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Nuclear 3rd CN Palsy with Vertical Gaze Palsy A patient with significant vasculopathy risk factors (DM, HTN, dyslipidemia), had a stroke affecting the right thalamus, midbrain, and right cerebellum due to basilar artery occlusion. He had a successful mechanical thrombectomy with a stent retriever a…

Nontuberculous Mycobacterial Keratitis A patient with past ocular history of uncomplicated pterygium surgery develops mycobacterial keratitis which progresses to a descemetocele. After worsening on topical antibiotics to the point of nearly perforating, the patient undergoes rose-Bengal photodynami…

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…

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…

Non-Paraneoplastic Autoimmune Retinopathy A patient presented to the uveitis clinic for progressively decreasing vision in both eyes. She first noticed difficulty in seeing at night and later also developed flashes and halos of light. Best-corrected visual acuity was 20/40 in the right eye and 20/8…

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…

Nocardia Bacterial Keratitis A patient presented to the Bascom Palmer Emergency Room with 2 weeks of red painful eye. On exam, he was found to have a patchy white stromal infiltrate suspicious for bacterial or fungal keratitis. Fortified antibiotics were started, and a culture was drawn. Ultimately…

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…

Neuromyleitis Optica A child presented to the ER with blurry vision and eye pain. Exam disclosed unilateral optic nerve edema and decreased color vision; subsequent MRI disclosed optic neuritis. Lab testing demonstrated +Aqp4 antibodies, and the patient subsequently developed longitudinally extensi…

Neovascular Glaucoma Secondary to Anterior Segment Ischemia After Vitreoretinal Surgery A middle-aged patient with a past ocular history of retinal detachment status-post repair with a combined pars plana vitrectomy and scleral buckle was managed by an outside ophthalmologist for elevated intraocul…

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…

Myotonic Dystrophy Associated Cataracts We present a case series of two siblings with myotonic dystrophy and cataract with different degrees of zonulopathies. Myotonic dystrophy usually presents with early onset cataracts. We showcase the challenges of doing surgery on patients with advanced myopat…

Myopic Traction Maculopathy This is a case of an elderly woman with pathologic myopia referred for asymptomatic worsening macular schisis in the right eye on optical coherence tomography (OCT). Fundus examination showed pathologic myopia and a posterior pole staphyloma. She was diagnosed with myopi…

Myelin Oligodendrocyte Glycoprotein Antibody Disease A middle-aged patient was referred from an outside facility for follow up of idiopathic intracranial hypertension. On careful review, she was found to have demyelinating disease on a prior MRI. Patient underwent a repeat MRI which did not demonst…

Mycobacterium Abscessus Keratitis A patient was referred for management of a corneal ulcer in their right eye. Initial exam revealed VA OD CF with diffuse corneal epithelial defect, infiltrate, and endothelial plaque and anterior inflammation with a hypopyon. Corneal cultures were positive for Myco…

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 …

Multifocal Uveal Melanoma in Setting of Oculodermal Melanocytosis A healthy young patient with prior history of myopia OU presents with sudden-onset decreased vision in the right eye. On presentation, patient’s exam was notable for visual acuity of HM in the right eye and 20/20 in the left eye. I…

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…

Muckle-Wells Syndrome A patient with a past ocular history of retinal vasculitis with subretinal hemorrhage, vitreous hemorrhage, herpetic keratitis, and cataract surgery presented to the emergency room due to sudden onset blurred vision and retrobulbar pain of the left eye. The patient reported lo…

Motility Disturbances after Glaucoma Drainage Device A patient with a history of traumatic angle recession glaucoma in the left eye presented with acute onset of double vision and persistent ocular soreness in the left eye. He denied generalized weakness or difficulty with respiration. His surgical…