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Normal Tension Glaucoma A 22-year-old previously healthy female from Guatemala presents as a referral for “severe glaucoma” with symptoms of intermittent headaches and gradual decline in vision most notable in the left eye. On exam the patient is found to have low-normal intraocular tension, op…

Nontuberculous Mycobacterium Keratitis A 39-year-old Hispanic male presented to the Emergency Room with worsening blurry vision and pain in the left eye for 1 month after feeling something “fly into his eye” while cutting wood. Visual acuity was 20/40 on presentation with a small 1 x 1 mm multi…

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…

Non-Arteritic Ischemic Optic Neuropathy We report a case of a 32-year-old male who presents with a four days blurry vision in the left eye. Patient denied any associated pain or systemic symptoms. His review of system includes mild gastrointestinal discomfort 2 years prior that led to eventual remo…

Non-Arteritic Anterior Ischemic Optic Neuropathy A patient presented to the Bascom Palmer Emergency Department with acute onset painless decreased vision in the right eye after awaking from sleep. The patient was found to have unilateral optic disc edema in the right eye. Visual acuity was 20/20 in…

Nocardia Amikacinitolerans Corneal Ulcer A 31-year-old male presented to the Bascom Palmer Eye Institute ER with six weeks of decreased vision in the right eye. Examination revealed 20/70 vision, a white and quiet eye, with a stromal corneal infiltrate and elevated IOP. The patient was treated with…

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…

Neuromyelitis Optica Spectrum Disorder (NMOSD) A patient presented to the emergency room with acute vision loss in the left eye for two weeks. Examination revealed 20/400 vision, crowded nerve with blurred margin, and afferent pupillary defect in the left eye. MRI orbit with and without contrast re…

Neovascular Glaucoma Secondary to Sickle Cell Retinopathy Neovascular glaucoma is a rare cause of elevated intraocular pressure and is typically caused by severe posterior segment ischemia resulting in anterior segment ischemia and neovascularization of the trabecular meshwork angle. Diabetic retin…

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…

Nasolacrimal Fungal Granuloma A 40-year-old man with a past medical history significant only for hyperthyroidism, and no past ocular history, presented with “several months” of left sided proptosis associated with bloody tears, left eye pain, and unilateral blurry vision. He denied trauma, feve…

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 A 62-year-old Asian male with history of myopia presents with decreased vision x 6 months. Found the have myopic traction maculopathy. Patient managed successfully with observation. He has had gradual worsening of vision but has not affected his quality of life. Myopic t…

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…