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Pentosan Polysulfate Maculopathy A patient presented to Bascom Palmer Eye Institute complaining of slowly progressive vision loss in both eyes occurring over several years. Examination revealed 20/25, 20/30 vision, bilateral hyperpigmented mottling in the posterior pole. Fundus autofluorescence sho…

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…

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…

Penetrating Ocular Fishhook Injury A patient with a history of stroke, hypertension, and pseudophakia of both eyes, presented with eye trauma while fishing without protective eyewear. While reeling in, his fishhook flew out of the water and hit him in the right eye. On presentation, his right eye v…

Paraneoplastic Autoimmune Retinopathy A patient with a history of advanced ovarian cancer presented with flashes, glare and peripheral visual field loss of 10 months duration. Best-corrected visual acuity was 20/30 in the right eye and 20/40 in the left eye with normal intraocular pressures in both…

Paracentral Acute Middle Maculopathy (PAMM) Associated with Antiphospholipid Antibody Syndrome and impending Central Retinal Vein Occlusion We report a case of paracentral acute middle maculopathy (PAMM) associated antiphospholipid antibody syndrome, and impending central retinal vein occlusion (CR…

PAM and OSSN This case presents a 67-year-old gentleman who was referred for a pigmented lesion. The HR-OCT suggested that this was not simply a small area of PAM, but rather demonstrated an epithelial hyper-reflectivity and thickening with an abrupt change from normal to mildly thickened epitheliu…

Pachyphakia, Microcornea, and Angle Closure A patient presented for right eyelid drooping and redness. The patient had a remote history of retinopathy of prematurity (ROP) which had been treated with extensive retinal laser ablation as a neonate. The patient was found to have pachyphakia, microcorn…

Orthokeratology Lens Related Keratitis A myopic patient with daily orthokeratology lens use presented for eye pain and decrease in vision of both eyes for one week. Patient had no changes in his normal use of lenses. On examination, patient demonstrated findings concerning for an infectious keratit…

Orbital Venous Lymphatic Malformation A 2-year-old previously healthy female presented with 2 days of sudden onset left lid swelling immediately following an episode of vomiting. She was found on exam to have ptosis, mild proptosis, and left upper lid edema, induration, and fullness. MRI of the orb…

Orbital Venous Lymphatic Malformation A patient presented to the ER complaining of 2 days of increasing pain and swelling behind the left eye. Of note the patient reported that as a teenager he was previously treated for an orbital tumor. On exam he was found to have massive proptosis, hyperglobus …

Orbital Sarcoidosis A patient presented with three months of left eye swelling and pain. He was found to have periorbital firmness and fullness, proptosis, and conjunctival chemosis. He underwent computed tomography imaging of the orbits with contrast, which demonstrated an ill-defined, irregular a…

Orbital Rhabdomyosarcoma - Recurrence A young patient with notable past ocular history of orbital rhabdomyosarcoma, s/p chemotherapy with vincristine, dactinomycin, and cyclophosphamide, and proton beam radiation presented to Bascom Palmer ED with 2 days of blurry vision and “seeing everything gr…

Orbital Necrotizing Fasciitis A patient found down by EMS with left orbital swelling for 2 days after he was unable to take his medications due to a recent illness. He was admitted to a hospital and treated for diabetic ketoacidosis, Group A Streptococcus sepsis and left orbital infection before pr…

Orbital Metastatic Breast Cancer A patient presented to the ER with redness of the right eye for months. Initial exam revealed VA 20/50 and was noted to have right sided ptosis and ophthalmoplegia. MRI of the orbits was performed which showed an ill-defined right orbital mass. The patient underwent…

Orbital Lympathic Dominant Lymphatic Venous Malformation A patient with a past ocular history of orbital lymphatic-venous malformation with left upper eyelid swelling and proptosis at childhood who underwent sclerosing therapy presents 7 years later with newly developed left upper eyelid swelling, …

Orbital Cysts An elderly patient presented with two years of chronic pain in an otherwise healthy-appearing anophthalmic socket after enucleation. CT orbits was obtained which showed two hyperdense cystic lesions superior and posterior to the orbital implant. Orbital exploration was performed, the …

Orbital Cellulitis, Cavernous Sinus Thrombosis, Pyomyositis of Extraocular Muscle, Bacteremia A 17-year-old female with no significant PMH presented to the BPEI Emergency Room with a red, swollen left eye for two days in the setting of recent lower lid lesion that the patient believed was a chalazi…

Optic Nerve Pit Optic nerve anomalies are rare entities with a variety of clinical presentations. They can be classified according to anomalies of disc size, disc conformation, or by the presence of abnormal tissue on the optic nerve head, or pseudoswelling. Here, we present a child with an inciden…

Optic Disc Drusen with Structural and Functional Changes A young child presented with crossing of the eyes without headaches or associated neurologic symptoms. Visual acuity was OD 20/30 and OS 20/40. Motility examination demonstrated moderate angle esotropia with full versions. Intraocular pressur…