Course name | Date

Fungal Keratitis Post Penetrating Keratoplasty

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Daniel S. Choi, MD; Nimesh A. Patel, MD; Sarah P. Read, MD, PhD
Presenter/Faculty: Choi, Patel, Read

Post penetrating keratoplasty for candida keratitis, this patient developed another foci of infection within the graft tissue. Stromal vascularization and edema can be seen indication failure of the graft.

Grade 5 Papilledema From Idiopathic Intracranial Hypertension

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong

Increased intracranial pressure leading to bilateral optic nerve edema. Grade 5 is considered when all vessels are partially obscured by edema.

Intradermal Nevus

Specialty: Ocular Oncology
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong

The patient presented with an enlarging lower eyelid lesion for 2 months. There was irregular pigmentation without ulceration or madarosis. Biopsy confirmed an intradermal nevus.

Intraocular Lymphoma Associated with Non-CNS Lymphoma Treated with Intravitreal Chemotherapy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Thomas A. Albini, MD; Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD
Presenter/Faculty: Albini, Fan, Patel
The patient presented with panuveitis and exudative retinal detachment OS. He had a recent skin biopsy of a mass on the arm that was found to be Diffuse large b cell lymphoma ABC type. Diagnostic vitrectomy showed +CD20 cells suggestive of intraocular lymphoma. The follow up photo (2 months later) …

Iridocorneal Endothelial (ICE) Syndrome - Iris Atrophy Sub-Type

Specialty: Glaucoma
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): J. William Harbour, MD; Nimesh A. Patel, MD
Presenter/Faculty: Harbour, Patel

This patient was referred for possible iris malignancy. Ultrasound confirmed no mass. There is atrophy of the iris nasally with some variable pigmentation.

Iridodialysis Pre and Post Repair

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Justin H. Townsend, MD
Presenter/Faculty: Patel, Townsend

Slit lamp photo post trauma with bungee cord. There was 5 clock hours of iridodialysis superior nasally with inferior crystalline lens subluxation seen on retroillumination. Post-surgical iris repair and lensectomy the anatomy is restored.

Keratoprosthesis Endophthalmitis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Guillermo Amescua, MD; Janet L. Davis, MD
Presenter/Faculty: Patel, Amescua, Davis

Keratoprosthesis infiltrate and epithelial defect. There was progression with pain and and vitritis that led to removal of the prosthesis.

Lupus Vasculitis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong

Fundus photos showing sheathing of the major and minor vasculature. Fluorescein angiography with small vessel vasculitis with diffuse temporal non-perfusion.

Metal Tip Post Phacoemulsification Surgery

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Carol L. Karp, MD; Nimesh A. Patel, MD; Swarup S. Swaminathan, MD
Presenter/Faculty: Karp, Patel, Swaminathan

This patient underwent uneventful cataract surgery. On post-operative day 1 there was found to be a fragment of metal on the iris likely from the phacoemulsification probe.

Myopic Degeneration

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Harry W. Flynn, Jr., MD; Nimesh A. Patel, MD
Presenter/Faculty: Flynn, Patel

Myopic degeneration patches of severe retinal and choroidal atrophy, lacquer cracks, a tilted disc and lattice degeneration.

Optic Nerve Cupping from Primary Open Angle Glaucoma

Specialty: Glaucoma
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD
Presenter/Faculty: Patel

Increased cup to disc ratio at > 0.9 with some peripapillary atrophy.

Pediatric Leber's Hereditary Optic Neuropathy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Maja Kostic, MD, PhD; Byron L. Lam, MD; Nimesh A. Patel, MD
Presenter/Faculty: Kostic, Lam, Patel

A 7-year-old patient with fundus photos showing temporal optic nerve pallor OU. Vision was 20/400 and 20/800. Ganglion cell layer of the patients male first cousin reveals diffuse thinning.

Penetrating Ocular Trauma with Staple Gun

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Jacob S. Duker, MD; Nimesh A. Patel, MD
Presenter/Faculty: Duker, Patel

The large staple was able to be surgically removed and was performed with phacoemulsification of the lens.

Peripapillary Congenital Hypertrophy of the Retinal Pigment Epithelium (CHRPE)

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Micheal C. Yim, MD
Presenter/Faculty: Patel, Yim

Pigmented lesion in the peripapillary area with lacunae suggesting chronicity.

Peripheral Ulcerative Keratitis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Jesse D. Sengillo, MD; Patrick Staropoli, MD
Presenter/Faculty: Patel, Sengillo, Staropoli

Inferior peripheral corneal thinning due to systemic inflammatory disease. Surgery was with conjunctival recession and amniotic membrane placement.

Peripheral Ulcerative Keratitis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Guillermo Amescua, MD; Nimesh A. Patel, MD; Humberto Salazar, III, MD
Presenter/Faculty: Amescua, Patel, Salazar
Peripheral crescentic ulceration and thinning along limbus from 0600 to 1200 with superior neovascularization associated with pain. Treatment was initially with lubrication, antibiotic, systemic steroids, vitamin C, and doxycycline. Ultimately, the patient needed conjunctival recession with AMT pla…

Polypoidal Choroidal Vasculopathy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD
Presenter/Faculty: Fan, Patel

Fundus photo with a nasal peripapillary sub retinal vascular complex surrounded by exudation. OCT with pigment epithelial detachment and associated sub-retinal fluid. ICG angiography makes the diagnosis clear with a hypercyanescent polyp in the choroid.

Pseudoxanthoma Elasticum with Angioid Streaks

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD
Presenter/Faculty: Fan, Patel

External photo depicting characteristic yellow papules, or p'eau d'orange, on the neck. Fundus photos with angioid streaks (yellow arrows).

Ruptured Macroaneurysm with Sub-Macula Hemorrhage Treated with TPA and Pneumatic Displacement

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Jorge Fortun, MD; Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Fortun, Patel, Rong

The patient presented with a RAM and sub-macular hemorrhage. Treatment was with pars plana vitrectomy, sub-retinal tissue plasminogen activator injection and 26% SF6 gas. The hemorrhage resolved with some photoreceptor changes, but no fibrosis and the patient regained 20/40 vision.

Silicone Oil Droplets on a Silicone Intraocular Lens

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Harry W. Flynn, Jr., MD; Diana M. Laura, MD; Nimesh A. Patel, MD
Presenter/Faculty: Flynn, Laura, Patel

Silicone oil droplets on a silicone intraocular lens