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Submacular Hemorrhage An 82-year-old woman presents for follow-up for macular degeneration. Her vision in the right eye at the time of presentation is 20/60. After loss to follow-up due to Covid-19, the patient presents with decreased vision in the right eye secondary to a submacular hemorrhage. He…

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…

Infantile Hemangioma A 17-month-old girl presented with her mother for evaluation of birthmarks that appeared shortly after birth. The patient was born at 38 weeks gestation weighing 7.2 lb. via C-section. Examination disclosed multiple confluent hemangiomas involving the right cheek, upper and low…

Squamous Cell Carcinoma, Metastatic Prostatic Adenocarcinoma A 77-year-old Caucasian male with a history of locally advanced prostate cancer on androgen deprivation therapy presented to BPEI for evaluation of a right lower lid lesion present for six weeks that did not improve with conservative trea…

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…

Primary Angle Closure Glaucoma A 73-year-old Hispanic female presented to Bascom Palmer Eye Institute emergency room on June 06, 2019 with complaints of decreased vision and intermittent pain in the left eye. The patient has no past medical and a history of hyperopia both eyes. Humphrey visual fiel…

Transient Visual Phenomena Associated with High G-Force Maneuvers A 30-year-old male fighter pilot presented with intermittent peripheral vision loss experienced during flight. Initial examination disclosed 20/20 vision in the right and left eye with normal motility, intraocular pressure, and no af…

Chorioretinitis Sclopetaria This case involves an elderly gentleman presenting after trauma to his right eye by an errant golf ball. He was diagnosed with rupture at an outside hospital, but globe exploration failed to identify the site of rupture. He presented to BPED and was diagnosed with chorio…

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…

Ocular Metastatic Cutaneous Melanoma A patient with metastatic cutaneous melanoma to the eye was referred to BPEI glaucoma service for elevated IOP. Examination revealed 20/125 vision and IOP 31 mmHg on multiple glaucoma drops. Gonioscopy revealed a diffuse melanomatous membrane and pigment accumul…

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…

Crystalline Keratopathy Secondary to Mycobacteria Abscesses in Setting of Pre-Existing Herpetic Keratitis A patient with history of herpetic keratitis referred to cornea service with multifocal, white, anterior stromal deposits left eye. Examination revealed 20/20 with inferior and temporal paracen…

Cystoid Macular Edema (CME) A patient presents with recent blurry vision OS. VA 20/200 OD and 20/25 OS. Exam significant for macular scar OD and macular edema OS. Imaging workup significant for OCT showing intra-retinal fluid and VMT OS, SS-OCTA OS showed CNV. Patient started on Aflibercept injecti…

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…

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…

Bilateral Exotropic Duane Syndrome A healthy 5-year-old male presented with an outward deviation of both eyes since approximately 4 months of age. Motility testing was notable for significant limitation to adduction in both eyes, significant downshoot in the right eye and downshoot and upshoot in t…

Juvenile Xanthogranuloma Patient presented to the BPEI emergency room with tearing and light sensitivity of the right eye for 1 month. Examination revealed grimace-to-light vision, soft to palpation intraocular pressure, and hyphema. Skin examination revealed yellowish raised skin lesions on the ne…

Limbal Stem Cell Deficiency We report a case of severe unilateral chemical-thermal injury complicated by total limbal stem cell deficiency and symblepharon, treated with Simple Limbal Epithelial Transplantation (SLET) combined with conjunctival autografting (CAG). We used an autologous limbal biops…

Leukemic Retinopathy A patient with no significant past medical history presented to BPEI ER complaining of blurry vision in the left eye for two weeks. On fundus exam, he had hemorrhages in multiple layers of the retina, venous dilation and tortuosity, and Roth spots. CBC was obtained which reveal…

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…