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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…

Pythium Insidiosum Keratitis An 83-year-old otherwise healthy female was referred to the BPEI ER for a progressive corneal ulcer. Exam in the left eye was notable for hand motions vision, normal IOP, and severe corneal ulcer associated with hypopyon and scleral extension. B-scan ultrasonography of …

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…

Post-transplant Interface Infectious Keratitis A patient with past ocular history of pseudoexfoliation syndrome, left eye Descemet’s Stripping Endothelial Keratoplasty (DSEK) and left eye scleral fixated intraocular lens after complicated left eye cataract surgery presented to the emergency room …

Post-Refractive Corneal Haze A patient presented to the Bascom Palmer Eye Institute with bilateral anterior stromal corneal haze after photorefractive keratectomy for high myopia in both eyes 5 years ago. His vision was 20/200 in both eyes, in the setting of significant irregular astigmatism induce…

Peters Anomaly Type 1 A 2-week-old girl presented with bilateral Type I Peters anomaly consisting of bilateral dense central corneal opacities and iridocorneal adhesions. Upon presentation patient had elevated IOP in both eyes (OU) (38 mmHg in the right eye (OD) and 40 mmHg in the left eye (OS)), w…

Peripheral Ulcerative Keratitis A patient with well-controlled HIV on antiretroviral therapy presented to the emergency department with five months of left eye pain, redness, discharge, and blurry vision. Visual acuity in the left eye was found to be 20/60 and slit lamp examination was remarkable f…

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…

Ophthalmia Nodosa A patient presented to the Bascom Palmer Eye Institute retina/uveitis clinic with 2 months of right eye irritation and floaters. He reported being hit in the right eye by a large flying insect while working on a cruise ship in the Bahamas immediately prior to the onset of symptoms…

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 …

Ocular Graft Versus Host Disease A 39-year-old female with 6 months of eye itchiness and yellow discharge for 6 months. Pt has a history of acute lymphoblastic leukemia treated with allogenic bone marrow transplant. Pt diagnosed with ocular graft versus host disease. Pt had some improvement with lu…

Ocular Cicatricial Pemphigoid / Mucous Membrane Pemphigoid A patient with a PMHx of HTN presented to BPEI with redness and discharge of the left eye for 3 months. Review of systems was negative for any systemic symptoms. Visual acuity of the left eye was 20/80, IOP was 13 mmHg, there was no APD, an…

Ocular Cicatricial Pemphigoid An 83-year-old monocular male presented to the Cornea division, Bascom Palmer Eye Institute with bilateral decreased vision, pain redness and burning for many years getting progressively worse. Examination revealed hand motion vision, ankyloblepharon and chronic cicatr…

Nontuberculous Mycobacterium Keratitis A 39-year-old Hispanic male presented to the Emergency Room with worsening blurry vision and pain in the left eye for 1 month after feeling something “fly into his eye” while cutting wood. Visual acuity was 20/40 on presentation with a small 1 x 1 mm multi…