Bascom Palmer Learn

Iris cyst

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…

Ocular Surface Squamous Neoplasia A patient with an ocular history of OSSN presents with several months of monocular double vision in his right eye. He states that symptoms came on slowly and have progressively gotten worse. His exam was notable for a vision of 20/150 in the right eye that pin-hole…

Giant Fornix Syndrome A patient with a past medical history of hematologic abnormalities undergoing workup for malignancy presented with chronic conjunctival hyperemia and a conjunctival lesion in the left eye. Slit lamp exam was notable for mild injection and irregular, bumpy conjunctiva. He under…

Keratitis Due to Severe Sinonasal Disease with Underlying Granulomatosis with Polyangiitis A young patient with no known prior medical history presents with decreased vision and pain in the right eye. On presentation, patient’s exam was notable for visual acuity of 20/150 in the right eye and 20/…

Ocular Surface Squamous Neoplasia An elderly patient with a diffuse ocular surface squamous neoplasia (OSSN) of the left eye is treated with cycles of Interferon, 5 Fluorouracil and Mitomycin C topical chemotherapy without improvement. Due to high out-of-pocket costs and epiltheliopathy after 7 mon…

Epithelial Downgrowth A patient with ocular history of ruptured globe presented with a new pupillary membrane. Argon laser photocoagulation showed blanching of the iris epithelium concerning for epithelial downgrowth. A biopsy of this membrane was positive for epithelial downgrowth. It was observed…

Sebaceous Carcinoma Presenting with Corneal Ulcer and Descemetocele An 87-year-old male was referred for second opinion due to nonhealing corneal ulcer of his right eye. He had a past medical history significant for basal cell carcinoma, arthritis, hypertension, hypothyroid, CABG, and carotid stent…

Scleral-Invasive Ocular Surface Squamous Neoplasia An 83-year-old male with history of skin cancer and tobacco use was referred to BPEI for evaluation of a subconjunctival mass which was previously biopsied. On presentation, a large firm subconjunctival mass with prominent feeder vessels was seen. …

Patient presents with unilateral blurred vision, foreign body sensation and redness. Picture on the right shows gelatinous pinguecula at limbal location 4 clock hour, corneal surface with significant PEE. Picture on the left is HR-OCT that shows thickened and hyperreflective epithelium with abrupt …

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 patient presented to BPEI for a cornea evaluation with blurred vision, foreign body sensation and redness for 1 year duration. The exam was notable for visual acuity of 20/150 in the right eye. Intraocular pressure was 8 in the right eye, Slit lamp exam was most …

Ocular Surface Squamous Neoplasia A 71-year-old male with a history of atopic dermatitis was referred to BPEI for evaluation of a corneal lesion. Exam revealed an opalescent and gelatinous lesion at 2-4 o'clock at the limbus in the left eye. Anterior segment OCT showed a thickened, hyperreflective …

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.

Lisch Corneal Dystrophy A patient presented with blurry vision in the left eye and was found to have a pigmented superficial corneal lesion which showed hyperreflectivity without thickening on the AS-OCT. The lesion was biopsied and confirmed to be Lisch corneal dystrophy on pathology. The lesion r…

Slit lamp photo of biopsy proven Lisch Corneal dystrophy.

Kaposi's Sarcoma of the Conjunctiva A patient presented to the BPEI Emergency Room with a painless red eye for the past 3 months. Past medical history was limited to a recent hospitalization for a complicated pneumonia and a new diagnosis of HIV. Examination of the eye revealed an elevated, vascula…

Infectious Scleritis An elderly patient presented to BPEI with 7 days of decreased vision and pain in the left eye. Visual acuity was hand motion and exam revealed a localized area of scleral necrosis and suppuration. B scan showed a very small and shallow ciliochoroidal detachment. Cultures of the…

Erdheim Chester Disease A 37-year-old male presented to clinic with bilateral conjunctival lesions for 7 months. Patient has a history of lytic bone lesions, 50-pound weight loss, and fevers. Examination revealed 20/20 vision in both eyes, mobile, discrete conjunctival lesions in bilateral bulbar c…

Epithelial Downgrowth A patient with a history of bilateral corneal transplants, glaucoma drainage device, and iris cysts presented with gradually decreasing vision after surgical removal of the cyst and cataract surgery in that eye. The patient was diagnosed with epithelial downgrowth and underwen…