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Epithelial Downgrowth This case presents a 56-year-old female who presented with dramatic decrease of vision over a one-year duration. Patient has previously undergone both eyes corneal transplant, glaucoma drainage device. Patient developed right eye iris cyst, that started growing occupying the a…

A patient with a history of pseudophakia OS presented with 5 years of low vision and 9 days of pain OD and was found to have light perception only vision and an IOP of 44mmHg OD. She had a granular appearing hypopyon in the anterior chamber corneal edema and a mature cataract. Immunohistological an…

Fungal Keratitis A patient with a history of corneal ulcer presents for a second opinion due to slow clinical improvement on topical medications. Cultures were negative, but biopsy showed numerous fungal elements. The patient was continued on topical antifungal medication and showed clinical improv…

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…

Giant Fornix Syndrome A patient with a past medical history of hematologic abnormalities undergoing workup for malignancy presented with chronic conjunctival hyperemia and a conjunctival lesion in the left eye. Slit lamp exam was notable for mild injection and irregular, bumpy conjunctiva. He under…

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…

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…

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…

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…

Patient presents with unilateral blurred vision, foreign body sensation and redness. Picture on the right shows gelatinous pinguecula at limbal location 4 clock hour, corneal surface with significant PEE. Picture on the left is HR-OCT that shows thickened and hyperreflective epithelium with abrupt …

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 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…

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…

Lisch Corneal Dystrophy A patient presented with blurry vision in the left eye and was found to have a pigmented superficial corneal lesion which showed hyperreflectivity without thickening on the AS-OCT. The lesion was biopsied and confirmed to be Lisch corneal dystrophy on pathology. The lesion r…

Kaposi's Sarcoma of the Conjunctiva A patient presented to the BPEI Emergency Room with a painless red eye for the past 3 months. Past medical history was limited to a recent hospitalization for a complicated pneumonia and a new diagnosis of HIV. Examination of the eye revealed an elevated, vascula…

Erdheim Chester Disease A 37-year-old male presented to clinic with bilateral conjunctival lesions for 7 months. Patient has a history of lytic bone lesions, 50-pound weight loss, and fevers. Examination revealed 20/20 vision in both eyes, mobile, discrete conjunctival lesions in bilateral bulbar c…