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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 …

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 …

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…

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…

Bosch-Boonstra-Schaaf Syndrome The following case review presents a 3-year-old, born full term, with developmental delay which was referred by an outside physician for further evaluation. Further testing was required for a final diagnosis which included an MRI of the brain and genetic testing. Resu…

Granulomatosis with Polyangiitis This presentation describes a case of granulomatosis with polyangiitis in which ocular disease (scleritis) led to the diagnosis. The patient subsequently developed scleral melt with uveal show, requiring a multidisciplinary approach with Rheumatology to escalate imm…

Toxoplasmosis Necrotizing Retinitis Mimicking Acute Retinal Necrosis A 38-year-old male was referred to Bascom Palmer retina department with a 7-month history of decreased vision in the right eye. Examination revealed hand motions vision, anterior and posterior segment inflammation, and a near tota…

Sebaceous Carcinoma Presenting with Corneal Ulcer and Descemetocele An 87-year-old male was referred for second opinion due to nonhealing corneal ulcer of his right eye. He had a past medical history significant for basal cell carcinoma, arthritis, hypertension, hypothyroid, CABG, and carotid stent…

Vitamin A Deficiency A 73-year-old woman with a past medical history significant for Crohn’s disease and recently diagnosed colon cancer with recent sigmoid colon resection, presented with ten days of blurry vision in both eyes and nyctalopia. Onset of her symptoms was during a hospitalization fo…

Cranial Nerve 6 Palsy from Metastatic Cholangiocarcinoma A 34-year-old woman presented with 2 weeks of diplopia. The patient had binocular horizontal diplopia with a right cranial nerve 6 palsy and moderate-to-severe headache of 1-week duration. Magnetic resonance imaging (MRI) of the brain and orb…

Conjunctival Amyloid Conjunctival amyloid is an uncommon ocular finding but important to consider in the differential of conjunctival lesions. We present a case of a patient who was referred for evaluation of a potential ‘malignant’ conjunctival tumor. On exam she was found to have a yellow, mo…

Exudative Age-Related Macular Degeneration, Type 3 Macular Neovascular Membrane A 68-year-old female with nonexudative AMD in both eyes, presents with new visual distortion in her left eye. Clinical exam shows markedly declined visual acuity, fundus examination shows small punctate extrafoveal hemo…

FLACS - AK Associated Infectious Keratitis A 62-year-old female 6 weeks after FLACS - AK presented to BPEI- ED for ocular irritation, decreased vision, and photophobia. Her examination disclosed vision = 20/30, focal conjunctival hyperemia and a corneal stromal infiltrate located beneath a mid-peri…

Bilateral Papillitis A 66-year-old man presented to Bascom Palmer with complaints of blurry vision in both eyes for three days which he described as painless. Vision was 20/350 in the right and 20/200 in the left eye with evident papillitis in both eyes on exam. An MRI revealed no retrobulbar optic…

Intraoperative Aqueous Misdirection A 3-year-old boy with primary congenital glaucoma OU s/p BVT (x1 OD, x2 OS) presents to clinic with elevated IOP OD despite maximum medical therapy. He undergoes exam under anesthesia with median intraocular pressure (IOP) 37 mm Hg OD. The patient then underwent …

Drug Associated Occlusive Retinal Vasculitis and Intraocular Inflammation A 78-year-old male with a known history of exudative age-related macular degeneration in both eyes had been treated with intravitreal aflibercept injections for many years unable to extend past 5 weeks. He was recently treate…