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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…

Phacomorphic Glaucoma and Anterior Lens Capsule Rupture After Laser Peripheral Iridotomy Patient with a history of multiple retinal detachments status post repair and brunescent cataract was seen at outside eye clinic with elevated intraocular pressure, eye pain and decreased vision. Vision was rep…

Bleb Leak A patient with past ocular history of trabeculectomy for juvenile open angle glaucoma and DSAEK for Fuch’s endothelial corneal dystrophy presented to the emergency room with left eye blurred vision and redness. The patient was diagnosed with acute graft rejection. The patient was starte…

Bartonella Retinitis A patient presented to the emergency department with 2 days of floaters and pain with ocular movements. He endorsed exposure to stray cats and being scratched by a kitten. Best-corrected visual acuity was 20/20 in both eyes. Anterior segment exam was unremarkable and posterior …

Idiopathic Intracranial Hypertension A patient presented with two weeks of vision loss alongside a year-long complaint of left-sided neck stiffness and headaches. Past medical history was remarkable for end-stage renal disease on peritoneal hemodialysis. Examination was notable for blood pressure o…

Miller Fisher Syndrome A patient with no significant PMH presented with acute onset of diplopia associated with loss of balance 2 weeks after having an influenza infection. On examination: a bilateral limitation in adduction with end gaze nystagmus in the abducted eye was noted. Also, dilated and n…

Mixed Mechanism Glaucoma Secondary to Retained Lens Material A patient with a past ocular history of diabetic cataracts status post cataract extraction with posterior chamber intraocular lens insertion 28 years prior to presentation, proliferative diabetic retinopathy with macular edema treated wit…

West Nile Virus Chorioretinitis A patient with a recent history of meningoencephalitis presents with blurry vision and increased number of floaters noted after discharge. During hospitalization, he required IV treatment with Meropenem and Acyclovir due to unclear etiology. Past ocular history was c…

Central Serous Chorioretinopathy This is a case of a young man with central serous choroidopathy (CSC) who presented for dysmorphopsia and color vision changes in the right eye. He was found to have subretinal fluid (SRF), RPE changes, pigment epithelial detachment (PED), and a thick choroid on opt…

Cicatrizing Conjunctivitis Secondary to Mycobacterium Tuberculosis A patient presented to the Bascom Palmer ER with chronic irritation in his right eye for 3 months. He was referred by an outside provider for possible ocular malignancy. The patient was found to have temporal symblepharon and inferi…

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…