Course name | Date

3-Piece Intraocular Lens in the Anterior Chamber

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Allister G. Gibbons, MD
Presenter/Faculty: Gibbons

An otherwise asymptomatic 82-year-old patient with uncorrected visual acuity of 20/25 at distance presents for a routine eye exam in clinic.

Widefield Optical Coherence Tomography of Neovascularization in Diabetic Retinopathy

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

OCTA demonstrating neovascularization (yellow arrow) growing into the vitreous with widefield imaging.

X-linked Retinoschisis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Audina M. Berrocal, MD; Nimesh A. Patel, MD; Camila V. Ventura, MD, PhD
Presenter/Faculty: Berrocal, Patel, Ventura
This is congenital retinal dystrophy is caused by a mutation in the retinoschisin (RS1) gene, which encodes for a protein that functions in cellular adhesion. The fundus photo shows a macular stellate pattern caused by schisis or splitting of the retinal layers at the level of the outer plexiform l…

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.

Anterior Dislocation of Crystalline Lens with Corneal Edema

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

Traumatic anterior dislocation of crystalline lens with Descemet’s folds in the cornea. The patient was treated with lensectomy and vitrectomy. Due to the high myopia, there was no need for secondary intraocular lens or contact lens. The final vision uncorrected visual acuity was 20/30 aphakic.

Chronic Retinal Detachment With Pseudocyst

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Hasenin Al-khersan, MD; Nimesh A. Patel, MD
Presenter/Faculty: Al-khersan, Patel
The pseudocyst (yellow arrow) can be a signal that the retinal detachment is chronic. The ultrasound helps to clearly define the fluid filled cavity. It is thought that these are formed by schisis cavities in the outer plexiform layer. If closure of the primary break is not possible, or if the pseu…

CMV Retinitis with Frosted Branch Angiitis

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

In this condition, vasculitis of both arteries and veins, with translucent exudation, gives a similar appearance to the frosted branches of a tree. (Yellow arrow). Superior nasally, there is also the classic retinal whitening with retinal hemorrhages, also known as a “pizza pie fundus”.

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…

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

Acanthamoeba Keratitis with Radial Perineuritis

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

White linear radial stromal haze caused by infiltration and inflammation of the corneal nerves by the amoeba.

Acute Retinal Necrosis Pre and Post Treatment

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Janet L. Davis, MD; Nimesh A. Patel, MD
Presenter/Faculty: Davis, Patel
Presentation with peripheral retinal whitening and perivascular hemorrhages. PCR was positive for HSV. Treatment was with the intravitreal antiviral Foscarnet as well as oral Valacyclovir. On 3 months follow up there was improvement in the retinitis with peripheral atrophy that was laser demarcated…

Amalric Triangular Choroidal Infarction in Giant Cell Arteritis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD
Presenter/Faculty: Patel
The patient presented with ocular ischemic syndrome and corneal edema in the fellow eye. In the right eye on angiography there is temporal non-perfusion as well as choroidal hyperfluorescent infarcts in the late phases. ESR and CRP were elevated. Diagnosis of GCA was made. The patient retained 20/3…

Anterior Chamber Intra-Ocular Lens

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

A well-positioned ACIOL with superior nasal iridotomy.

Bartonella Neuroretinitis

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

Fundus photo with exudates in a stellate pattern surrounding macula. OCT showing the hyperdense exudates in the outerplexiform layer.

Bee Stinger in the Cornea

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

The bee stinger seen in the cornea has remained stable for many years and not affected the vision or required removal.

Bilateral Retinal Artery Occlusions

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

Right eye with central retinal artery occlusion and left eye with superior branch retinal artery occlusion.

Birdshot Chorioretinopathy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Janet L. Davis, MD; Nimesh A. Patel, MD
Presenter/Faculty: Davis, Patel
Fundus photos with creamy yellow sub-retinal lesions emanating radially from the nerve. FA OS with late staining and ICG with delineated hypocyanescent spots in the mid and late phases. The patient was HLA-A29 positive. ERG was used to monitor, assessing the B wave for a delayed 30hz flicker time.

Carotid Cavernous Fistula with Ocular Ischemic Syndrome

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong
Slit lamp photo with dilated epi-scleral veins. Fundus photo with retinal hemorrhages. FA with severe non perfusion, leakage from the disc, and laser scars. MRI/MRA demonstrates left distal precavernous/proximal cavernous ICA fistula into the cavernous sinus with arterialized flow. There is resulta…

Central Retinal Vein Occlusion Associated with Cocaine Abuse

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

A 40-year-old patient with systemic hypertension and history of polysubstance abuse. CBC was within normal limits. Photo shows dilated and engorged vessels, cotton wool spots, and flame hemorrhages.

Central Serous Retinal with Choroidal Neovascularization

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

Fundus photos showing sub-retinal angiogenesis with hemorrhage. OCT with pigment epithelial detachment and outer-retinal atrophy. Autofluorescence with a guttering pattern of the atrophy typical with CSR.