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Leber Hereditary Optic Neuropathy – LHON An 18-year-old healthy man was evaluated in the eye emergency room for acute progressive painless vision loss in both eyes. First was affected a right eye and a six days later, left eye was affected too. Best-corrected visual acuity was 20/800 right eye an…

Leber Hereditary Optic Neuropathy An 18-year-old male presented to the ER with bilateral decreased vision and eye pain for 10 days. His visual acuity was HM OD, 20/300 OS. He was noted to have disc pallor OD and temporal pallor with slight nasal elevation OS on fundus exam. His MRI showed T2 hyper …

Leber Hereditary Optic Neuropathy (LHON) A previously healthy patient presented to the emergency department (ED) with a 2-week history of bilateral blurry vision associated with painful eye movement. The patient denied eye redness, eye discharge, photophobia, double vision, or headache. The ophthal…

Leber's Hereditary Optic Neuropathy A patient came to ED due to subacute decreased vision in his right eye since 1/2023. He had a history of decreased vision in his left eye following phacoemulsification surgery in Oct 2022. BCVA was 20/70 OD and 20/400 OS Past medical history was positive for HTN,…

In this module, we will look at:




Anatomy of the Lens


Cataracts

A pediatric patient with leukemic infiltrate of the optic nerve in both eyes.

Leukemic Optic Neuropathy Leukemic optic neuropathy is a rare entity that is characterized as optic nerve dysfunction resulting from direct infiltration of neoplastic leukocytes. It is an indicator of central nervous system involvement, and it is a neuro-ophthalmic and oncologic emergency that warr…

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…

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…

Lipemia Retinalis A patient with past ocular history of nonproliferative diabetic retinopathy presented for routine examination to retina clinic. Patient had no vision concerns nor any systemic symptoms on review of systems. On examination, patient found to have cream colored large calibre vessels …

Lisch Corneal Dystrophy A patient presented with blurry vision in the left eye and was found to have a pigmented superficial corneal lesion which showed hyperreflectivity without thickening on the AS-OCT. The lesion was biopsied and confirmed to be Lisch corneal dystrophy on pathology. The lesion r…

Slit lamp photo of biopsy proven Lisch Corneal dystrophy.

Fundus photos showing sheathing of the major and minor vasculature. Fluorescein angiography with small vessel vasculitis with diffuse temporal non-perfusion.

MacTel Type 1 A patient presented with chronic cystoid macular edema (CME) in the left eye. His BCVA OS was 20/60. Despite prior long-term interventions with intravitreal steroids and anti-VEGF agents (ranibizumab and aflibercept), the macular edema persisted, prompting the exploration of alternati…

Fundus photograph of the left eye demonstrating macular telangiectasia with surrounding exudates in the fovea and temporal macula.

Macular Hole A 64-year-old male veteran presents to the clinic on Feb. 15, 2019, with report of having blurry vision in the left eye for 30 years, following left-sided head trauma. He has been told by multiple providers that there was nothing that could be done for his vision. He complains of a “…

Macular Neovascularization Secondary to Best Disease in a Pregnant Female A patient with a history of Best Disease mutation in BEST1 presented with a sudden onset of blurriness and distortion in her left eye (OS) for three weeks. The patient's family history reveals genetic and visual implications,…

Macular Telangiectasia Type 1 - Torpedo Maculopathy This is a case of a middle-aged man presenting with a decrease in vision in his left eye for a period of 2 months. On fundus examination the patient presented with a pigmented macular asymptomatic lesion in the right eye and vascular telangiectasi…

Marfan Syndrome with Ectopia Lentis A young child presented to the ophthalmology clinic with blurry vision. Slit lamp examination was notable for superotemporally subluxed lenses in both eyes, along with a tall slender body frame. Due to these findings, the patient was referred to a geneticist and …

Melanocytoma with Vitreous Seeding A patient with 7 years of blurry vision in the right eye presents to clinic for evaluation. He reports no recent acute changes in vision and no precipitating events in the past. He noticed the blurry vision incidentally while driving when he covered his left eye. …