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Neuromyleitis Optica A child presented to the ER with blurry vision and eye pain. Exam disclosed unilateral optic nerve edema and decreased color vision; subsequent MRI disclosed optic neuritis. Lab testing demonstrated +Aqp4 antibodies, and the patient subsequently developed longitudinally extensi…

Pachyphakia, Microcornea, and Angle Closure A patient presented for right eyelid drooping and redness. The patient had a remote history of retinopathy of prematurity (ROP) which had been treated with extensive retinal laser ablation as a neonate. The patient was found to have pachyphakia, microcorn…

White Cataract with Pre-existing Posterior Capsule Rupture from Intravitreal Injection A patient who underwent an intravitreal anti-vascular endothelial growth factor injection developed a white cataract after his procedure. Careful examination and ultrasonography revealed a white cataract with a p…

Idiopathic Intracranial Hypertension A patient with slow and progressive, painless, visual decline OD for two weeks presents to BPEI ED. She also notes moderate intensity full-day headaches and TVOs in the same time period. She saw an outside provider and was referred to BPEI ED for optic nerve hea…

Nuclear 3rd CN Palsy with Vertical Gaze Palsy A patient with significant vasculopathy risk factors (DM, HTN, dyslipidemia), had a stroke affecting the right thalamus, midbrain, and right cerebellum due to basilar artery occlusion. He had a successful mechanical thrombectomy with a stent retriever a…

IRVAN (Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis) A patient presented to the BPEI Emergency Room with a red painful eye and blurred vision. At the time of presentation she was diagnosed with elevated intraocular pressure in the setting of neovascularization of the optic nerve, ir…

Radiation Optic Neuropathy A patient with a history of proton beam therapy for a chordoma near the clivus presented with 1 week of blurry vision in the left eye. On presentation, patient’s exam was notable for a visual acuity of 20/25 in the right eye and 20/50 in the left eye. Intraocular pressu…

Terson's Syndrome A patient with no known past ocular history was referred for evaluation of bilateral retinal detachments. Prior to his presentation, the patient was admitted to an outside hospital and was diagnosed with a sub-arachnoid hemorrhage originating from the right anterior communicating …

Ethambutol Induced Optic Neuropathy A patient with a past medical history of chronic Mycobacterium avium infection, on anti-mycobacterial medication for 5 months, presented with bilateral, painless, progressive visual loss for 1 month. Previous medical history significant for B cell lymphoma and ma…

Granular Cell Tumor A patient was referred by an outside ophthalmologist for evaluation. The patient reported having headaches, double vision, and eye bulging for 3 months. Her exam was notable for restricted extraocular movements in her left eye on abduction and adduction. Her slit lamp exam was n…

Familial Exudative Vitreoretinopathy and Retinopathy of Prematurity An infant underwent ophthalmic examination. Born at 32 weeks, the infant weighed 680 grams and received high-flow nasal cannula for respiratory distress of the newborn. Dilated fundus examination of the right eye revealed periphera…

Full Thickness Macular Hole A middle-aged patient presented to the Bascom Palmer Institute with complaints of persistent floaters in left eye one month after a bicycle accident s/p laser retinopexy. A full-thickness macular hole was subsequently found on exam in the left eye. The patient subsequent…

Choroidal Metastasis A patient presented to the Bascom Palmer Eye Institute with blurred vision in the left eye for 5 days. Past medical and ocular history was unremarkable. Past social history was notable for 25 pack-year smoking history. Visual acuity in the right eye was 20/20. Visual acuity in …

Macular Neovascularization Secondary to Best Disease in a Pregnant Female A patient with a history of Best Disease mutation in BEST1 presented with a sudden onset of blurriness and distortion in her left eye (OS) for three weeks. The patient's family history reveals genetic and visual implications,…

Pressure-Induced Stromal Keratopathy (PISK) and Corneal Scarring After Infectious Keratitis A patient presented with eye pain and decreased vision in the left eye after having LASIK in both eyes. She was found to have an interface infectious keratitis that required re-lifting of the LASIK flap twic…

Post LASIK infectious keratitis and pressure-induced stromal keratopathy.

Choroidal Effusion After Glaucoma Drainage Device A patient with a past medical history of intellectual disability and ocular history of constant eye rubbing, a left eye with central retinal venous occlusion and mixed mechanism glaucoma and a right eye that is pseudophakic with open angle glaucoma …

Myotonic Dystrophy Associated Cataracts We present a case series of two siblings with myotonic dystrophy and cataract with different degrees of zonulopathies. Myotonic dystrophy usually presents with early onset cataracts. We showcase the challenges of doing surgery on patients with advanced myopat…