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Traumatic Optic Neuropathy A patient presented with no light perception four days following being hit in the eye with a curling iron. Besides decreased vision, an afferent pupillary defect, and periorbital edema/ecchymosis, clinical exam including of the optic nerve was otherwise unremarkable. Init…

Hermansky-Pudlak Syndrome An infant was brought to the emergency department by his mother referred from his pediatrician after a routine well-child visit. Parents had noticed severe light sensitivity, but patient was otherwise developing well. Patient grimaced to light in both eyes but had poor fix…

POEMS Syndrome A patient presented for evaluation of grade 4 optic disc swelling in both eyes. The patient has a history of polyneuropathy both sensory and motor involving the upper limbs more than lower limbs consistent with a diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) a…

High Myopia A patient presented to BPEI for laser vision correction. Manifest refraction revealed high myopia with spherical equivalent -9.75 diopters in both eyes. Anterior and posterior segment exam were normal. Tomography imaging showed minimal astigmatism, pachymetry of 557 OD and 566 OS, and n…

IRVAN Syndrome An adult patient presented to the Uveitis clinic for evaluation after developing visual deficits in the right eye. He was previously diagnosed with multiple branch retinal artery and vein occlusions in both eyes concerning for an occlusive retinal vasculitis. On examination he was fo…

Susac Syndrome A patient with a history of a central retinal artery occlusion presented with acute vision loss in his right eye and was found to have a branch retinal artery occlusion. A fluorescein angiogram showed retinal vasculitis of both eyes and the patient was diagnosed with Susac Syndrome. …

Hypotony Due to Cyclodialysis Clef A patient with a history of high myopia presented as a referral from an the retina service for low intraocular pressure and blurry vision five months after pars plana vitrectomy for vitreous opacities in the left eye. His intraocular pressure was 8 on difluprednat…

Pseudoangiomatous Retinal Gliosis (PARG) A patient with known history of a chronic inferior rhegmatogenous retinal detachment (RD) of the left eye (OS) presented to the Bascom Palmer Eye Institute (BPEI) emergency department (ED) complaining of new floaters OS. On examination the patient had a visu…

Radiation Optic Neuropathy A patient with a history of skull base meningioma status-post gamma knife radiation presented with three weeks of decreased vision in both eyes. She had no light perception in the right eye and a visual acuity of 20/50 in the left. Magnetic resonance imaging of the brain …

Leukemic Optic Neuropathy Leukemic optic neuropathy is a rare entity that is characterized as optic nerve dysfunction resulting from direct infiltration of neoplastic leukocytes. It is an indicator of central nervous system involvement, and it is a neuro-ophthalmic and oncologic emergency that warr…

Intraosseous Hemangioma An otherwise healthy patient presented to the Emergency Room for evaluation of a left orbital rim lesion, found incidentally by an eyebrow technician. On exam, there was a firm bony mass along the superior orbital rim. Eye exam was otherwise unremarkable. CT scan of the orbi…

Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy A patient with no family history of retinal disease presented to the Bascom Palmer emergency room with 4 days of floaters in her right eye. Her VA was 20/30 and her intraocular pressure was normal. She was found to have vitreous hemorrha…

Hydrolyzed MIRAgel Scleral Buckle A patient presented with one year of gradually worsening left eye pain and binocular diplopia. He had a history of remote retinal detachment repair in 1988 and prostate cancer in 2019 s/p radiation therapy in remission. In the left eye, he had limitations to gaze i…

Coats' Plus Disease An infant born prematurely via emergency cesarean section at 27-weeks due to IUGR and fetal distress weighting 650 g was referred for the evaluation of incomplete vascularization of the retina. After birth, the patient spent 117 days in the neonatal intensive care unit (NICU), w…

C2orf71 Retinitis Pigmentosa A patient presents to the neuro-ophthalmology clinic for evaluation of chronic progressive vision loss over many years. There is high suspicion for a genetic disorder given findings of bilateral symmetric nerve pallor, diffuse chorioretinal atrophy, and attenuated vascu…

Pleomorphic Adenoma A patient with a past ocular history of presumed thyroid eye disease presented with left eye discomfort and left upper eyelid swelling for two days. She endorsed double vision but denied any blurry vision. Her exam was notable for visual acuity of 20/20 in the right eye and 20/2…

Conjunctival Squamous Cell Carcinoma, Keratoacanthoma Type A patient presented with a rapidly enlarging lesion of the nasal conjunctiva of the left eye. The past ocular history was significant only for bilateral surgical removal of cataracts with intraocular lens placement. The patient had a past m…

Exposed Glaucoma Drainage Device A patient with a history of moderate primary open angle glaucoma, pseudophakia, and diabetic macular edema of the right eye presented for a regularly scheduled glaucoma follow-up examination. He had previously undergone a trabeculectomy and subsequent revision in th…

Spontaneous Intracranial Hypotension A patient presented with sudden onset of postural headaches that improved with recumbency associated with nausea, vomit, photophobia and phonophobia of 5 days of evolution followed by binocular horizontal diplopia at distance and in left gaze. Patient denied rec…

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…