Ophthalmology Cases

Indexed by Condition


Cataracts

Communication Issues Following a Post Operative Surprise: Blurry Vision Following Cataract Surgery

Endophthalmitis: 82-year-old male status post phacoemulsification in the left eye with acute decrease in vision

Intraoperative Floppy Iris Syndrome: IFIS presents problems during cataract surgeries by decreasing the size of the work field and increasing the rate of complications such as iris trauma, posterior capsule rupture, and vitreous loss.

Intralenticular Foreign Body: 23-year-old male with staple in the eye

Intraocular Foreign Body: A Classic Case of Metal on Metal Eye Injury

Intraocular Lens "Time Out": A Systems Based Case

Marfan Syndrome: 28-year-old female with Marfan syndrome and decreased vision/glare in both eyes

Morgagnian Cataract: 59-year-old female with decreased vision at distance and near, more so in the right eye than the left and iincreasing difficulty with glare from bright lights at night, seeing road signs, watching television, and reading the newspaper.

Ocular Syphilis Presenting with Posterior Subcapsular Cataract and Optic Disc Edema: bilateral painless progressive vision loss

Phacoemulsification: Considerations for Astigmatism Management, a tutorial and case

Posterior capsular folds creating a Maddox rod effect following cataract surgery: 73-year-old female presents with glare in the right eye 5 months after cataract surgery

Posterior Polar Cataract. 38-year-old male with blurry distance vision and problems seeing at night and significant glare from oncoming headlights when driving at night.

Toxic Anterior Segment Syndrome (TASS): A System's Based View of a Day in the Life of a Canula

Traumatic Cataract: 11-year-old boy with glass injury to the right eye


Cornea & Anterior Segment

Acanthamoeba Keratitis: 39-year-old contact lens wearer with persisting keratitis & pain

Allergic Contact Dermatoblepharitis: 55-year-old female with a Medical History significant for multiple sclerosis presented with a one-week history of itchy eyes and blurry vision

Atopic Keratoconjunctivitis: 52-year-old male with poor vision, severe ocular itchin, and mucoid discharge. He reports a history of waxing and waning eczema

Bilateral Corneal Edema Associated with Amantadine Use: 42-year-old female with 2-month history of blurry vision, photophobia, and mild, aching pain in both eyes.History of Huntington disease-related movement disorder

Boston Keratoprosthesis: An option for patients with multiple failed corneal grafts

Cogan's Syndrome: 42-year-old Female with Interstitial Keratitis and Vertigo

Corneal Endothelial Transplantation: Descemet's Stripping Endothelial Keratoplasty (DSEK)

Corneal Stromal Dystrophies: A Clinicopathologic Review

Cystinosis: 4-year-old girl with failure to thrive, severe photophobia, and newly diagnosed renal insufficiency.

Deep Lamellar Endothelial Keratoplasty (DLEK) for Fuchs: 72-year-old female with Fuchs.

Descemet’s membrane endothelial keratoplasty (DMEK) for Fuchs’ endothelial dystrophy

The Evolution of Surgical Approaches to AlphaCor Keratoprosthesis Insertion and Associated Complications

Exposure Keratopathy in the Critically Ill: A Case Report, Discussion, and Systems-Based Intervention

Fuchs Endothelial Dystrophy: 35-year-old female with blurry vision OU lasting hours in the morning

Functional Visual Loss: 37-year-old male with decreased vision progressively worsening over the past year. The patient was referred because he could not read any of the letters on the chart and showed no improvement with refraction.

Fungal Keratitis - Fusarium: 41-year-old female contact lens wearer with persisting keratitis

Granular Corneal Dystrophy Discovered Following LASIK: A Clinicopathologic Correlation of Granular Corneal Dystrophy Type II and LASIK. 44-year-old male with progressive decrease in vision in both eyes with "tremendous" glare symptoms. Eight years prior to presentation he underwent Laser-assisted in situ keratomileusis (LASIK) in both eyes.

Herpes Simplex Keratitis: 36-year-old female presented to the Emergency Treatment Center (ETC) with one day of right eye pain, photophobia and decreased vision.

Infectious Crystalline Keratopathy (ICK): 72-year-old female with decreased vision

Iris Melanoma: 47-year-old male referred in 1997 for evaluation of iris lesion OS

Lattice Corneal Dystrophy Type II – Meretoja's Syndrome: patient with anterior stromal corneal dystrophy, progressive decline in vision with glare

Laser Assisted Keratoplasty: 63-year-old female with history of Fuchs endothelial dystrophy and bilateral pseudophakic bullous keratopathy presents with decreasing vision in the right eye

Megalocornea. 60-year-old male with a history of simple megalocornea reported visual disturbance while changing head position, his vision worsened with his head bent down.He previously had cataract surgery with an iris-sutured IOL.

