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Autosomal Recessive RPE65-Deficient Leber Congenital Amaurosis A 17-year-old male with a biallelic RPE65 mutation resulting in autosomal recessive Leber Congenital Amaurosis is referred for evaluation for subretinal gene therapy with voretigene neparvovec-rzyl. Baseline evaluation was remarkable fo…

Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy A patient with no family history of retinal disease presented to the Bascom Palmer emergency room with 4 days of floaters in her right eye. Her VA was 20/30 and her intraocular pressure was normal. She was found to have vitreous hemorrha…

Aspergillus Keratitis A patient with a history of eye trauma with metallic foreign body presented with pain and blurry vision and was found to have severe Aspergillus infectious keratitis. He continued to progress despite topical, systemic, and intrastromal anti-fungal therapy. He was initially tre…

Aqueous Misdirection After Glaucoma Drainage Implant A 54-year-old male presented to the clinic flat anterior chamber 6 weeks after a glaucoma implant device. His vision was 20/200 in the affected eye with an IOP of 10. He had lenticular-corneal touch. His other eye was NLP from presumed POAG. He w…

Traumatic anterior dislocation of crystalline lens with Descemet’s folds in the cornea. The patient was treated with lensectomy and vitrectomy. Due to the high myopia, there was no need for secondary intraocular lens or contact lens. The final vision uncorrected visual acuity was 20/30 aphakic.

A well-positioned ACIOL with superior nasal iridotomy.

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…

The patient presented with ocular ischemic syndrome and corneal edema in the fellow eye. In the right eye on angiography there is temporal non-perfusion as well as choroidal hyperfluorescent infarcts in the late phases. ESR and CRP were elevated. Diagnosis of GCA was made. The patient retained 20/3…

Alveolar Rhabdomyosarcoma A patient presented to BPEI for evaluation of a left upper lid lesion present since birth with no improvement with conservative treatment. Examination revealed a firm, blue, red lesion involving the upper left eyelid and lower eyelid. MRI orbit imaging revealed extensive s…

Histopathology and radiographic images of rhabdomyosarcoma in a young infant.

Alternaria Keratitis A patient with a history of a failed DMEK who required a DSAEK, was referred to the BPEI's cornea department after a 1-month history of culture-confirmed Alternaria keratitis that developed after the DSAEK. The ulcer progressed despite topical and systemic antifungal treatment.…

Alstrom Syndrome A 5-year-old male referred to the BPEI pediatric ophthalmology clinic for second opinion regarding bilateral progressive vision loss since infancy. VA was 20/200 OU and the patient had nystagmus. He was 99% percentile for weight but had no hearing loss or polydactyl. He underwent s…

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…

Age-Related Macular Degeneration We present an elderly patient with new onset visual distortions in the right eye. Vision is 20/30 OD, 20/20 OS. She is diagnosed with exudative Age-related Macular Degeneration (AMD) in the right eye and non-exudative AMD in the left eye. Swept Source OCT Angiograph…

Age Related Macular Degeneration RPE tears occur in AMD as part of the normal disease progression. They are usually associated with vascularized pigment epithelial detachments at a rate of 10%. RPE tears are also associated with Central Serous Retinopathy, Retinal Angiomatous Proliferation, Polypoi…

Adult Onset Xanthogranuloma A 48-year-old male presented with intermittent bilateral eyelid swelling for 5 years and progressively enlarging well-demarcated yellow eyelid lesions. On exam, patient had chemosis, and reduced up gaze in the right eye, prompting orbital imaging with MRI which demonstra…