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Postoperative Endophthalmitis An elderly patient with past medical history of quiescent birdshot chorioretinopathy on immunosuppressive therapy underwent uneventful cataract surgery in the right eye followed by intracameral injection of moxifloxacin at the end of the case. On postoperative day 4, t…

Aniridia and Secondary Glaucoma A patient presented with bilateral uncontrolled intraocular pressure (IOP) on maximum medical therapy. Clinical exam was limited by corneal scarring of both eyes but visual acuity was 20/350 OD and 20/250 OS. Intraocular pressure was 27 OD and 29 OS. She had long-sta…

Downbeat Nystagmus A patient was referred with double vision and oscillopsia. He reported to have nystagmus and oscillopsia for a few years, and recently mild worsening. He denies head trauma, weakness, numbness, changes in his vision, transient visual loss, or headache. Patient has trouble reading…

Dystrophic Epidermolysis Bullosa A child presented to BPEI in 2013 with symblepharon and limbal stem cell deficiency in both eyes. His visual acuity (VA) was 20/40 in his right eye and 20/80 in the left. He came back one year later in 2014 with an advanced inferior symblepharon, covering the visual…

Subperiosteal Orbital Hematoma A patient with a history of chronic pansinusitis and absence of midline nasal cavity structures due to chronic inhalational cocaine usage, presents with acute onset left-sided proptosis. She was found to have a non-traumatic, spontaneous subperiosteal orbital hematoma…

Vogt-Koyanagi-Harada A patient with acute onset bilateral blurry vision presented with bilateral multifocal serous detachments in the absence of other intraocular inflammatory findings. The patient had a past medical history notable for treated chlamydia and gonorrhea. The use of immunosuppressive …

Brown Syndrome A patient was diagnosed with thyroid eye disease (TED) 2 years before presenting to our clinic. He complained of horizontal and vertical diplopia. The diplopia was constant and affected distance vision only. The patient was previously treated with teprotumumab. His exam was notable f…

Nanophthalmos with Angle Closure Glaucoma A patient presented with uncontrolled intraocular pressure (IOP) on maximum medical therapy and had bilateral laser iridotomy. The patient was diagnosed with angle-closure glaucoma. Biometry measurements were consistent with nanophthalmos. The right eye und…

Lipemia Retinalis A patient with past ocular history of nonproliferative diabetic retinopathy presented for routine examination to retina clinic. Patient had no vision concerns nor any systemic symptoms on review of systems. On examination, patient found to have cream colored large calibre vessels …

Primary Congenital Glaucoma A young child with no past ocular history presents with vision loss for 2 months. Her exam was notable for visual acuity of 20/250 in the affected eye with intraocular pressures of 38, relative afferent pupillary defect. Slit lamp findings were notable for subtle bupthal…

ABCA-4 Retinal Dystrophy A patient with bilateral progressive vision loss presents to the clinic for evaluation. The patient’s initial vision was hand motion in both eyes. Fundus photos shows extensive retinal degeneration, geographic atrophy, and optic nerve pallor. ABCA-4 related retinopathies …

Microsporidial Keratitis A patient with chronic nonresponse keratitis presented to Bascom Palmer with a 2 year history of progressive eye pain and blurry vision in the left eye. He was initially diagnosed with herpes stromal keratitis of the left eye and was treated for >1 year with steroids and…

Bartonella Neuroretinitis A patient presented with subacute painless decreased vision in the left eye. On examination, she had evidence of stellate macular exudates in the left eye, as well as optic disc edema in the right eye. Imaging including fluorescein angiography and OCT of the macula and ret…

Fuchs Endothelial Dystrophy A patient presents for cataract surgery evaluation with bilateral guttata and specular microscopy consistent with Fuchs endothelial dystrophy. Preoperative vision was 20/40 in the right eye with pachymetry of 595. Cataract surgery was uncomplicated, however postoperative…

Multi-Drug Resistant Pseudomonas Keratitis Pseudomonas aeruginosa is a gram-negative rod that is both an aerobic and facultative anaerobic organism. It is commonly spread through contact with exposed water, medical equipment, or human contact. As an opportunistic infection, it causes mild disease i…

Neurotrophic Keratitis A patient presented to the Bascom Palmer Eye Institute’s emergency room with acute on chronic left eye pain. The history was notable for a left petroclival chondrosarcoma that had been resected with post-operative, left-sided cranial nerve 5, 6, 7 and 8 palsies. The patient…

Non-Paraneoplastic Autoimmune Retinopathy (npAIR) A patient presented to the neuro-ophthalmology clinic for progressively decreasing vision in both eyes. He first noticed flashes and a blind spot in both eyes 3 months ago. Best-corrected visual acuity was 20/80 in the right eye and 20/50 in the lef…

Type C Carotid Cavernous Fistula A patient presented with acute, painless, intermittent double vision. The patient had a past medical history of hypertension, hyperlipidemia, and myocardial infarction. The presenting visual acuity was 20/25 in both eyes with normal pupillary responses and intraocul…

Endophthalmitis in the Setting of a XEN Stent A patient presented with eye pain and worsening vision 1.5 months after cataract surgery. Exam revealed purulent discharge, severe anterior chamber inflammation, and a XEN stent with nearby erosion of conjunctiva and Tenon’s down to bare sclera. Cultu…

Simple Corectopia An otherwise healthy patient without past ocular history presented with left eye irregular pupils since birth and no associated symptoms. The birth history was unremarkable. The examination under anesthesia was notable for visual acuity based on Teller Acuity Cards was approximate…