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Choroideremia with Secondary Choroidal Neovascularization A patient with no past medical history presented to the emergency department complaining of floaters in the right eye. Exam was notable for visual acuity of 20/70 in the right eye and 20/30 in the left eye. Intraocular pressures were 14 and …

Conjunctival Melanoma Two darkly pigmented patients with a diagnosis of conjunctival melanoma by an outside provider are presented here. Case 1 presented with a large jet black conjunctival lesion that was present for nearly 12 years. This lesion was biopsied by an outside provider and interpreted …

Juvenile X-linked Retinoschisis A pediatric patient with a past medical history of Kawasaki disease presents for retinal evaluation of reported vitreous hemorrhage in the right eye and retinal detachment in the left eye. The visual acuity was 20/200 in the right eye and 20/800 in the left eye. The …

Dorzolamide Induced Choroidal Effusion A patient with POAG of both eyes presented with unilateral decreased vision and flashes to the left eye after starting dorzolamide two days prior. Visual acuity was 20/40 in the right eye and 20/20 in the left eye. Intraocular pressure was 09 OD and 08 OS. Ant…

Intraocular Foreign Body A patient with past ocular history of remote trauma, unilateral retinal detachment repair, and cataract extraction presented with inferior iris pigmentation and chronic corneal edema. He complains of decreased vision, redness, and foreign body sensation. His visual acuity w…

Restrictive Strabismus Secondary to a Large Encapsulated Non-Valved Glaucoma Drainage Implant Fibrotic Capsule A patient with a history of primary open angle glaucoma of both eyes and myopic degeneration with amblyopia and chronic poor central vision of the right eye presented with elevated intraoc…

Cosmetic Iris Implant A patient presented for bilateral blurred vision and eye pain of 3 days duration. The patient had previously undergone bilateral LASIK and cosmetic iris implantation. He was found to have decreased vision of 20/800 on the right eye and could see the 20/200 E when held at his f…

Tolosa Hunt Syndrome Tolosa Hunt Syndrome is an idiopathic inflammatory process of the cavernous sinus of unknown etiology. There are no known risk factors, but an inciting event, such as a viral illness, vaccination, trauma, or tumors, are known to be preceding events that result in nonspecific in…

Heavy Eye Syndrome/Adult Onset Esotropia Secondary to High Axial Myopia A patient with history of amblyopia right eye, and no previous ocular surgery or childhood strabismus presents with large angle esotropia and hypotropia. Exam was notable for hand movements vision in the right eye and 20/20 in …

Slipped Medial Rectus Muscle A patient with history of childhood esotropia presented to our clinic. She reported experiencing binocular visual confusion/jumping images and eye pain in the right eye. The patient was previously treated with prism glasses. Her exam was notable for a comitant esotropia…

Acute Macular Neuroretinopathy A young patient presents with acute onset of blurry vision and scotoma. Visual acuity is 20/25 in both eyes. Exam reveals hypopigmented patches in the macula of both eyes, as well as a flame hemorrhage in the left. Imaging reveals disruption of the outer plexiform, ou…

Acute Zonal Occult Outer Retinopathy (AZOOR) A patient with a history of photopsias in the left eye for approximately 20 years comes for evaluation due to photopsias now involving both eyes. Concomitantly, the patient also notices scotomas in both eyes. Infectious, immune, and degenerative retinopa…

Bardet-Biedl Syndrome A young adult presented with progressive decrease in the visual acuity of both eyes. Past medical history included idiopathic intracranial hypertension suspect, obesity, learning disabilities, anxiety, polydactyly (status post excision of an extra toe). Family history includes…

Marfan Syndrome with Ectopia Lentis A young child presented to the ophthalmology clinic with blurry vision. Slit lamp examination was notable for superotemporally subluxed lenses in both eyes, along with a tall slender body frame. Due to these findings, the patient was referred to a geneticist and …

Nontuberculous Mycobacteria Keratitis A patient five months after bilateral simultaneous cataract surgery in another country presents to the BPEI emergency room with bilateral decreased vision and extreme right eye pain for the last 2 weeks. Their exam was notable for visual acuity of hand motion i…

Central Retinal Artery Occlusion An elderly patient presented to the BPEI Emergency Room 3 hours after onset of painless vision loss. Past medical history included hypertension and atrial fibrillation treated with apixaban, of which the patient reported good adherence. The patient had no other sign…

Choroidal Folds Related to Multiple Myeloma Recurrence A patient with a prior diagnosis of Fuchs endothelial dystrophy and a past medical history including renal amyloidosis previously treated with chemotherapy presented to the outpatient ophthalmology clinic for routine follow-up. Examination disc…

Non-Infectious Scleritis A monocular patient admitted for pyoderma gangrenosum flare complained of decreased vision and left eye pain. Four years prior she had scleritis OD which requiring scleral reinforcement surgery after which the patient was lost to follow up, developed endophthalmitis and eve…

Mixed Mechanism Angle Closure Glaucoma A patient presented with eye pain and decreased vision in the left eye and treated for HSV keratouveitis. A few months later, he presented with halos and high IOP. He was placed on topical glaucoma drops and continued to have episodes. A laser peripheral iride…

NUT Carcinoma A patient presented with several weeks of right eye proptosis. On initial examination, his visual acuity in the right eye was 20/400, and a relative afferent pupillary defect was noted. He had 4 mm relative proptosis on the right and restricted motility in all gaze directions. CT orbi…