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Cranial Nerve 6 Palsy from Metastatic Cholangiocarcinoma A 34-year-old woman presented with 2 weeks of diplopia. The patient had binocular horizontal diplopia with a right cranial nerve 6 palsy and moderate-to-severe headache of 1-week duration. Magnetic resonance imaging (MRI) of the brain and orb…

Vitamin A Deficiency A 73-year-old woman with a past medical history significant for Crohn’s disease and recently diagnosed colon cancer with recent sigmoid colon resection, presented with ten days of blurry vision in both eyes and nyctalopia. Onset of her symptoms was during a hospitalization fo…

Lattice Corneal Dystrophy Lattice corneal dystrophy is a rare disease with a variety of etiologies. Historically, corneal dystrophies have been defined as bilateral, progressive processes that start in a patient’s first to second decade of life and have no correlation with systemic illnesses. Whi…

Gonococcal Preseptal Cellulitis, Gonococcal Conjunctivitis A 21-year-old female presented to the hospital with 5 days of right eye redness, swelling, discharge and pain. Exam revealed VA OD 20/70, painful EOM and severe conjunctival chemosis and discharge, and eyelid swelling. CT scan revealed righ…

Proliferative Sickle Retinopathy A 3-year-old female was referred to BPEI for treatment of congenital cataracts. After bilateral lensectomy and vitrectomy, the patient was noted to have elevated intraocular pressure. She underwent placement of BGI and was incidentally found to have vitreous hemorrh…

Idiopathic Intracranial Hypertension A 39-year-old male presented to the BPEI ER with blurry vision in his right eye for 2 weeks. Examination revealed CF OD, 20/60 OS vision, right APD, and bilateral disc edema. OCT showed diffusely elevated RNFL thickness and HVF 30-2 was not able to be performed …

Combined Hamartoma of the Retina and Retinal Pigment Epithelium A 19-month-old girl with an unremarkable prenatal and infantile history presented with esotropia of the left eye and was found to have a vascularized mass concerning for retinoblastoma. Examination under anesthesia revealed a charcoal …

Retinal Cavernous Hemangioma with Vitreous Hemorrhage A five-week-old full-term male with a history of seizures and birth trauma underwent ophthalmology screening. Initial eye examination revealed vitreous hemorrhage. Subsequent examination under anesthesia with multi-modal imaging revealed vitreou…

Conjunctival Amyloidosis A 48-year-old male with no PMH or POH presented to clinic with painless ptosis OD>OS noticed by his wife for several months. Visual acuity was 20/25 in each eye with unremarkable ocular vitals. Large, yellow-pink, fleshy lesions were noted on the superior bulbar conjunct…

Intraorbital Foreign Body Intraorbital foreign bodies most commonly present with an ocular or penetrating injury. However, when the globe is not involved, the presentation of an intraorbital foreign body can be subtle. Here, we present a case of a 21-year-old female with right upper and lower lid s…

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…

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…

Knobloch Syndrome An infant presented to the eye clinic with nystagmus. The patient underwent examination. Initial eye examination revealed horizontal nystagmus, a midline occipital scalp lesion, hypoplastic macula in both eyes, and high myopia (greater than -15.0 D in both eyes). Given a family hi…

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 …

Intracanalicular Optic Nerve Sheath Meningioma A middle-aged patient with a PMH of breast cancer, migraines, and hyperlipidemia presents to the Bascom Palmer ER with a chief complaint of headache and left eye blurry vision for the past month. Recent work-up outside is remarkable for normal laborato…

Conjunctival SCC A patient presented to the emergency department with a right eye conjunctival mass. Examination showed a large mass, emanating from the conjunctiva. CT scan showed inferior orbital involvement. Surgical treatment via exenteration was carried out, using a lid sparing technique, prov…

Tattoo Granuloma with Uveitis A patient presented with painful decreased vision in the right eye for 3 weeks. He was found to be in pupillary block with 360* posterior synechiae and anterior chamber cell in both eyes. A laser peripheral iridotomy was performed with relief of pain and elevated press…

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…

Epithelial Downgrowth This case presents a 56-year-old female who presented with dramatic decrease of vision over a one-year duration. Patient has previously undergone both eyes corneal transplant, glaucoma drainage device. Patient developed right eye iris cyst, that started growing occupying the a…

Central Retinal Vein Occlusion in Patient with MTHFR Mutation A patient in good health presented with painless acute blurred vision in the right eye. She was found to have macular edema and retinal hemorrhages consistent with a CRVO. Her initial visual acuity was 20/40 in the right eye and 20/20 in…