Ocular Cicatricial Pemphigoid: atypical presentation as pseudopterygium and limbal stem cell deficiency. 78-year-old male with chronic irritation and dry eye unresponsive to aggressive lubrication, punctal occlusion, and prednisolone/sulfacetamide drops

Ocular Manifestations of Stevens-Johnson Syndrome: 13-year-old female treated with trimethoprim-sulfamethoxazole developed mucosal and dermatologic eruptions with ocular involvement.

Ocular Rosacea: 62-year-old female with blurry vision and red, itchy eyes

Perioperative Corneal Abrasions: Systems-based review and analysis. 64-year-old male patient noted severe pain in his right eye while in the post-anesthesia care unit shortly after laparoscopic surgery. A bedside ocular examination was remarkable for a linear, horizontal corneal epithelial defect.

Peripheral Ulcerative Keratitis (PUK): A 79-year-old woman was referred for the evaluation of a corneal ulcer in the right eye (OD). She began experiencing foreign body sensation in the right eye about 2 months prior to presentation after getting poked in the eye while gardening

Peters Anomaly: 2-day-old infant evaluated for bilateral corneal opacity noted at the time of delivery. There were no known maternal infections during the pregnancy and no problems during the perinatal period. The infant did not show evidence of tearing, blepharospasm, photophobia, drainage, or ocular redness.

Phlyctenular Keratoconjunctivitis: 12-year-old Female with Staphylococcal Blepharitis

Phacoemulsification: Considerations for Astigmatism Management, a tutorial and case

Pseudophakic Bullous Keratopathy: Deep Lamellar Endothelial Keratoplasty (DLEK) and Intraocular Lens (IOL) exchange with Anterior Vitrectomy.

Post LASIK Ectasia: Female patient presented status post bilateral LASIK for myopia. Vision in the right eye was progressively more blurred.

Salzmann's Nodular Corneal Degeneration: 62-year-old woman presents with 3 years of progressive decrease in vision. She has had 3 updates of her spectacle prescription that have not provided satisfactory vision.

Surgical Management of Keratoconus: A 22-year-old male with a history of progressive keratoconus

Vernal Keratoconjunctivitis: 8-year-old asthmatic male with reduced vision

Verticillata: 54-year-old white male with a known history of atrial fibrillation and hypertension on amiodarone.

Vision Loss After Contact Lens-Related Pseudomonas Keratitis. Since the majority of cases of microbial keratitis (mk) in contact lens wearers are due to Pseudomonas, and this specific infection heralds a worse prognosis, we investigated outcomes at our facility to determine the frequency and extent of visual loss in cases of Pseudomonas keratitis occurring in eyes with previously normal visual acuity and no risk factors for MK except contact lens wear.

External Disease

Adenoviral Conjunctivitis: 38-year-old white female with watery, red, irritated eyes; left more than right.

Allergic Contact Dermatoblepharitis: 55-year-old female with a Medical History significant for multiple sclerosis presented with a one-week history of itchy eyes and blurry vision.

Adult Chlamydial Conjunctivitis: 23-year-old male with 6-week duration of red eye

Conjunctival Melanoma arising from Primary Acquired Melanosis (PAM): 61-year-old Caucasian female presenting for evaluation of corneal mass OS found on routine exam ~2 months previous.

Erythema Multiforme: 22-year-old male with a persistent red eye for two weeks

Ocular Rosacea: 62-year-old female with blurry vision and red, itchy eyes


Genetic Eye Disease

Autosomal Dominant Optic Atrophy: 47-year-old female with chronic, mildly subnormal vision

Best Vitelliform Macular Dystrophy: 30-year-old female referred for bilateral macular lesions.

Juvenile open-angle glaucoma: 22-year-old Caucasian female referred in 1990 for evaluation of elevated intraocular pressure (IOP)

Lattice Corneal Dystrophy Type II – Meretoja's Syndrome: patient with anterior stromal corneal dystrophy, progressive decline in vision with glare

Leber Hereditary Optic Neuropathy:  A 17-year-old male presents with progressive, painless, bilateral vision loss

Malattia Leventinese (Familial Dominant Drusen): 30-year-old female with drusen

Pattern Dystrophy Associated with Myotonic Dystrophy: 56-year-old female presented with a one-year history of increasingly distorted vision OS described as "crinkled"

RPE65-associated Leber Congenital Amaurosis

Unilateral Retinitis Pigmentosa: Visual field changes in a 31-year-old female


Glaucoma

Blebitis: 74-year-old with red eye after trabeculectomy

Competition Leads to Healthcare Savings: A systems based case from the VA

Giant reservoir formation from Ahmed seton valve: A 79-year-old man presenting for treatment of a chalazion on the left eye and follow-up care of his right anophthalmic socket. His wife mentioned that he exhibits a right head turn while watching television.

