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Persistent Pupillary Membrane, Complete Coloboma A pediatric patient was referred for iris abnormalities. Initial BCVA was 20/60 and 20/70 and exam showed dense central pupillary membranes and complete colobomas. Given obscuration of the visual axis and amblyopia, optical iridectomy and pupillary m…

Acanthamoeba Keratitis A patient presented to the BPEI emergency room with left eye redness and pain for 2 weeks. He had been diagnosed with HSV keratitis by an outside provider but had no improvement on valacyclovir. The vision was 20/20 in the right eye and 20/60 in the left eye, and intraocular …

Subepithelial Infiltrates Secondary Due to Epidemic Keratoconjunctivitis An adult patient presented to the Bascom Palmer Emergency Room with complaint of red eyes and was diagnosed with viral conjunctivitis. He was treated symptomatically and returned with decreased visual acuity and diffuse subepi…

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…

Residual Ametropia, Symptomatic Higher Order Aberration A patient who presents for refractive surgery evaluation. They were noted to have no ocular pathology and was deemed a good refractive surgical candidate. Patient underwent uncomplicated bilateral laser in situ keratomileusis, however the pati…

Ocular Cicatricial Pemphigoid An elderly patient with severe ocular cicatricial pemphigoid (OCP) and immunosuppressed with mycophenolate mofetil has previously lost the right eye due to corneal perforation and choroidal hemorrhage resulting in evisceration. After 5 years of quiescence, his left eye…

Intraocular Foreign Body A patient with past ocular history of remote trauma, unilateral retinal detachment repair, and cataract extraction presented with inferior iris pigmentation and chronic corneal edema. He complains of decreased vision, redness, and foreign body sensation. His visual acuity w…

Traumatic Iris Tear A patient presented to the ER with traumatic cataract, blown pupil, and hyphema. During follow up, noted to have a cyclodialysis cleft with subsequent closure and elevation in intra-ocular pressure. The patient failed medical management of the elevated pressure. The patient requ…

Terrien Marginal Degeneration Our patient presented with progressive decreased vision in the left eye and was found to have significant thinning of the inferior cornea associated with corneal neovascularization and lipid deposition, which was worse in the left than the right eye. Inflammatory lab w…

Stickler Syndrome This presentation describes a teenage patient who presented with bilateral retinal detachments. He has a strong family history of Stickler Syndrome. Additionally, there is a family history of multiple types of cancers, specifically GI cancers. The patient underwent an exam under a…

Smooth Muscle Hamartoma Our patient presented due to a one-year history of a slowly growing conjunctival lesion. A large, red, non-tender lesion of the right bulbar conjunctiva was identified on examination. It did not improve after several weeks of medical management with steroids. He had no previ…

Pseudophakic Bullous Keratopathy with Prior Descemet Membrane Tears due to Forceps Trauma A patient with a history of forceps trauma at birth and amblyopia of the left eye who presents with persistent corneal edema 1 year after uncomplicated cataract surgery. Initial visual acuity was 20/200, intra…

Penetrating Ocular Fishhook Injury A patient with a history of stroke, hypertension, and pseudophakia of both eyes, presented with eye trauma while fishing without protective eyewear. While reeling in, his fishhook flew out of the water and hit him in the right eye. On presentation, his right eye v…

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 …

Nontuberculous Mycobacteria Keratitis A patient five months after bilateral simultaneous cataract surgery in another country presents to the BPEI emergency room with bilateral decreased vision and extreme right eye pain for the last 2 weeks. Their exam was notable for visual acuity of hand motion i…

Non-Infectious Scleritis A monocular patient admitted for pyoderma gangrenosum flare complained of decreased vision and left eye pain. Four years prior she had scleritis OD which requiring scleral reinforcement surgery after which the patient was lost to follow up, developed endophthalmitis and eve…

Neurotrophic Keratitis A patient presented to the Bascom Palmer Eye Institute’s emergency room with acute on chronic left eye pain. The history was notable for a left petroclival chondrosarcoma that had been resected with post-operative, left-sided cranial nerve 5, 6, 7 and 8 palsies. The patient…

Mycobacterium Abscessus Keratitis A patient was referred for management of a corneal ulcer in their right eye. Initial exam revealed VA OD CF with diffuse corneal epithelial defect, infiltrate, and endothelial plaque and anterior inflammation with a hypopyon. Corneal cultures were positive for Myco…

Multi-Drug Resistant Pseudomonas Keratitis Pseudomonas aeruginosa is a gram-negative rod that is both an aerobic and facultative anaerobic organism. It is commonly spread through contact with exposed water, medical equipment, or human contact. As an opportunistic infection, it causes mild disease i…