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Elevated Episcleral Venous Pressure (Idiopathic) An otherwise healthy patient without past ocular history presented with left eye redness and no associated symptoms. Her examination was notable for corrected visual acuity of 20/15 and intraocular pressure of 14 mmHg on no topical treatment in the r…

Acanthamoeba Keratitis A patient presented to the BPEI emergency room with left eye redness and pain for 2 weeks. He had been diagnosed with HSV keratitis by an outside provider but had no improvement on valacyclovir. The vision was 20/20 in the right eye and 20/60 in the left eye, and intraocular …

Pentosan Polysulfate Associated Maculopathy A patient presents with a history of difficulty reading and progressive blurry vision in both eyes prior to her presentation. Patient has a significant history of interstitial cystitis with long term use of Pentosan Polysulfate Sodium for 20 years. Her ex…

Choroidal Metastases from Cutaneous Melanoma A patient with history of cutaneous melanoma presents with worsening vision of the right eye over a period of a few weeks. His exam was notable for visual acuity of 20/40 in the right eye and 20/25 in the left eye. Intraocular pressure was 18 in both eye…

Peripheral Exudative Hemorrhagic Chorioretinopathy An elderly patient presented to the emergency room with 2 days of progressive floaters and vision loss in the right eye. His visual acuity was 20/80 in the right eye and 20/25 in the left eye. His intraocular pressure was normal in both eyes. Fundu…

Penetrating Open Globe Injury with Retained Intraocular Foreign Body, Left Eye A patient presented with acute decreased vision in the left eye after motor vehicle accident. The patient stated in the accident his car spun out and airbags deployed. Upon presentation, visual acuity was 20/25 in the ri…

Multiple Evanescent White Dot Syndrome (MEWDS) An otherwise healthy young patient without significant medical or ocular history presents with 3 days of acute-onset decreased vision in the right eye. On presentation, patient’s exam was notable for visual acuity of 20/50 in the right eye and 20/20 …

Subepithelial Infiltrates Secondary Due to Epidemic Keratoconjunctivitis An adult patient presented to the Bascom Palmer Emergency Room with complaint of red eyes and was diagnosed with viral conjunctivitis. He was treated symptomatically and returned with decreased visual acuity and diffuse subepi…

Endogenous Endophthalmitis A middle-aged patient presented to the ophthalmology emergency department with 1-day of blurred vision in his left eye. He reported fevers the week prior. Examination of the left eye was remarkable for a subretinal abscess with hemorrhage, vasculitis, and a preretinal hyp…

Ocular Surface Squamous Neoplasia An elderly patient with a diffuse ocular surface squamous neoplasia (OSSN) of the left eye is treated with cycles of Interferon, 5 Fluorouracil and Mitomycin C topical chemotherapy without improvement. Due to high out-of-pocket costs and epiltheliopathy after 7 mon…

Epithelial Downgrowth A patient with ocular history of ruptured globe presented with a new pupillary membrane. Argon laser photocoagulation showed blanching of the iris epithelium concerning for epithelial downgrowth. A biopsy of this membrane was positive for epithelial downgrowth. It was observed…

Leber's Hereditary Optic Neuropathy A patient came to ED due to subacute decreased vision in his right eye since 1/2023. He had a history of decreased vision in his left eye following phacoemulsification surgery in Oct 2022. BCVA was 20/70 OD and 20/400 OS Past medical history was positive for HTN,…

Phacomorphic Glaucoma A patient with a history of chronic angle closure glaucoma (ACG) referred by local ophthalmologist to ED for evaluation. Patient had previously undergone a laser iridotomy in both eyes and had a history of chronic angle closure glaucoma. The intraocular pressure (IOP) was been…

Radiation Retinopathy A patient with past medical history of CNS lymphoma treated with chemotherapy but refractory and necessitating radiation therapy later presented to ophthalmology with slight decrease in vision. On examination, found to have cotton wool spots in both eyes. Fluorescein angiogram…

Residual Ametropia, Symptomatic Higher Order Aberration A patient who presents for refractive surgery evaluation. They were noted to have no ocular pathology and was deemed a good refractive surgical candidate. Patient underwent uncomplicated bilateral laser in situ keratomileusis, however the pati…

Retinal Detachment in Proliferative Sickle Cell Retinopathy A middle-aged patient presented with decreased vision in her right eye. She had a history of proliferative sickle cell retinopathy. She is blind in the left eye from a prior failed retinal detachment repair. Her vision in the right eye was…

Hypotony Following Glaucoma Drainage Implant A patient with a past ocular history of primary open angle glaucoma who underwent cataract extraction and trabeculectomy in the right eye and cataract extraction in the left eye presented for evaluation of high intraocular pressure in both eyes. Visual a…

Ocular Cicatricial Pemphigoid An elderly patient with severe ocular cicatricial pemphigoid (OCP) and immunosuppressed with mycophenolate mofetil has previously lost the right eye due to corneal perforation and choroidal hemorrhage resulting in evisceration. After 5 years of quiescence, his left eye…

Vitelliform Maculopathy A middle-aged patient with a remote history of prostate cancer in remission presented as a referral for evaluation of retinal lesions. He denied any complaints initially. He was noted to have orangeish vitelliform lesions deposited around his vascular arcades. Workup for oth…

Sub-Periosteal Abscess A pediatric patient presented as a transfer from OSH with orbital cellulitis secondary to a superior located sub-periosteal abscess (SPA). The patient has a history of acute on chronic sinusitis and had FESS with sinus debridement and abscess drainage 5 days prior to arrival.…