Grant syndrome (Syndrome of precipitates on the trabecular meshwork): 60-year-old male referred for evaluation of elevated intraocular pressure (IOP), right eye with corneal edema. Treated with a laser peripheral iridotomy and started on bimatoprost and brimonidine/timolol. The only pertinent exam findings were pigmented precipitates on the anterior trabecular meshwork OD on gonioscopy.

Iris Cyst: 38-year-old female with iris lesion and gradual decrease in vision

Iris Melanoma: 47-year-old male referred in 1997 for evaluation of iris lesion OS

Iridocorneal Endothelial Syndrome (ICE) - essential iris atrophy: 63-year-old female with PAS, "iris mass", corectopia, and increased IOP OS.

Juvenile open-angle glaucoma: 22-year-old Caucasian female referred in 1990 for evaluation of elevated intraocular pressure (IOP)

Normal Tension Glaucoma: 50-year-old female with progressive visual field loss, glaucomatous disc change and normal IOP

Pigmentary Glaucoma: 24-year-old male with episodic haloes around lights and blurry vision

Plateau Iris: A healthy 47-year-old female referred for evaluation for glaucoma exhibitsan uncommon form of primary angle closure glaucoma

Primary Congenital Glaucoma (Infantile Glaucoma): 3-year-old female referred for evaluation of increased eye size, left eye

Pseudoexfoliation Glaucoma: 65-year-old male with complaints of painless, gradual loss of vision OS.

Seton Infection: Serratia Marcescens: 57-year-old white female with 1 day history of redness, swelling, and pain in her right eye.

Sturge-Weber Syndrome: 4-year-old child with a history of seizures and glaucoma.


Neuro-ophthalmology

Acute Demyelinating Encephalomyelitis (ADEM) with associated optic neuritis: 9-year-old girl presents to an outside hospital with fatigue, poor appetite, and decreased activity for 3 weeks.

All-trans retinoic acid (ATRA) induced intracranial hypertension in a patient with acute promyelocytic leukemia: 19-year-old male ungergoing ATRA and Idarubicin induction therapy for APL with one-week complaint of intermittent headaches and transient visual obscurations.

ANCA-associated granulomatous vasculitis (Wegener's granulomatosis): 54-year-old male with binocular vertical diplopia 4 months prior to presentation and progressively worsening. Vision in the right eye was starting to "darken." Prior to presentation, patient was followed by an otolaryngologist for his sinus disease and nosebleeds.

2-month-old with bilateral optic nerve hypoplasia: Highlighting the importance of a multi-disciplinary approach

Dorsal Midbrain Syndrome (Parinaud's Syndrome) with Bilateral Superior Oblique Palsy: 43-year-old male referred for evaluation of binocular diplopia.

Dramatic Visual Recovery in Untreated Indirect Traumatic Optic Neuropathy: Severe vision loss in one eye immediately after motorcycle accident.

Ethambutol Toxicity and Optic Neuropathy: 60-year-old female with bilateral painless central vision loss

Functional Visual Loss: 37-year-old male with decreased vision progressively worsening over the past year. The patient was referred because he could not read any of the letters on the chart and showed no improvement with refraction.

Horner's Syndrome (due to Cluster Headache): 46-year-old male presenting with HA and ptosis.

Idiopathic Intracranial Hypertension (Pseudotumor Cerebri): 31-year-old obese female presenting with a history of headaches and transient visual obscurations for six months.

Leber Hereditary Optic Neuropathy:  A 17-year-old male presents with progressive, painless, bilateral vision loss

Myasthenia Gravis: 32-year-old female with progressive LUL ptosis for several years.

Neurofibromatosis Type 1 - Optic Nerve Glioma: 8-year-old white female with acute awareness of complete vision loss, left eye.

Ophthalmoplegic Migraine: 30-year-old male with migraine headaches and occasional diplopia

Optic Nerve Drusen: 19-year-old female with blurred vision

Optic Nerve Hypoplasia: 51-year-old female referred for consideration of cataract surgery. {Related Case: Communicating with patients about alternative therapies: A case of optic nerve hypoplasia in a 14-year-old male with poor vision since birth}

Optic Neuritis: A 40-year-old female noticed visual loss in her right eye accompanied by pain with eye movements and a dull retro-orbital ache, two weeks prior to her clinic visit.  She also noted decreased perception of color and contrast.

