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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…

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…

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…

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…

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…

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…

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…

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…

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…

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…

Recurrent Benign Sixth Nerve Palsy A young patient presented with acute onset of crossed eyes and diplopia. He reported no associated vision changes in either eye. His examination revealed right eye esotropia of 6 prism diopters (PD) in primary gaze, 14 PD in right gaze, and 4 PD in left gaze. The …

Bilateral Inferior Rectus Muscle Aplasia, Severe Hypertropia, Deprivation Amblyopia An infant was referred to BPEI for strabismus/oculoplastic evaluation. They were born prematurely at 32 weeks of gestation with a previous surgical history notable for superior rectus tenotomy. The patient presented…

[Diagnosis] An infant with history of preterm birth presented to the Bascom Palmer emergency room with a rapidly progressive left upper lid mass. Evaluation showed non-axial proptosis and a large superonasal, vascular mass deep in the left orbital rim. MRI brain and orbits with and without contrast…

Autosomal Dominant Cone-Rod Dystrophy Caused by a Mutation in the Cone-Rod Homeobox (CRX) Gene A patient presented with decreased vision, photophobia and glare affecting both eyes within the past year. Their past medical history included sleep apnea and anxiety/depression treated with hydroxyzine a…

PDE6-Associated Retinitis Pigmentosa  A patient with a family history of vision loss presented with a 2 year history of progressive vision loss in both eyes. Patient’s exam was notable for visual acuity of 20/40 in the right eye and 20/30 in the left eye. Intraocular pressure was 20 and 21 i…

Myelin Oligodendrocyte Glycoprotein Antibody Disease A middle-aged patient was referred from an outside facility for follow up of idiopathic intracranial hypertension. On careful review, she was found to have demyelinating disease on a prior MRI. Patient underwent a repeat MRI which did not demonst…

Invasive Cutaneous Melanoma of the Eyelid A patient presented to clinic for a long-standing history of a left lower eyelid/ cheek lesion with more recent growth. He had a history of multiple previously resected basal cell carcinomas of the face, neck and scalp. Initial examination was notable a lef…

Kabuki Syndrome Associated Euryblepharon and Ptosis Repair with Post Operative Hematoma A teenager with a history of Kabuki Syndrome presents to the ophthalmology clinic for evaluation of bilateral ptosis and eye rubbing, and epiphora. Best corrected visual acuity is 20/40 bilaterally, intraocular …