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An otherwise asymptomatic 82-year-old patient with uncorrected visual acuity of 20/25 at distance presents for a routine eye exam in clinic.

ABCA-4 Retinal Dystrophy A patient with bilateral progressive vision loss presents to the clinic for evaluation. The patient’s initial vision was hand motion in both eyes. Fundus photos shows extensive retinal degeneration, geographic atrophy, and optic nerve pallor. ABCA-4 related retinopathies …

Acanthamoeba Keratitis Acanthamoeba keratitis, while an uncommon form of keratitis, is important to recognize and treat aggressively. Unfortunately, due to its encysted form, acanthamoeba is not only difficult to diagnose with standards methods of culture, but it is also very resistant to treatment…

White linear radial stromal haze caused by infiltration and inflammation of the corneal nerves by the amoeba.

Achromobacter Xylosoxidans Endophthalmitis A 79-year-old male with history of Fuchs endothelial dystrophy of both eyes s/p penetrating keratoplasty of both eyes (1980s), repeat penetrating keratoplasty of left eye (2018) and regmatogenous retinal detachment of left eye s/p repair with silicon oil w…

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…

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.

Acute Macular Neuroretinopathy A young patient presents with acute onset of blurry vision and scotoma. Visual acuity is 20/25 in both eyes. Exam reveals hypopigmented patches in the macula of both eyes, as well as a flame hemorrhage in the left. Imaging reveals disruption of the outer plexiform, ou…

Acute Posterior Multifocal Placoid Pigment Epitheliopathy A patient presented with one week of blurred vision. He noted a concomitant headache and cold symptoms as well. He had a history of IV drug use 10 days prior. His visual acuity was 20/100 in the right eye and 20/20 in the left eye. Examinati…

Fundus photo demonstrating confluent creamy yellow-white lesions representing acute posterior multifocal placoid pigment epitheliopathy.

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…

Presentation with peripheral retinal whitening and perivascular hemorrhages. PCR was positive for HSV. Treatment was with the intravitreal antiviral Foscarnet as well as oral Valacyclovir. On 3 months follow up there was improvement in the retinitis with peripheral atrophy that was laser demarcated…

Acute Retinal Necrosis Secondary to HSV-2 Acute retinal necrosis is a rare entity clinically defined by one or more foci of retinal necrosis in the peripheral retina with circumferential spread and rapid progression in the absence of therapy. It typically includes an occlusive vasculopathy and prom…

Acute Syphilitic Posterior Placoid Chorioretinitis A 56-year-old Hispanic male with past medical history of gout presented to the emergency room with a “purple spot” in his right eye for the last four days. Examination was significant for best corrected visual acuity (BCVA) 20/70, no anterior c…

Acute Syphilitic Posterior Placoid Uveitis An adult patient presented to the Bascom Palmer emergency room for evaluation of five days of bilateral painless vision loss and floaters. On slit lamp examination he did not have any conjunctival injection or anterior chamber cell or flare. Dilated fundus…

Acute Zonal Occult Outer Retinopathy (AZOOR) 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 conj…

Acute Zonal Occult Outer Retinopathy (AZOOR) A patient with a history of photopsias in the left eye for approximately 20 years comes for evaluation due to photopsias now involving both eyes. Concomitantly, the patient also notices scotomas in both eyes. Infectious, immune, and degenerative retinopa…