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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…

Non-Arteritic Anterior Ischemic Optic Neuropathy A patient presented to the Bascom Palmer Emergency Department with acute onset painless decreased vision in the right eye after awaking from sleep. The patient was found to have unilateral optic disc edema in the right eye. Visual acuity was 20/20 in…

Ocular Cicatricial Pemphigoid An elderly patient with a past ocular history of biopsy-negative cicatrizing conjunctivitis with symblepharon in both eyes, dry eye syndrome, myopic degeneration, and bilateral pseudophakia presented with right eye pain and itching for 3 days. She reported no associate…

Ocular Cicatricial Pemphigoid / Mucous Membrane Pemphigoid A patient with a PMHx of HTN presented to BPEI with redness and discharge of the left eye for 3 months. Review of systems was negative for any systemic symptoms. Visual acuity of the left eye was 20/80, IOP was 13 mmHg, there was no APD, an…

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…

Ocular Neuromyotonia A child with a history of left exotropia secondary to a congenital third nerve palsy treated with strabismus surgery and ptosis repair presented with sudden onset intermittent left upper lid twitching and involuntary eye movements. Patient had no previous history of intracrania…

Ocular Surface Squamous Neoplasia A 71-year-old male with a history of atopic dermatitis was referred to BPEI for evaluation of a corneal lesion. Exam revealed an opalescent and gelatinous lesion at 2-4 o'clock at the limbus in the left eye. Anterior segment OCT showed a thickened, hyperreflective …

Ophthalmia Nodosa A patient presented to the Bascom Palmer Eye Institute retina/uveitis clinic with 2 months of right eye irritation and floaters. He reported being hit in the right eye by a large flying insect while working on a cruise ship in the Bahamas immediately prior to the onset of symptoms…

Optic Disc Drusen with Structural and Functional Changes A young child presented with crossing of the eyes without headaches or associated neurologic symptoms. Visual acuity was OD 20/30 and OS 20/40. Motility examination demonstrated moderate angle esotropia with full versions. Intraocular pressur…

Orbital Cellulitis, Cavernous Sinus Thrombosis, Pyomyositis of Extraocular Muscle, Bacteremia A 17-year-old female with no significant PMH presented to the BPEI Emergency Room with a red, swollen left eye for two days in the setting of recent lower lid lesion that the patient believed was a chalazi…

Orbital Cysts An elderly patient presented with two years of chronic pain in an otherwise healthy-appearing anophthalmic socket after enucleation. CT orbits was obtained which showed two hyperdense cystic lesions superior and posterior to the orbital implant. Orbital exploration was performed, the …

Orbital Venous Lymphatic Malformation A patient presented to the ER complaining of 2 days of increasing pain and swelling behind the left eye. Of note the patient reported that as a teenager he was previously treated for an orbital tumor. On exam he was found to have massive proptosis, hyperglobus …

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…

Peripheral Ulcerative Keratitis A patient with well-controlled HIV on antiretroviral therapy presented to the emergency department with five months of left eye pain, redness, discharge, and blurry vision. Visual acuity in the left eye was found to be 20/60 and slit lamp examination was remarkable f…

Pleomorphic Adenoma A patient with a past ocular history of presumed thyroid eye disease presented with left eye discomfort and left upper eyelid swelling for two days. She endorsed double vision but denied any blurry vision. Her exam was notable for visual acuity of 20/20 in the right eye and 20/2…

Polypoidal Choroidal Vasculopathy This is a case of a patient with 3 years of blurry vision. He was diagnosed with polypoidal choroidal vasculopathy by an outside physician and was receiving monthly aflibercept injections with documented worsening of vision and appearance on OCT. ICG was repeated o…

Polypoidal Choroidal Vasculopathy (PCV) A patient diagnosed with neovascular AMD in the left eye was referred to retina clinic at Bascom Palmer Eye Institute because of poor answer to monthly Ranibizumab and Bevacizumab intra vitreal injections. VA was 20/200 in the left eye. OCT showed intra retin…

Posner-Schlossman Syndrome Due to CMV Virus A 31-year-old woman with recurrent intraocular pressure spikes despite acyclovir therapy was found to have PCR-confirmed CMV anterior uveitis consistent with one of the presumptive etiologies of Posner-Schlossman. She was started on oral valganciclovir an…

Post-Refractive Corneal Haze A patient presented to the Bascom Palmer Eye Institute with bilateral anterior stromal corneal haze after photorefractive keratectomy for high myopia in both eyes 5 years ago. His vision was 20/200 in both eyes, in the setting of significant irregular astigmatism induce…

Post-transplant Interface Infectious Keratitis A patient with past ocular history of pseudoexfoliation syndrome, left eye Descemet’s Stripping Endothelial Keratoplasty (DSEK) and left eye scleral fixated intraocular lens after complicated left eye cataract surgery presented to the emergency room …