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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…

Leber Hereditary Optic Neuropathy – LHON An 18-year-old healthy man was evaluated in the eye emergency room for acute progressive painless vision loss in both eyes. First was affected a right eye and a six days later, left eye was affected too. Best-corrected visual acuity was 20/800 right eye an…

Restrictive Strabismus and Brown Syndrome Secondary to Graves’ Disease A 68-year-old male with restrictive strabismus and Brown syndrome with extraocular movement restriction secondary to TED. He was on clinical trial for Teprotumumab 302 and had prior RAI ablation. His visual acuity OD is 20/20,…

Bilateral Retinoblastoma A 7-month-old girl with a white pupil in the right eye is diagnosed with group D retinoblastoma in the right eye and group B retinoblastoma in the left eye. Her right eye is treated with intra-arterial chemotherapy with melphalan, carboplatin, and topotecan. Her left eye wa…

Retina Vasculitis, Leprosy A 56-year-old man referred to the BPEI for intermediate uveitis and retinal vasculitis. Examination revealed 20/25 vision in both eyes and trace vitreous cells in both eyes. Ocular coherence tomography showed no macular edema. Fluorescein angiogram showed retinal vasculit…

Choroidal Metastasis Consistent with Renal Cell Primary A 57-year-old male presented to clinic with a one-week history of red line in his vision OS. The patient was noted to have a history of left nephrectomy for renal cell carcinoma that was diagnosed after a metastatic lesion was detected in the …

Intraorbital Wooden Foreign Body A 63-year-old male with a history of decreased extraocular motility, binocular diplopia and proptosis presenting to the ED after trauma with a palm tree branch a few days before presentation. The patient presents 6 days after trauma with a tree branch. He had a 360-…

Retinal Vasculitis in Birdshot Chorioretinopathy A 51-year-old female who presents to the uveitis clinic for evaluation of progressive vision loss of both eyes. Patient was referred after a complete infectious and non-infectious uveitis lab workup which was negative. Retinal vasculitis with abnorma…

Exudative Retinal Detachment Following Treatment of Posterior Uveal Melanoma A 55-year-old male presented to Bascom Palmer with complaints of flashing lights in his right eye and found to have a large choroidal mass. Work-up revealed a likely choroidal melanoma with an associated small inferior exu…

Iridocorneal Endothelial Syndrome (ICE) A 27-year-old woman presented for corneal evaluation with a history of secondary glaucoma. She was found to have iridocorneal endothelial syndrome (ICE). She underwent DSAEK, which failed after 13 months. Subsequent Type 1 Boston Keratoprosthesis was successf…

Peters Anomaly Type 1 A 2-week-old girl presented with bilateral Type I Peters anomaly consisting of bilateral dense central corneal opacities and iridocorneal adhesions. Upon presentation patient had elevated IOP in both eyes (OU) (38 mmHg in the right eye (OD) and 40 mmHg in the left eye (OS)), w…

Central Areolar Choroidal Dystrophy A 56-year-old male that presents as a follow up for Dry Age-Related Macular Degeneration and complaining of nyctalopia. VA 20/20 both eyes on initial presentation. DFE revealed hypopigmented areas in the macula of both eyes. Fluoresencin angiogrpahy revealed spec…

Conjunctival Squamous Cell Carcinoma with Intraorbital and Intraocular Invasion A 64-year-old male with a history of T2DM and HTN was referred for 2 weeks of severe pain and redness in the right eye. Two months earlier, he had undergone reported pterygium removal surgery in another country. At pres…

Severe Ocular Chemical Injury A 41-year-old male international patient presented to BPEI 2 months after the initial injury with persistent redness and decreased vision. Clinical exam revealed scleral melt and ischemia and the patient was started on medical treatment and scheduled for urgent tenopla…

MEWDS A healthy, myopic 18-year-old female presented with 2 days of blurry vision in her left eye after having a viral upper respiratory infection for 1 week. Dilated fundus exam revealed posterior pole gray-white spots sparing the fovea and a granulated foveal appearance, as well as mild posterior…

Closed-Globe Ocular Trauma An 18-year-old female presents to BPEI ER after sustaining injuries to the eye from a motor vehicle accident. The patient was diagnosed with a closed-globe injury and had subsequent traumatic angle-recession glaucoma, vitreous prolapse, and traumatic cataract. She also ha…

Conjunctival Melanoma A 55-year-old male who presented to Bascom Palmer for a multi-year history of a progressively enlarging painless pigmented conjunctival lesion of the right eye. He was found to have a large non-mobile pigmented lesion of the right perilimbal conjunctiva. While initially he was…

Extranodal Marginal Zone Lymphoma 52-year-old male with Stage IV extranodal MALT lymphoma who initially presented with paranasal and perioribtal disease. He failed treatment with multiple chemotherapeutic agents and represented with decreased VA 20/40 and 20/80 thought to be due to diffuse choroida…

Retinal Detachment Caused by Proliferative Sickle Cell Retinopathy A 44-year-old man and 19-year-old man, neither with initially disclosed medical history, present with severe vision loss one eye. Both patients have findings consistent with retinal detachment associated with proliferative retinopat…