Course name | Date

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.

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.

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.

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.

Penetrating Ocular Trauma with Staple Gun

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

The large staple was able to be surgically removed and was performed with phacoemulsification of the lens.

Peripapillary Congenital Hypertrophy of the Retinal Pigment Epithelium (CHRPE)

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

Pigmented lesion in the peripapillary area with lacunae suggesting chronicity.

Peripheral Ulcerative Keratitis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Jesse D. Sengillo, MD; Patrick Staropoli, MD
Presenter/Faculty: Patel, Sengillo, Staropoli

Inferior peripheral corneal thinning due to systemic inflammatory disease. Surgery was with conjunctival recession and amniotic membrane placement.

Polypoidal Choroidal Vasculopathy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD
Presenter/Faculty: Fan, Patel

Fundus photo with a nasal peripapillary sub retinal vascular complex surrounded by exudation. OCT with pigment epithelial detachment and associated sub-retinal fluid. ICG angiography makes the diagnosis clear with a hypercyanescent polyp in the choroid.

Pseudoxanthoma Elasticum with Angioid Streaks

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Kenneth C. Fan, MD, MBA; Nimesh A. Patel, MD
Presenter/Faculty: Fan, Patel

External photo depicting characteristic yellow papules, or p'eau d'orange, on the neck. Fundus photos with angioid streaks (yellow arrows).

Retinitis Pigmentosa

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

Fundus photo with peripheral hyperpigmentation and bone spicules. Angiogram demonstrating peripheral atrophy and mild vessel leakage. OCT with cystoid macula edema.

Retinoblastoma

Specialty: Ocular Oncology
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Zelia M. Correa, MD, PhD; J. William Harbour, MD
Presenter/Faculty: Correa, Harbour

Group E retinoblastoma

Ruptured Macroaneurysm with Sub-Macula Hemorrhage Treated with TPA and Pneumatic Displacement

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

The patient presented with a RAM and sub-macular hemorrhage. Treatment was with pars plana vitrectomy, sub-retinal tissue plasminogen activator injection and 26% SF6 gas. The hemorrhage resolved with some photoreceptor changes, but no fibrosis and the patient regained 20/40 vision.

Silicone Oil Droplets on a Silicone Intraocular Lens

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

Silicone oil droplets on a silicone intraocular lens

Sub Internal Limiting Membrane Hemorrhage in a Patient With Leukemia

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

Large sub-ILM hemorrhage leading to sub-retinal exudative changes in a patient with leukemia.

Sub-Conjunctival Lens Migration

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

Patient with history of multiple retinal detachments with a phthisis eye. The crystalline lens is noted to have migrated external to the sclera and subconjunctivally.

Susac Syndrome

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Janet L. Davis, MD; Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Davis, Patel, Rong
A 40-year-old female with headaches, hearing loss and a superior scotoma in the right eye. Fundus photo with multiple inferior branch retinal artery occlusions. Angiography with non-filling of the inferior arterioles and capillary dropout in the area of the infarct. MRI showed scatter FLAIR lesions…

Toxocara with Tractional Retinal Detachment

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

The temporal toxocara lesion led to sub retinal exudation, macular fold and tractional retinal detachment. Surgery was performed with pars plana vitrectomy.