Orbital inflammation secondary to bisphosphonate therapy: 80-year-old female with right eyelid swelling, pain, decreased vision, diplopia

Pituitary Adenoma Causing Compression of the Optic Chiasm: 49-year-old white female with painless progressive vision loss.

Progressive Supranuclear Palsy in a Patient with Progressive Nonfluent Aphasia: A case of an 81-year-old woman with limited eye movements

Pseudoabducens palsy: When a VI nerve palsy is not a VI nerve palsy

Recurrent Neuroretinitis: 29-year-old white female with progressively worsened vision, right eye, diminished central vision, and pain with eye movements.

Sarcoidosis: 53-year-old A female with gradual, painless loss of vision in both eyes. (also see Ocular Sarcoidosis)

See-Saw Nystagmus: 64-year-old male who first noted the onset of oscillopsia five months prior to presentation.

Spinocerebellar Ataxia with Ophthalmoplegia: 46-year-old male presenting with progressive esotropia

Thyroid Eye Disease (Graves' ophthalmopathy): 51-year-old male seen in consultation from the internal medicine service for evaluation and management of "dry and red eyes.

Tumor Necrosis Factor Alpha Antagonist Precipitating Demyelinating Disease: A 34-year-old woman presents with optic neuritis and develops demyelinating brain lesions

Unilateral Optic Nerve Hypoplasia in a patient desiring surgical treatment for exotropia. 17-year-old male with a longstanding sensory left exotropiainquiring about strabismus surgery.


Oculoplastic Surgery, Orbit, Eyelids, Lacrimal

Allergic Contact Dermatoblepharitis: 55-year-old female with a Medical History significant for multiple sclerosis presented with a one-week history of itchy eyes and blurry vision

ANCA-associated granulomatous vasculitis (Wegener's granulomatosis): 54-year-old male with binocular vertical diplopia 4 months prior to presentation and progressively worsening. Vision in the right eye was starting to "darken." Prior to presentation, patient was followed by an otolaryngologist for his sinus disease and nosebleeds.

Basal Cell Carcinoma, Morpheaform subtype: 78-year-old male with complaints of enlarging Left Lower Lid lesion.

Bilateral Nasolacrimal Duct Obstruction after Adjuvant I-131 for Thyroid Cancer: 53-year-old female with bilateral tearing worsening over the preceding year. She describes tears that run down the front of her face and denies any ocular irritation.

Canalicular Laceration - Dog Bite: 5-year-old white female presenting with dog bite to left side of face.

Capillary Hemangioma: 4 month-old female with occlusive vascular lesion of right upper eyelid

Carotid Cavernous Fistula: 46-year-old female patient presented twith double vision and visual distortion.

Cavernous Hemangioma: Painless Proptosis in a 62-year-old female: Patient states that over the last year she has noticed that her right pupil is higher than her left

Chalazion: Acute presentation and recurrence in a 4-year-old female

Chronic Progressive External Ophthalmoplegia (CPEO) - Kearns-Sayre Syndrome: 12-year-old boy with painless, progressive ptosis OU over 3 years

Churg-Strauss Syndrome with Orbital Inflammation. 56-year-old male with two-month history of progressive proptosis & drooping of the left upper eyelid and binocular diplopia for several weeks

Ciliary Body Leiomyoma: Clinicopathologic Correlation

Congenital dacryocystocele with spontaneous resolution: Full-term 10 day-old female referred to the pediatric ophthalmology clinic by dermatologist for a bluish mass inferior to the right medial canthus

Congenital Ptosis. Seven month-old male patient with drooping of the left upper lid/left upper eyelid ptosis

Dermoid Cyst: 6 month-old male was referred by his pediatrician for evaluation of a right upper eyelid mass.

Distichiasis: 64-year-old white male with bilateral eye irritation.

Enophthalmos Secondary to Metastatic Breast Cancer. 63-year-old female presenting with progressive double vision and a droopy right eyelid.

Giant reservoir formation from Ahmed seton valve: A 79-year-old man presenting for treatment of a chalazion on the left eye and follow-up care of his right anophthalmic socket. His wife mentioned that he exhibits a right head turn while watching television.

Invasive Fungal Orbitorhinocerebral Mucormycosis

Lymphoma, Orbital: 60-year-old male who was evaluated 1 wk ago for "conjunctivitis" left eye by internal medicine.

Meningiomas: a case and review. A 36-year-old female presented with a "bulging" and apparently swollen left eye noticed about one month prior to her visit.

