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Erdheim Chester Disease A 37-year-old male presented to clinic with bilateral conjunctival lesions for 7 months. Patient has a history of lytic bone lesions, 50-pound weight loss, and fevers. Examination revealed 20/20 vision in both eyes, mobile, discrete conjunctival lesions in bilateral bulbar c…

Lattice Corneal Dystrophy Lattice corneal dystrophy is a rare disease with a variety of etiologies. Historically, corneal dystrophies have been defined as bilateral, progressive processes that start in a patient’s first to second decade of life and have no correlation with systemic illnesses. Whi…

Primary Uveal Melanoma, Left Eye A 30-year-old Hispanic female with a history of thyroid disease presented to the Bascom Palmer ER with complaints of blurry vision and eye strain in the left eye while reading for a 1-month duration. Her last eye exam was a decade ago and was normal. She was diagnos…

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…

Carcinoma Ex Pleomorphic Adenoma A 76-year-old female referred by primary care physician for right eye proptosis. The patient complained of diplopia for the last six months without associated pain or irritation. External exam was significant for proptosis of the right eye and hypoglobus. Visual acu…

Juvenile Psammomatous Ossifying Fibroma An 18-year-old female presented with blurry vision, headaches for 4 months. She was diagnosed to have papilledema on an outside eye exam and referred to BPEI. Her visual acuity was 20/20 OD, 20/100 OS. Additionally, she was noted to have junctional scotoma on…

Idiopathic Central Serous Chorioretinopathy A 47-year-old male with previous diagnosis of exudative AMD s/p multiple Avastin injections presents with complaint of decreased vision OU. Exam was significant for VA 20/200 OD, 20/25 OS. DFE significant for macular mottling OU. OCT shows serous retinal …

Group E retinoblastoma

Klebsiella Pneumoniae Endogenous Endophthalmitis A 46-year-old healthy male presented with a red and painful eye with a preceding febrile gastrointestinal illness. Examination and work-up revealed concomitant intraocular and liver abscesses that required pars plana vitrectomy, drainage of subretina…

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 …

Retinal Capillary Hemangioblastoma in Von-Hippel Lindau Syndrome A 40-year-old male with family history of renal cell carcinoma and history of neurosurgical excision of cerebellar hemangioblastoma presents for routine ophthalmic examination. Vision is 20/20 in both eyes. Fundus examination reveals …

Retinoblastoma A 2-year-old female with an unremarkable past medical history presented with pain and swelling of the left eye. One examination she was able to fix and follow with both eyes but had a dull red reflex of the left eye as well as a retinal mass. An exam under anesthesia was performed wh…

These are caused by failure of the embryonic fissure to close during the second month of development in utero. The iris defect is also known as a "keyhole" pupil. Here, there is not only an iris defect, but also missing tissue in the lens (yellow arrow) and zonules. This can cause difficulties duri…

In this condition, vasculitis of both arteries and veins, with translucent exudation, gives a similar appearance to the frosted branches of a tree. (Yellow arrow). Superior nasally, there is also the classic retinal whitening with retinal hemorrhages, also known as a “pizza pie fundus”.

Gonococcal Preseptal Cellulitis, Gonococcal Conjunctivitis A 21-year-old female presented to the hospital with 5 days of right eye redness, swelling, discharge and pain. Exam revealed VA OD 20/70, painful EOM and severe conjunctival chemosis and discharge, and eyelid swelling. CT scan revealed righ…

Suprachoroidal Hemorrhage A 76-year-old male that presented to the retina service at Bascom Palmer Eye Institute with left eye pain and elevated intraocular pressure eleven days status post complicated cataract surgery during which he was left aphakic. Of note, the patient was on Aspirin 81mg daily…

The pseudocyst (yellow arrow) can be a signal that the retinal detachment is chronic. The ultrasound helps to clearly define the fluid filled cavity. It is thought that these are formed by schisis cavities in the outer plexiform layer. If closure of the primary break is not possible, or if the pseu…