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A patient with orbital venous lymphatic malformation causing massive proptosis. MRI demonstrates an enhancing, T1 hypointense, T2 hyperintense, lobulated mass with small blood-fluid levels in the left medial orbit compressing the globe and causing bony deformation of the bony orbit. Surgical specim…

Retinoblastoma A 2-year-old female with an unremarkable past medical history presented with pain and swelling of the left eye. One examination she was able to fix and follow with both eyes but had a dull red reflex of the left eye as well as a retinal mass. An exam under anesthesia was performed wh…

Sebaceous Carcinoma, Concern for Muir-Torre Syndrome Our patient presented with a greater than one year history of a non-resolving right eyelid mass that began to hemorrhage due to accidental trauma. Exam was remarkable for and extensive multi-lobar ulcerated mass found along the right lower lid al…

Squamous Cell Carcinoma, Metastatic Prostatic Adenocarcinoma A 77-year-old Caucasian male with a history of locally advanced prostate cancer on androgen deprivation therapy presented to BPEI for evaluation of a right lower lid lesion present for six weeks that did not improve with conservative trea…

Uveal Effusion Syndrome A patient was referred to the ocular oncology service for evaluation of a suspicious choroidal mass and serous retinal detachment in the right eye. The Snellen visual acuity was 20/80 and intraocular pressures were normal in both eyes. Examination and imaging of the right ey…

A stark example of iridoschisis with Iris sloughing in a left eye after blunt force trauma to the eye and orbit.

Orbital Necrotizing Fasciitis A patient found down by EMS with left orbital swelling for 2 days after he was unable to take his medications due to a recent illness. He was admitted to a hospital and treated for diabetic ketoacidosis, Group A Streptococcus sepsis and left orbital infection before pr…

Aneurysmal Bone Cyst A patient with a 2-week history of proptosis and vision changes in the right eye is transferred from an outside hospital. Neuroimaging revealed a large intraorbital and intracranial expansile lesion with multilobulated cystic spaces, surrounded by a thin cortical shell with per…

NUT Carcinoma A patient presented with several weeks of right eye proptosis. On initial examination, his visual acuity in the right eye was 20/400, and a relative afferent pupillary defect was noted. He had 4 mm relative proptosis on the right and restricted motility in all gaze directions. CT orbi…

Orbital Lympathic Dominant Lymphatic Venous Malformation A patient with a past ocular history of orbital lymphatic-venous malformation with left upper eyelid swelling and proptosis at childhood who underwent sclerosing therapy presents 7 years later with newly developed left upper eyelid swelling, …

Adult Onset Xanthogranuloma A 48-year-old male presented with intermittent bilateral eyelid swelling for 5 years and progressively enlarging well-demarcated yellow eyelid lesions. On exam, patient had chemosis, and reduced up gaze in the right eye, prompting orbital imaging with MRI which demonstra…

Basal Cell Carcinoma A 73-year-old female presented to clinic with a large ulcerated lesion involving the forehead, glabella, upper eyelids and extending towards the medial canthi bilaterally. The lesion had been present and growing for over 19 years, but the patient was reluctant to seek medical c…

Congenital Zika Syndrome A 20 m/o female presented to an eye clinic in Colombia for a follow-up eye exam. Ocular examination revealed a normal anterior segment exam, but fundus photos displayed focal pigment mottling in the macula bilaterally. These ocular findings were attributed to ocular involve…

Myelinated retinal nerve fiber layer

Nasolacrimal Fungal Granuloma A 40-year-old man with a past medical history significant only for hyperthyroidism, and no past ocular history, presented with “several months” of left sided proptosis associated with bloody tears, left eye pain, and unilateral blurry vision. He denied trauma, feve…

Pleomorphic Adenoma A patient with a past ocular history of presumed thyroid eye disease presented with left eye discomfort and left upper eyelid swelling for two days. She endorsed double vision but denied any blurry vision. Her exam was notable for visual acuity of 20/20 in the right eye and 20/2…

Retinal Capillary Hemangioblastoma in Von-Hippel Lindau Syndrome A 40-year-old male with family history of renal cell carcinoma and history of neurosurgical excision of cerebellar hemangioblastoma presents for routine ophthalmic examination. Vision is 20/20 in both eyes. Fundus examination reveals …

Presumed Rhino-Orbital Mucormycosis A patient with a past medical history of PCOS and type 2 diabetes mellitus presented to an outside hospital six weeks pregnant with right sided facial pain and periorbital swelling. Ophthalmology was consulted for sudden, progressive vision loss in the right eye.…

An elderly patient with anophthalmic socket pain underwent orbital exploration. Intra-operative photo shows a large cystic lesion superior to her orbital implant. Close up photograph of the cyst shows a 1-mm intact cystic lesion filled with gray opaque fluid.

Sturge-Weber Syndrome A child was born with an extensive, bilateral, flat, red facial skin lesion that was initially flat and barely noticeable but over time has grown and become thicker and a deeper red color. He was born at term to a healthy mother, had no other lesions on his body, no other symp…