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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…

A patient with bilateral corneal edema and elevated intraocular pressure due to cosmetic iris implants. Slit lamp photos showing left worse than right corneal edema, with distortion of native iris behind the implant. High resolution ultrasound biomicroscopy showing iris implant resting in the angle…

Ocular cicatricial pemphigoid with symblepharon in both eyes.

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…

Traumatic Aniridia A patient with past ocular history of penetrating screwdriver trauma to the left globe presents with debilitating glare symptoms and poor vision. The patient has a previous surgical history of primary corneal laceration repair and lensectomy with subsequent reconstruction with sc…

A patient presented with blurred vision in the left eye. Examination showed corneal neovascularization and lipid deposition inferiorly. Anterior segment OCT revealed significant corneal stromal thinning with descemetocele. Treatment was with a with an optical penetrating keratoplasty with corrected…

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…

Patient with history of multiple retinal detachments with a phthisis eye. The crystalline lens is noted to have migrated external to the sclera and subconjunctivally.

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…

Silent Brain Syndrome A 34-year-old male presents for corneal evaluation with progressive decline in vision in both eyes associated with pain, redness and discharge. The patient’s past medical history is notable for a cerebellar cyst that was removed at age 21 and placement of a ventricular-atria…

Severe Ocular Chemical Injury A 41-year-old male international patient presented to BPEI 2 months after the initial injury with persistent redness and decreased vision. Clinical exam revealed scleral melt and ischemia and the patient was started on medical treatment and scheduled for urgent tenopla…

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. …

Recurrent Pterygium We present a 71-year-old male patient with multiple pterygium resection surgeries on the left eye and one on the right eye. Referred to BPEI with progressive horizontal diplopia on lateral gaze for seven months. On ocular examination revealed 20/60 vision in the left eye, restri…