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NUT Carcinoma A patient presented with several weeks of right eye proptosis. On initial examination, his visual acuity in the right eye was 20/400, and a relative afferent pupillary defect was noted. He had 4 mm relative proptosis on the right and restricted motility in all gaze directions. CT orbi…

Pseudophakic Bullous Keratopathy with Prior Descemet Membrane Tears due to Forceps Trauma A patient with a history of forceps trauma at birth and amblyopia of the left eye who presents with persistent corneal edema 1 year after uncomplicated cataract surgery. Initial visual acuity was 20/200, intra…

Slit lamp photos of non-infectious necrotizing scleritis at presentation, week 4, 7, 9.5, and 12 of treatment with systemic corticosteroids and rituximab.

Metastatic Melanoma; Side Effect of Immune Checkpoint Inhibitor A patient with a history of recurrent metastatic conjunctival melanoma presented with a left upper lid orbital lesion and pigmented lesion in the medial fornix. The original conjunctival melanoma was originally excised in an outside ce…

Bilateral Diffuse Uveal Melanocytic Proliferation A patient with a past medical history of bladder and lung cancer s/p primary excisional therapy, chemotherapy, and a short course of immunotherapy presented with a recent episode of blurry vision in both eyes. Patient’s exam was notable for visual…

Exudative Age-Related Macular Degeneration A patient with neovascular age-related macular degeneration in both eyes has been receiving intravitreal aflibercept in her left eye every 4-5 weeks, for more than 10 years. Whenever the interval between the intravitreal injections was increased there was …

Conjunctival Lymphoma A patient presented to the Bascom Palmer Emergency Room with a complaint of a drooping right eyelid that had been slowly progressive over 9 months. Her vision was 20/25 OD and 20/20 OS. Intraocular pressures were 17 OD and 15 OS. External exam was notable for mild right eye pt…

Postoperative Endophthalmitis An elderly patient with past medical history of quiescent birdshot chorioretinopathy on immunosuppressive therapy underwent uneventful cataract surgery in the right eye followed by intracameral injection of moxifloxacin at the end of the case. On postoperative day 4, t…

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…

Dystrophic Epidermolysis Bullosa A child presented to BPEI in 2013 with symblepharon and limbal stem cell deficiency in both eyes. His visual acuity (VA) was 20/40 in his right eye and 20/80 in the left. He came back one year later in 2014 with an advanced inferior symblepharon, covering the visual…

Photograph of a peripheral iridotomy.

UBM demonstrating iris hypoplasia in a patient with aniridia.

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…