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OCTA demonstrating neovascularization (yellow arrow) growing into the vitreous with widefield imaging.

This is congenital retinal dystrophy is caused by a mutation in the retinoschisin (RS1) gene, which encodes for a protein that functions in cellular adhesion. The fundus photo shows a macular stellate pattern caused by schisis or splitting of the retinal layers at the level of the outer plexiform l…

PAM and OSSN This case presents a 67-year-old gentleman who was referred for a pigmented lesion. The HR-OCT suggested that this was not simply a small area of PAM, but rather demonstrated an epithelial hyper-reflectivity and thickening with an abrupt change from normal to mildly thickened epitheliu…

Syphilitic Uveitis A 64-year-old male presented to the VA Eye Clinic with painless vision loss in the right eye. He was found to have vitreous hemorrhage, thought to be secondary to a hemorrhagic PVD, which was observed. Over several weeks, the patient’s vision worsened and his vitreous became mo…

Leukemic Retinopathy A patient with no significant past medical history presented to BPEI ER complaining of blurry vision in the left eye for two weeks. On fundus exam, he had hemorrhages in multiple layers of the retina, venous dilation and tortuosity, and Roth spots. CBC was obtained which reveal…

Bilateral Exotropic Duane Syndrome A healthy 5-year-old male presented with an outward deviation of both eyes since approximately 4 months of age. Motility testing was notable for significant limitation to adduction in both eyes, significant downshoot in the right eye and downshoot and upshoot in t…

Juvenile Xanthogranuloma Patient presented to the BPEI emergency room with tearing and light sensitivity of the right eye for 1 month. Examination revealed grimace-to-light vision, soft to palpation intraocular pressure, and hyphema. Skin examination revealed yellowish raised skin lesions on the ne…

Limbal Stem Cell Deficiency We report a case of severe unilateral chemical-thermal injury complicated by total limbal stem cell deficiency and symblepharon, treated with Simple Limbal Epithelial Transplantation (SLET) combined with conjunctival autografting (CAG). We used an autologous limbal biops…

Neuromyelitis Optica Spectrum Disorder (NMOSD) A patient presented to the emergency room with acute vision loss in the left eye for two weeks. Examination revealed 20/400 vision, crowded nerve with blurred margin, and afferent pupillary defect in the left eye. MRI orbit with and without contrast re…

Pentosan Polysulfate Maculopathy A patient presented to Bascom Palmer Eye Institute complaining of slowly progressive vision loss in both eyes occurring over several years. Examination revealed 20/25, 20/30 vision, bilateral hyperpigmented mottling in the posterior pole. Fundus autofluorescence sho…

Adenoid Cystic Carcinoma A patient with past medical history of a previously resected lacrimal gland mass presented to the emergency room with worsening unilateral proptosis and eye pain with persistent new eversion of the upper eyelid for several days. Examination was significant for severe propto…

Crystalline Keratopathy Secondary to Mycobacteria Abscesses in Setting of Pre-Existing Herpetic Keratitis A patient with history of herpetic keratitis referred to cornea service with multifocal, white, anterior stromal deposits left eye. Examination revealed 20/20 with inferior and temporal paracen…

Cystoid Macular Edema (CME) A patient presents with recent blurry vision OS. VA 20/200 OD and 20/25 OS. Exam significant for macular scar OD and macular edema OS. Imaging workup significant for OCT showing intra-retinal fluid and VMT OS, SS-OCTA OS showed CNV. Patient started on Aflibercept injecti…

Chorioretinitis Sclopetaria This case involves an elderly gentleman presenting after trauma to his right eye by an errant golf ball. He was diagnosed with rupture at an outside hospital, but globe exploration failed to identify the site of rupture. He presented to BPED and was diagnosed with chorio…

Intraorbital Foreign Body Intraorbital foreign bodies most commonly present with an ocular or penetrating injury. However, when the globe is not involved, the presentation of an intraorbital foreign body can be subtle. Here, we present a case of a 21-year-old female with right upper and lower lid s…

Ocular Metastatic Cutaneous Melanoma A patient with metastatic cutaneous melanoma to the eye was referred to BPEI glaucoma service for elevated IOP. Examination revealed 20/125 vision and IOP 31 mmHg on multiple glaucoma drops. Gonioscopy revealed a diffuse melanomatous membrane and pigment accumul…

Nasolacrimal Fungal Granuloma A 40-year-old man with a past medical history significant only for hyperthyroidism, and no past ocular history, presented with “several months” of left sided proptosis associated with bloody tears, left eye pain, and unilateral blurry vision. He denied trauma, feve…