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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…

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…

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…

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…

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…

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…

Postoperative Endophthalmitis An elderly patient with past medical history of quiescent birdshot chorioretinopathy on immunosuppressive therapy underwent uneventful cataract surgery in the right eye followed by intracameral injection of moxifloxacin at the end of the case. On postoperative day 4, t…

Elevated Intraocular Pressure After Phakic Posterior Chamber Intraocular Lens Placement A patient with a history of high myopia and contact lens intolerance underwent uncomplicated placement of phakic posterior chamber intraocular lenses in both eyes. She was started on a postoperative tapering cou…

Black Cataract A patient with no past ocular history presented with painless vision loss to HM in the left eye over last 6 weeks. The patient had poor, chronically declining visual acuity in that eye for years but did not have access to care. Slit lamp exam was notable for a dense, black cataract i…

Ocular Cicatricial Pemphigoid A patient with a past medical history significant for biopsy-proven ocular cicatricial pemphigoid (OCP) was referred for cataract evaluation in the right eye. At presentation, her vision in the right eye was hand motion, and she had been off systemic immunosuppression …

Intraoperative Fluid Deviation Syndrome A patient underwent routine cataract surgery one month after uncomplicated cataract extraction and intraocular lens implantation of the contralateral eye. Intraoperatively, during the hydrodissection step of cataract extraction, the anterior chamber shallowed…

Post RK Hyperopia A patient with a history of 16-cut radial keratotomy presented with significant hyperopia, an epiretinal membrane, and cataract in the right eye. Corneal topography was notable for significant central flattening and irregular astigmatism in both eyes. He underwent cataract surgery…

Achromobacter Xylosoxidans Endophthalmitis A 79-year-old male with history of Fuchs endothelial dystrophy of both eyes s/p penetrating keratoplasty of both eyes (1980s), repeat penetrating keratoplasty of left eye (2018) and regmatogenous retinal detachment of left eye s/p repair with silicon oil w…

Bilateral Dense White Cataracts This is a patient with significant complex medical history who presented with hand motion vision secondary to bilateral dense white cataracts. Due to high anesthesia risk given the severity of medial comorbidities including an implanted left ventricular assist device…

Cataract Associated with Ciliary Body Melanoma A patient with recently diagnosed ciliary body melanoma was referred to the BPEI glaucoma service for cataract evaluation. Examination revealed CF vision, a dense white cataract, and ciliary body melanoma that had extended into the iris. The patient ha…

Cataracts and Radial Keratotomy A 69-year-old male presented to Bascom Palmer Eye Institute for glare and blurry vision in both eyes. Exam revealed 20/70 vision in right eye and 20/60 in left eye. Patient had 8 RK incision in both eyes and 2+ NS in both eyes. Patient's preoperative evaluation inclu…

Dislocated Intraocular Lens A 74-year-old male presented to the BPEI ER with blurred vision in the right eye for 3 days. He underwent cataract surgery in both eyes 9 years prior in Costa Rica. He denied any other prior ocular history or trauma. Exam revealed VA 20/200+1 in the right eye. IOP was wi…

Epithelial Downgrowth This case presents a 56-year-old female who presented with dramatic decrease of vision over a one-year duration. Patient has previously undergone both eyes corneal transplant, glaucoma drainage device. Patient developed right eye iris cyst, that started growing occupying the a…

Isolated Spherophakia A patient with ocular hypertension and narrow angle was found to have Isolated Spherophakia. She underwent phacoemulsification with a capsular tension ring and intraocular lens in the bag OS. She then had a pars plana vitrectomy with a scleral fixated lens OD. Post-operatively…

Proliferative Sickle Retinopathy A 3-year-old female was referred to BPEI for treatment of congenital cataracts. After bilateral lensectomy and vitrectomy, the patient was noted to have elevated intraocular pressure. She underwent placement of BGI and was incidentally found to have vitreous hemorrh…