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A patient with bilateral progressive vision loss who presents to clinic for evaluation. Patient's vision loss started in childhood, with initial vision being 20/200 in both eyes. Fundus photos show optic nerve pallor, macular atrophy and extensive pigmentary changes in the periphery. Genetic testin…

A patient with Fuchs' Endothelial corneal dystrophy. Slit lamp photos with retroillumination demonstrate corneal guttate.

A patient presented complaining of decreased vision in the right eye for the past 3-4 months. Best-corrected visual acuity was 20/80 in the right eye. Posterior segment examination revealed a macular hole and cystoid macular edema. (B) Optical coherence tomography demonstrated a macular hole with v…

Cyclodialysis Cleft A patient with a history of sudden vision loss (hand motion) in the left eye following an intravitreal injection for chronic central serous retinopathy (CSR) presented with reduced vision five months later. At the time of presentation, the left eye's visual acuity had improved t…

Infiltrative Optic Neuropathy Secondary to Pleomorphic Mantle Cell Lymphoma A patient presented to the ophthalmology emergency room with a 2-day history of decreased vision of his left eye. Examination revealed vision of 20/25 OD and 20/50 OS, with a relative afferent pupillary defect in the left e…

A patient discovered to have infiltrative optic neuropathy secondary to pleomorphic mantle cell lymphoma. Color fundus photo of the left eye shows grade 3 optic nerve edema with associated splinter hemorrhages as well as a few, scattered dot blot hemorrhages.

A patient with Fabry disease. Slit lamp photos show tortuous conjunctival vessels, corneal verticillata, and cataract. Fundus photos show tortuous vasculature.

Blepharophimosis Syndrome Two patients, both children, presented with FOXL2 mutation and similar constellation of findings, namely blepharophimosis, ptosis, telecanthus, and epicanthus inversus. Exam demonstrates ptosis with amblyopia risk, chin up positioning, and frontalis activation. The first p…

Recurrent Diffuse Conjunctival Malignant Melanoma: Extending onto Cornea and Inferior Palpebra, Right Eye A patient with a previous history of redness and pain in the right eye, for about 2 years. Two months prior presentation, the patient had a Pterygium/Conjunctival lesion excision in the right e…

Ocular Sarcoidosis A patient with past medical history significant for Chronic Lymphocytic Leukemia presents with blurry vision, photophobia and redness of both eyes for two weeks. Examination is remarkable for keratic precipitates, anterior chamber cell, and Koeppe nodules, with unremarkable poste…

Retinal Artery Macroaneurysm An elderly patient with history of uncontrolled hypertension presented with acute onset vision loss of the left eye. Vision was noted to be 20/25 and 20/60. Exam and imaging showed focal macular hemorrhage with significant intraretinal fluid. Intra-vitreal bevacizumab w…

Traumatic Cataract from Glaucoma Drainage Implant Tube Contact A patient with a history of pediatric glaucoma and buphthalmos in the setting of Bardet-Bield syndrome presented to the emergency room with acute progressive vision loss in the left eye after a seizure. The patient prior to injury had n…

Active Thyroid Eye Disease with Pretibial Myxedema A patient with a 10-year history of hyperthyroidism treated with levothyroxine and liothyronine developed one month of intermittent double vision, redness, and foreign body sensation. His exam was notable for vision 20/20 in the right eye and 20/30…

Endogenous Candida Endophthalmitis Endogenous endophthalmitis is an ophthalmic emergency that requires prompt recognition, treatment, and full systemic workup to identify the source of the infection. This case describes a male with a past medical history of diabetes, hypothyroidism, and nephrolithi…

Uveal Melanoma Arising in Ocular Melanocytosis A patient was referred to Bascom Palmer Eye Institute for evaluation due to new onset blurry vision and a dark inferotemporal lesion extending out of the right eye for one month. Her ocular and surgical history includes non-exudative age-related macula…

Ghost Cell Glaucoma A patient with history of T2DM and HTN presented to an emergency department with 2 days of eye pain. The patient endorsed a history of CEIOL in both eyes several years prior and recent history of vitreous hemorrhage for which he had been receiving intravitreal injections. Upon p…

ICE Syndrome with Secondary Angle Closure Glaucoma A patient presented to the Emergency Department with one day of right eye pain and blurry vision. She was noted to have decreased visual acuity in the right eye of 20/400 with highly elevated intraocular pressure at 50. Visual acuity and intraocula…

Sebaceous Cell Carcinoma A patient presents to the Bascom Palmer emergency room with complaints of bloody tearing. Exam demonstrates a large, erythematous epithelial mass on the left upper eyelid palpebral surface. Biopsy of the lesion demonstrates a poorly differentiated carcinoma demonstrating po…