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Thyroid Eye Disease A 57-year-old woman with PMH of hyperthyroidism presents with eye pain, swelling, and blurry vision worsening for 3 weeks. Exam revealed severe proptosis, exposure keratopathy, orbital congestion, and markedly reduced visual acuity. CT and laboratory were workup consistent with …

Conjunctival Keratoacanthoma Keratoacanthoma (KA) is an epithelial tumor characterized by rapid, abundant growth and a potential for spontaneous resolution. It typically occurs on the skin in sun-exposed areas such as the face, neck, and hands. Rarely it can occur on the conjunctiva and vulvar regi…

Pseudoangiomatous Retinal Gliosis A 54-year-old Hispanic male presented with decreased vision in the right eye over 3 months. Dilated fundus exam of the right eye showed a geographic area of chorioretinal alteration in the far temporal periphery at 9 o’clock, a gliovascular retinal mass superiorl…

Sterile Endophthalmitis Post-injection sterile endophthalmitis is an acute intraocular inflammation of the vitreous cavity that resolves without the need of intravitreal antibiotics and/or vitreoretinal surgery. Differentiating between infectious and sterile endopthalmitis is often difficult and no…

Optic Disc Drusen Routine eye exam of a 58-year-old African-American female revealed small discs with visible optic disc drusen, for which she had been monitored with visual fields. Her best-corrected visual acuity was 20/20 and intraocular pressure was 19 in both eyes. Visual fields were concernin…

Retinopathy of Prematurity An 19-year-old woman presented with decreased vision in the right eye and was found to have a retinal detachment. She had a history of retinopathy of prematurity as an infant and had been treated with laser photocoagulation. Treatment for retinopathy of prematurity in the…

Central Serous Retinopathy A 48-year-old female presents with a history of chronically decreased vision in her right eye. Multimodal imaging reveals serous macular detachment, thickened choroid, and focal areas of late leakage on fluorescein angiography. The left eye has pigmentary changes in the p…

Ocular Ischemic Syndrome Ocular ischemic syndrome (OIS) is a rare condition associated with severe carotid artery occlusive disease leading to ocular hypoperfusion. It typically presents at mean age of 65, there is no racial predilection, and is two times more common in men than women. It is typica…

Severe Non-Proliferative Diabetic Retinopathy with Cystoid Macular Edema A 65-year-old male with diabetic retinopathy and CME presented to the BPEI retina clinic for continued management of his chronic ocular condition. His care was complicated by an inability to submit to ocular examinations in th…

Extranodal Rosai-Dorfman Disease A 28-year-old male without past medical history presented with a 1 year history of painless bilateral upper lid swelling. After multimodal imaging studies, the patient underwent diagnostic orbital biopsy. The pathologic analysis of the biopsy showed a plasmacytic in…

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…

Fungal Keratitis A 59-year-old female presented to the Bascom Palmer Eye Institute emergency room with a 7-day history of a red and painful eye, and loss of vision. The right eye exam demonstrated HM vision with a diffuse limbal-to-limbal cornea ulcer within a previous penetrating keratoplasty graf…

Ocular Cicatricial Pemphigoid An 83-year-old monocular male presented to the Cornea division, Bascom Palmer Eye Institute with bilateral decreased vision, pain redness and burning for many years getting progressively worse. Examination revealed hand motion vision, ankyloblepharon and chronic cicatr…

Primary Vitreoretinal Lymphoma A 77-year-old female with a history of vitritis of unknown origin and two non-diagnostic vitrectomies presented with a white plaque on the posterior capsule of her left eye after being lost to follow up for several years. Repeat vitrectomy confirmed the suspected diag…

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…

Conjunctival Melanoma A 38-year-old healthy man presents with a pigmented lesion two years after onset and undergoes excisional biopsy which confirms conjunctival melanoma. Systemic work-up reveals metastasis, and the patient undergoes multiple cycles of radiation and chemotherapy. He later died of…

Retained Lens Fragment A 61-year-old male referred after complicated cataract extraction surgery (phacoemulsification). On exam he was found to have a large piece of retained nuclear fragment in the inferior vitreous. He underwent PPV along with lens exchange with anterior chamber IOL placement. He…

Recurrent Pterygium We present a 71-year-old male patient with multiple pterygium resection surgeries on the left eye and one on the right eye. Referred to BPEI with progressive horizontal diplopia on lateral gaze for seven months. On ocular examination revealed 20/60 vision in the left eye, restri…

Dislocated Intraocular Lens A 74-year-old male presented to the BPEI ER with blurred vision in the right eye for 3 days. He underwent cataract surgery in both eyes 9 years prior in Costa Rica. He denied any other prior ocular history or trauma. Exam revealed VA 20/200+1 in the right eye. IOP was wi…

Mucormycosis A 61-year-old male with interstitial lung disease status post left lung transplant on immunosuppression develops worsening left facial and periorbital swelling after dental cleaning. Symptoms are unresponsive to oral antibiotics and after three days the patient is examined by ophthalmo…