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Fungal Endogenous Endophthalmitis A 32-year-old male presented with eye pain and decreased vision and was found to have vitritis in a “string-of-pearls” configuration. Clinical findings, epidemiology, diagnostic techniques and management of fungal endogenous endophthalmitis are described. Prese…

Pulled-in-Two Syndrome A 61-year-old female with longstanding left sixth nerve palsy secondary to meningioma that was resected. Her visual acuity OD was 20/20, OS 20/40. Her traction testing OS revealed severe restriction to abduction. She had visual confusion with superimposition of the images tha…

VKH A 52-year-old female that presents with blurry vision and eye pain for 2 days. VA OD E at 6' and OS 20/400. AC trace cell. Vit 1+ cell. DFE and OCT showed swollen optic disc and bilateral serous retinal detachments. Most likely diagnosis for bilateral panuveitis with serous retinal detachments …

Basal Cell Carcinoma A 73-year-old female presented to clinic with a large ulcerated lesion involving the forehead, glabella, upper eyelids and extending towards the medial canthi bilaterally. The lesion had been present and growing for over 19 years, but the patient was reluctant to seek medical c…

Macular Hole A 64-year-old male veteran presents to the clinic on Feb. 15, 2019, with report of having blurry vision in the left eye for 30 years, following left-sided head trauma. He has been told by multiple providers that there was nothing that could be done for his vision. He complains of a “…

Post-Ruptured Globe Associated Retinal Detachment A 75-year-old-man presented to Bascom Palmer Eye Institute for a second opinion following a mechanical fall with trauma sustained to the right eye, resulting in a ruptured globe one month prior. Examination revealed 20/LP vision, no APD, normal IOP,…

Congenital Zika Syndrome A 20 m/o female presented to an eye clinic in Colombia for a follow-up eye exam. Ocular examination revealed a normal anterior segment exam, but fundus photos displayed focal pigment mottling in the macula bilaterally. These ocular findings were attributed to ocular involve…

Nocardia Amikacinitolerans Corneal Ulcer A 31-year-old male presented to the Bascom Palmer Eye Institute ER with six weeks of decreased vision in the right eye. Examination revealed 20/70 vision, a white and quiet eye, with a stromal corneal infiltrate and elevated IOP. The patient was treated with…

Adenoid Cystic Carcinoma of the Lacrimal Gland A 43-year-old female presented to her primary care physician with swelling of the lateral aspect of the right upper eyelid without visual complaints. The primary care physician noted proptosis of the right globe and ordered a CT scan which revealed a m…

Toxic Anterior Segment Syndrome A 73-year-old male with history of myopia presents with 1 day of blurry vision in the right eye after uncomplicated cataract extraction and intraocular lens implant. Patient reports mild irritation without associated pain. Vision at presentation was count fingers wit…

Indirect Carotid Cavernous Fistula A 72-year-old female referred to Bascom Palmer Emergency room with 4 months of progressive painless diplopia and eye redness after dental procedure. Exam revealed VA 20/25 OU with bilateral abducens palsy, and arterialization of the conjunctival vessels. Review of…

Ocular Surface Squamous Neoplasia A 65-year-old male with history of suspected glaucoma, diabetes, hypertension, and hyperlipidemia presented for a routine eye exam. Patient reported spending a lot of time in the sun. Visual acuity was 20/20 and intraocular pressure was normal in both eyes. Exam re…

Retinal Arterial Macroaneurysm 82-year-old female presented to BPEI from the Cayman Islands with 3 weeks of floaters and decreased vision in the right eye. Visual acuity was hand motion and posterior exam revealed vitreous hemorrhage, submacular hemorrhage, and a retinal arterial macroaneurysm (RAM…

HLA-B27-Associated Uveitis A 58-year-old male with a history of CAD, HTN, atrial fibrillation, and schizophrenia presented with 2 days of decreased vision, redness, and pain in the right eye. There was no trauma. Visual acuity was CF OD and IOP OD was elevated. Exam revealed a hemorrhagic hypopyon …

Myopic Traction Maculopathy A 62-year-old Asian male with history of myopia presents with decreased vision x 6 months. Found the have myopic traction maculopathy. Patient managed successfully with observation. He has had gradual worsening of vision but has not affected his quality of life. Myopic t…

Adenoviral Conjunctivitis A 31-year-old male presents with eye redness, foreign body sensation, and blurry vision in both eyes, worse in the right eye. On exam he is found to have follicular conjunctivitis in both eyes with sub epithelial infiltrates on the right cornea. His conjunctiva were cultur…

Alkaline Chemical Corneal Burn A 63-year-old male presented with decreased vision and pain after alkali chemical splash to both eyes at a utility plant. He presented with perilimbal ischemia in the right eye greater than the left, complete opacification of the right cornea and a large epithelial de…

Dislocated Intraocular Lens A 74-year-old male presented to the BPEI ER with blurred vision in the right eye for 3 days. He underwent cataract surgery in both eyes 9 years prior in Costa Rica. He denied any other prior ocular history or trauma. Exam revealed VA 20/200+1 in the right eye. IOP was wi…

Mucormycosis A 61-year-old male with interstitial lung disease status post left lung transplant on immunosuppression develops worsening left facial and periorbital swelling after dental cleaning. Symptoms are unresponsive to oral antibiotics and after three days the patient is examined by ophthalmo…