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Pulled-in-Two Syndrome A 61-year-old female with longstanding left sixth nerve palsy secondary to meningioma that was resected. Her visual acuity OD was 20/20, OS 20/40. Her traction testing OS revealed severe restriction to abduction. She had visual confusion with superimposition of the images tha…

Basal Cell Carcinoma A 73-year-old female presented to clinic with a large ulcerated lesion involving the forehead, glabella, upper eyelids and extending towards the medial canthi bilaterally. The lesion had been present and growing for over 19 years, but the patient was reluctant to seek medical c…

Basal Cell Carcinoma A 73-year-old female presented to clinic with a large ulcerated lesion involving the forehead, glabella, upper eyelids and extending towards the medial canthi bilaterally. The lesion had been present and growing for over 19 years, but the patient was reluctant to seek medical c…

Macular Hole A 64-year-old male veteran presents to the clinic on Feb. 15, 2019, with report of having blurry vision in the left eye for 30 years, following left-sided head trauma. He has been told by multiple providers that there was nothing that could be done for his vision. He complains of a “…

Macular Hole A 64-year-old male veteran presents to the clinic on Feb. 15, 2019, with report of having blurry vision in the left eye for 30 years, following left-sided head trauma. He has been told by multiple providers that there was nothing that could be done for his vision. He complains of a “…

Post-Ruptured Globe Associated Retinal Detachment A 75-year-old-man presented to Bascom Palmer Eye Institute for a second opinion following a mechanical fall with trauma sustained to the right eye, resulting in a ruptured globe one month prior. Examination revealed 20/LP vision, no APD, normal IOP,…

Post-Ruptured Globe Associated Retinal Detachment A 75-year-old-man presented to Bascom Palmer Eye Institute for a second opinion following a mechanical fall with trauma sustained to the right eye, resulting in a ruptured globe one month prior. Examination revealed 20/LP vision, no APD, normal IOP,…

Nocardia Amikacinitolerans Corneal Ulcer A 31-year-old male presented to the Bascom Palmer Eye Institute ER with six weeks of decreased vision in the right eye. Examination revealed 20/70 vision, a white and quiet eye, with a stromal corneal infiltrate and elevated IOP. The patient was treated with…

Nocardia Amikacinitolerans Corneal Ulcer A 31-year-old male presented to the Bascom Palmer Eye Institute ER with six weeks of decreased vision in the right eye. Examination revealed 20/70 vision, a white and quiet eye, with a stromal corneal infiltrate and elevated IOP. The patient was treated with…

Adenoid Cystic Carcinoma of the Lacrimal Gland A 43-year-old female presented to her primary care physician with swelling of the lateral aspect of the right upper eyelid without visual complaints. The primary care physician noted proptosis of the right globe and ordered a CT scan which revealed a m…

Adenoid Cystic Carcinoma of the Lacrimal Gland A 43-year-old female presented to her primary care physician with swelling of the lateral aspect of the right upper eyelid without visual complaints. The primary care physician noted proptosis of the right globe and ordered a CT scan which revealed a m…

Toxic Anterior Segment Syndrome A 73-year-old male with history of myopia presents with 1 day of blurry vision in the right eye after uncomplicated cataract extraction and intraocular lens implant. Patient reports mild irritation without associated pain. Vision at presentation was count fingers wit…

Toxic Anterior Segment Syndrome A 73-year-old male with history of myopia presents with 1 day of blurry vision in the right eye after uncomplicated cataract extraction and intraocular lens implant. Patient reports mild irritation without associated pain. Vision at presentation was count fingers wit…

Indirect Carotid Cavernous Fistula A 72-year-old female referred to Bascom Palmer Emergency room with 4 months of progressive painless diplopia and eye redness after dental procedure. Exam revealed VA 20/25 OU with bilateral abducens palsy, and arterialization of the conjunctival vessels. Review of…

Indirect Carotid Cavernous Fistula A 72-year-old female referred to Bascom Palmer Emergency room with 4 months of progressive painless diplopia and eye redness after dental procedure. Exam revealed VA 20/25 OU with bilateral abducens palsy, and arterialization of the conjunctival vessels. Review of…

Ocular Surface Squamous Neoplasia A 65-year-old male with history of suspected glaucoma, diabetes, hypertension, and hyperlipidemia presented for a routine eye exam. Patient reported spending a lot of time in the sun. Visual acuity was 20/20 and intraocular pressure was normal in both eyes. Exam re…

Ocular Surface Squamous Neoplasia A 65-year-old male with history of suspected glaucoma, diabetes, hypertension, and hyperlipidemia presented for a routine eye exam. Patient reported spending a lot of time in the sun. Visual acuity was 20/20 and intraocular pressure was normal in both eyes. Exam re…

Retinal Arterial Macroaneurysm 82-year-old female presented to BPEI from the Cayman Islands with 3 weeks of floaters and decreased vision in the right eye. Visual acuity was hand motion and posterior exam revealed vitreous hemorrhage, submacular hemorrhage, and a retinal arterial macroaneurysm (RAM…

Retinal Arterial Macroaneurysm 82-year-old female presented to BPEI from the Cayman Islands with 3 weeks of floaters and decreased vision in the right eye. Visual acuity was hand motion and posterior exam revealed vitreous hemorrhage, submacular hemorrhage, and a retinal arterial macroaneurysm (RAM…