Course name | Date

Fungal Endogenous Endophthalmitis With Breakthrough Viritis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Harry W. Flynn, Jr., MD; Nimesh A. Patel, MD
Presenter/Faculty: Flynn, Patel

Patient with history of intravenous drug abuse. Fundus photo with a creamy yellow superficial retinal lesion in superior macula (arrow). OCT with breakthrough under hyaloid and overlying (arrow).

Fungal Keratitis Post Penetrating Keratoplasty

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Daniel S. Choi, MD; Nimesh A. Patel, MD; Sarah P. Read, MD, PhD
Presenter/Faculty: Choi, Patel, Read

Post penetrating keratoplasty for candida keratitis, this patient developed another foci of infection within the graft tissue. Stromal vascularization and edema can be seen indication failure of the graft.

Glaucoma Drainage Device Exposure

Specialty: Glaucoma
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Yasmin Islam, MD
Presenter/Faculty: Islam

Slit lamp photos demonstrating exposure of a glaucoma drainage device tube in the inferonasal quadrant without evidence of infection.

Grade 5 Papilledema From Idiopathic Intracranial Hypertension

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong

Increased intracranial pressure leading to bilateral optic nerve edema. Grade 5 is considered when all vessels are partially obscured by edema.

Intradermal Nevus

Specialty: Ocular Oncology
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong

The patient presented with an enlarging lower eyelid lesion for 2 months. There was irregular pigmentation without ulceration or madarosis. Biopsy confirmed an intradermal nevus.

Intraocular Lymphoma Associated with Non-CNS Lymphoma Treated with Intravitreal Chemotherapy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Thomas A. Albini, MD; Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD
Presenter/Faculty: Albini, Fan, Patel
The patient presented with panuveitis and exudative retinal detachment OS. He had a recent skin biopsy of a mass on the arm that was found to be Diffuse large b cell lymphoma ABC type. Diagnostic vitrectomy showed +CD20 cells suggestive of intraocular lymphoma. The follow up photo (2 months later) …

Iridocorneal Endothelial (ICE) Syndrome - Iris Atrophy Sub-Type

Specialty: Glaucoma
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): J. William Harbour, MD; Nimesh A. Patel, MD
Presenter/Faculty: Harbour, Patel

This patient was referred for possible iris malignancy. Ultrasound confirmed no mass. There is atrophy of the iris nasally with some variable pigmentation.

Iridodialysis Pre and Post Repair

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Justin H. Townsend, MD
Presenter/Faculty: Patel, Townsend

Slit lamp photo post trauma with bungee cord. There was 5 clock hours of iridodialysis superior nasally with inferior crystalline lens subluxation seen on retroillumination. Post-surgical iris repair and lensectomy the anatomy is restored.

Iris, Lens and Zonule Coloboma

Specialty: Glaucoma
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Audina M. Berrocal, MD; Brenda Fallas; Nimesh A. Patel, MD
Presenter/Faculty: Berrocal, Fallas, Patel
These are caused by failure of the embryonic fissure to close during the second month of development in utero. The iris defect is also known as a "keyhole" pupil. Here, there is not only an iris defect, but also missing tissue in the lens (yellow arrow) and zonules. This can cause difficulties duri…

Keratoprosthesis Endophthalmitis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Guillermo Amescua, MD; Janet L. Davis, MD
Presenter/Faculty: Patel, Amescua, Davis

Keratoprosthesis infiltrate and epithelial defect. There was progression with pain and and vitritis that led to removal of the prosthesis.

Lupus Vasculitis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong

Fundus photos showing sheathing of the major and minor vasculature. Fluorescein angiography with small vessel vasculitis with diffuse temporal non-perfusion.

Metal Tip Post Phacoemulsification Surgery

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Carol L. Karp, MD; Nimesh A. Patel, MD; Swarup S. Swaminathan, MD
Presenter/Faculty: Karp, Patel, Swaminathan

This patient underwent uneventful cataract surgery. On post-operative day 1 there was found to be a fragment of metal on the iris likely from the phacoemulsification probe.

Multifocal Pattern Dystrophy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD
Presenter/Faculty: Patel
A 50-year-old patient presenting asymptomatically with 20/30 vision was found to have yellow outer retinal lesions bright on autofluorescence. Genetic testing confirmed a mutation in the RDS gene. Often this can simulate Stargardt’s disease which has a mutation in the ABCA4 gene. There is no trea…

Myelinated Retinal Nerve Fiber Layer

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Brandon Sparling
Presenter/Faculty: Sparling

Myelinated retinal nerve fiber layer

Myopic Degeneration

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Harry W. Flynn, Jr., MD; Nimesh A. Patel, MD
Presenter/Faculty: Flynn, Patel

Myopic degeneration patches of severe retinal and choroidal atrophy, lacquer cracks, a tilted disc and lattice degeneration.

Ocular Bartonella Henselae Infection

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Thomas A. Albini, MD; Jason C. Fan, MD, PhD; Benjamin R. Lin, MD; Landon J. Rhowetz, MD
Presenter/Faculty: Albini, Fan, Lin, Rhowetz

A patient with ocular Bartonella henselae infection manifesting as neuroretinitis and branch retinal artery occlusion.

Optic Nerve Cupping from Primary Open Angle Glaucoma

Specialty: Glaucoma
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD
Presenter/Faculty: Patel

Increased cup to disc ratio at > 0.9 with some peripapillary atrophy.

Optic Nerve Cyst and Coloboma

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Audina M. Berrocal, MD; Nimesh A. Patel, MD
Presenter/Faculty: Berrocal, Patel

Optic nerve cyst (first image) that over time revealed an optic nerve coloboma (second image).

Orbital Cysts

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Shanlee M. Stevens, MD
Presenter/Faculty: Stevens

An elderly patient with anophthalmic socket pain underwent orbital exploration. Intra-operative photo shows a large cystic lesion superior to her orbital implant. Close up photograph of the cyst shows a 1-mm intact cystic lesion filled with gray opaque fluid.

Pediatric Leber's Hereditary Optic Neuropathy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Maja Kostic, MD, PhD; Byron L. Lam, MD; Nimesh A. Patel, MD
Presenter/Faculty: Kostic, Lam, Patel

A 7-year-old patient with fundus photos showing temporal optic nerve pallor OU. Vision was 20/400 and 20/800. Ganglion cell layer of the patients male first cousin reveals diffuse thinning.