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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…

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…

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 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…

Adenoviral Conjunctivitis 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 conjunctiva were cultur…

Adenoid Cystic Carcinoma of the Lacrimal Gland A 43-year-old female presented to her primary care physician with swelling of the lateral aspect of the right upper eyelid without visual complaints. The primary care physician noted proptosis of the right globe and ordered a CT scan which revealed a m…

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…

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 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 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…

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…

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…