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Subconjunctival Dirofilariasis A patient presents with one week of left eye redness and irritation. There was no inciting event or trauma. At presentation, his vision was 20/20 in both eyes, intraocular pressure within normal limits, and pupils equal and reactive bilaterally without afferent pupill…

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/…

Granular Corneal Dystrophy Type II A patient presented to the Bascom Palmer General Eye Care Clinic with a progressive decline in her vision in both eyes. The patient was found to have bilateral corneal opacities extending throughout the deep stroma. She underwent genetic testing which confirmed th…

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…

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…

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…

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. …