted to an outside hospital and was diagnosed with a sub-arachnoid hemorrhage originating from the right anterior communicating …

Ethambutol Induced Optic Neuropathy A patient with a past medical history of chronic Mycobacterium avium infection, on anti-mycobacterial medication for 5 months, presented with bilateral, painless, progressive visual loss for 1 month. Previous medical history significant for B cell lymphoma and ma…