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Ocular Surface Squamous Neoplasia A patient with an ocular history of OSSN presents with several months of monocular double vision in his right eye. He states that symptoms came on slowly and have progressively gotten worse. His exam was notable for a vision of 20/150 in the right eye that pin-hole…

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…

Sheet form of epithelial downgrowth.

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…

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. …

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 …

Microsporidial Keratitis A patient with chronic nonresponse keratitis presented to Bascom Palmer with a 2 year history of progressive eye pain and blurry vision in the left eye. He was initially diagnosed with herpes stromal keratitis of the left eye and was treated for >1 year with steroids and…

Keratoacanthoma

Conjunctival Squamous Cell Carcinoma with Intraorbital and Intraocular Invasion A 64-year-old male with a history of T2DM and HTN was referred for 2 weeks of severe pain and redness in the right eye. Two months earlier, he had undergone reported pterygium removal surgery in another country. At pres…

Conjunctival Keratoacanthoma Keratoacanthoma (KA) is an epithelial tumor characterized by rapid, abundant growth and a potential for spontaneous resolution. It typically occurs on the skin in sun-exposed areas such as the face, neck, and hands. Rarely it can occur on the conjunctiva and vulvar regi…

Conjunctival Amyloidosis A 48-year-old male with no PMH or POH presented to clinic with painless ptosis OD>OS noticed by his wife for several months. Visual acuity was 20/25 in each eye with unremarkable ocular vitals. Large, yellow-pink, fleshy lesions were noted on the superior bulbar conjunct…

Juvenile Xanthogranuloma A baby was referred for a new-onset subconjunctival lesion in the right eye. He was found to have a thickened, yellow corneoscleral lesion and hyphema, presumed to be ocular juvenile xanthogranuloma (JXG). He was started on topical steroids as empiric treatment, with initia…

Juvenile Xanthogranuloma Patient presented to the BPEI emergency room with tearing and light sensitivity of the right eye for 1 month. Examination revealed grimace-to-light vision, soft to palpation intraocular pressure, and hyphema. Skin examination revealed yellowish raised skin lesions on the ne…

Extra-Parenchymal Neurocysticercosis (NCC) A patient presented with blurry vision and headaches for 6 months. He was found to have grade 5 papilledema with hemorrhages. MRI brain/orbits showed bilateral flattening of the posterior sclera with intraocular protrusion of the optic nerve head and promi…

Juvenile Psammomatous Ossifying Fibroma An 18-year-old female presented with blurry vision, headaches for 4 months. She was diagnosed to have papilledema on an outside eye exam and referred to BPEI. Her visual acuity was 20/20 OD, 20/100 OS. Additionally, she was noted to have junctional scotoma on…

Granular Cell Tumor A patient was referred by an outside ophthalmologist for evaluation. The patient reported having headaches, double vision, and eye bulging for 3 months. Her exam was notable for restricted extraocular movements in her left eye on abduction and adduction. Her slit lamp exam was n…

Multimodal imaging of a patient with ciliochoroidal melanoma with extraocular extension associated with sympathetic ophthalmia before and after treatment.

Ciliochoroidal Melanoma with Extraocular Extension Complicated by Sympathetic Ophthalmia A patient presented with a pigmented conjunctival lesion in the right eye of insidious onset and progressive course. She was found to have a ciliochoroidal melanoma with extraocular extension and underwent exci…