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Bartonella Henselae Multifocal Choroiditis A patient with a history of Crohns disease controlled with infliximab presented with 2 weeks left sided blurred vision. He had recently been admitted to the hospital for fever of unknown origin where extensive testing was performed and he was evaluated by …

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…

Autosomal Recessive RPE65-Deficient Leber Congenital Amaurosis A 17-year-old male with a biallelic RPE65 mutation resulting in autosomal recessive Leber Congenital Amaurosis is referred for evaluation for subretinal gene therapy with voretigene neparvovec-rzyl. Baseline evaluation was remarkable fo…

Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy A patient with no family history of retinal disease presented to the Bascom Palmer emergency room with 4 days of floaters in her right eye. Her VA was 20/30 and her intraocular pressure was normal. She was found to have vitreous hemorrha…

Aspergillus Keratitis A patient with a history of eye trauma with metallic foreign body presented with pain and blurry vision and was found to have severe Aspergillus infectious keratitis. He continued to progress despite topical, systemic, and intrastromal anti-fungal therapy. He was initially tre…

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…

Aneurysmal Bone Cyst A patient with a 2-week history of proptosis and vision changes in the right eye is transferred from an outside hospital. Neuroimaging revealed a large intraorbital and intracranial expansile lesion with multilobulated cystic spaces, surrounded by a thin cortical shell with per…

Alveolar Rhabdomyosarcoma A patient presented to BPEI for evaluation of a left upper lid lesion present since birth with no improvement with conservative treatment. Examination revealed a firm, blue, red lesion involving the upper left eyelid and lower eyelid. MRI orbit imaging revealed extensive s…

Alternaria Keratitis A patient with a history of a failed DMEK who required a DSAEK, was referred to the BPEI's cornea department after a 1-month history of culture-confirmed Alternaria keratitis that developed after the DSAEK. The ulcer progressed despite topical and systemic antifungal treatment.…

Alstrom Syndrome A 5-year-old male referred to the BPEI pediatric ophthalmology clinic for second opinion regarding bilateral progressive vision loss since infancy. VA was 20/200 OU and the patient had nystagmus. He was 99% percentile for weight but had no hearing loss or polydactyl. He underwent s…

Alkaline Chemical Corneal Burn A 63-year-old male presented with decreased vision and pain after alkali chemical splash to both eyes at a utility plant. He presented with perilimbal ischemia in the right eye greater than the left, complete opacification of the right cornea and a large epithelial de…

Age-Related Macular Degeneration We present an elderly patient with new onset visual distortions in the right eye. Vision is 20/30 OD, 20/20 OS. She is diagnosed with exudative Age-related Macular Degeneration (AMD) in the right eye and non-exudative AMD in the left eye. Swept Source OCT Angiograph…

Age Related Macular Degeneration RPE tears occur in AMD as part of the normal disease progression. They are usually associated with vascularized pigment epithelial detachments at a rate of 10%. RPE tears are also associated with Central Serous Retinopathy, Retinal Angiomatous Proliferation, Polypoi…

Adult Onset Xanthogranuloma A 48-year-old male presented with intermittent bilateral eyelid swelling for 5 years and progressively enlarging well-demarcated yellow eyelid lesions. On exam, patient had chemosis, and reduced up gaze in the right eye, prompting orbital imaging with MRI which demonstra…

Adenoviral Conjunctivitis A 31-year-old male presents with eye redness, foreign body sensation, and blurry vision in both eyes, worse in the right eye. On exam he is found to have follicular conjunctivitis in both eyes with sub epithelial infiltrates on the right cornea. His conjunctiva were cultur…

Adenoid Cystic Carcinoma of the Lacrimal Gland A 43-year-old female presented to her primary care physician with swelling of the lateral aspect of the right upper eyelid without visual complaints. The primary care physician noted proptosis of the right globe and ordered a CT scan which revealed a m…

Adenoid Cystic Carcinoma A patient with past medical history of a previously resected lacrimal gland mass presented to the emergency room with worsening unilateral proptosis and eye pain with persistent new eversion of the upper eyelid for several days. Examination was significant for severe propto…

Acute Zonal Occult Outer Retinopathy (AZOOR) A 31-year-old male presents with eye redness, foreign body sensation, and blurry vision in both eyes, worse in the right eye. On exam he is found to have follicular conjunctivitis in both eyes with sub epithelial infiltrates on the right cornea. His conj…

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…

Acute Syphilitic Posterior Placoid Uveitis An adult patient presented to the Bascom Palmer emergency room for evaluation of five days of bilateral painless vision loss and floaters. On slit lamp examination he did not have any conjunctival injection or anterior chamber cell or flare. Dilated fundus…