Myeloid Sarcoma: 20-year-old female with a history of intermittent binocular diplopia that worsened with right head tilt and a six week history of progressive fullness of the right upper eyelid. Medical History is notable for Acute Myelogenous Leukemia reported to be in remission.

Nodular Basal Cell Carcinoma: 49-year-old female with left lower lid lesion

Oculopharyngeal muscular dystrophy: 58-year-old female with gradual worsening of bilateral blepharoptosis.She also has mild dysphagia and proximal muscle weakness

Spontaneous Retrobulbar Hemorrhage with Subsequent Orbital Compartment Syndrome. 80-year-old male presented with diplopia and proptosis of right eye. Complained of sudden vision loss in the right eye. Symptoms began that morning with diplopia when he left home to walk his dog. By the time he returned home, he had profound vision loss and right eye protruding.

Orbital Cellulitis in a Child: 9-year-old female with left nasal pain, swollen, red left eye and diplopia in all gazes

Orbital Eosinophilic Granuloma. 16-month-old male patient with left-sided periorbital swelling beginning three weeks prior to presentation in the setting of an upper respiratory infection

Orbital inflammation secondary to bisphosphonate therapy: 80-year-old female with right eyelid swelling, pain, decreased vision, diplopia

Orbital Osteoma: 20-year-old female with a 9-month history of left upper lid droopiness

Pan-endophthalmitis and Orbital Cellulitis: 89-year-old female with a history of gradual redness and proptosis, right eye over 3 weeks.

Punctal and Canalicular stenosis (dacryostenosis) from Docetaxel: 38-year-old female with persisting tearing for 6 months.

Sarcoidosis Affecting the Lacrimal Gland: 39-year-old female with left upper eyelid swelling of 4 months duration

Sebaceous Cell Carcinoma: A Masquerade Syndrome

Secondary Tumors After Hereditary Retinoblastoma: A Case of Orbital Leiomyosarcoma 50 Years After Initial Enucleation and Radiation Therapy..

Silent Brain Syndrome: 32-year-old male with history of excess tearing in both eyes with mucous-like yellowish discharge. Excess tearing henders vision.

Silent Sinus Syndrome: 36-year-old male with sunken left orbit (Enophthalmos)

White-eyed blowout fracture: 17-year-old male with diplopia, pain with eye movement, nausea and vomiting after blunt trauma to the left eye


Pediatric Ophthalmology & Strabismus

Acute Acquired Brown Syndrome: 38-year-old Male with Ethmoidal Sinus Mucocele

Anisometropic Amblyopia. 5-year-old male with unequal vision.

2-month-old with bilateral optic nerve hypoplasia: Highlighting the importance of a multi-disciplinary approach

Capillary Hemangioma: 4 month-old female with occlusive vascular lesion of right upper eyelid

Chalazion: Acute presentation and recurrence in a 4-year-old female

Coats Disease: 11-year-old male with poor vision in left eye

Congenital dacryocystocele with spontaneous resolution: Full-term 10 day-old female referred to the pediatric ophthalmology clinic by dermatologist for a bluish mass inferior to the right medial canthus

Congenital Lymphocytic Choriomeningitis Virus (LCMV) infection: 1-week-old male with hydrocephalus and bilateral chorioretinitis

Congenital Ptosis. 7 month-old male patient with drooping of the left upper lid/left upper eyelid ptosis.

Dermoid Cyst: 6 month-old male was referred by his pediatrician for evaluation of a right upper eyelid mass.

Duane Retraction Syndrome: 31-year-old Male With Globe Retraction

Goldenhar Syndrome (Oculo-Auriculo-Vertebral Spectrum): 6 day-old male with limbal dermoids

Holoprosencephaly and Strabismus. Female child presenting to the eye clinic at age 15 months for eye crossing. She had a history of severe hydrocephalus with seizures and alobar holoprosencephaly at birth.

Infantile (Congenital) Esotropia: 2 month-old female began crossing her eyes shortly after birth. Parents feel that it is worsening. Crossing is worse when patient is tired and alternates between the right eye and the left eye

Juvenile Idiopathic Arthritis with Associated Bilateral Anterior Uveitis in a Four-year-old Girl. Routine preschool screening found central posterior synechiae in both eyes. Patient was found to have macular edema and was referred to rheumatology for systemic evaluation with suspicion of inflammatory etiology.

Management of Amblyopia: Discussing Options for Treatment in the Age of the Internet.

Non-accidental Trauma: An unresponsive infant with bilateral retinal hemorrhages

Orbital Cellulitis in a Child: 9-year-old female with left nasal pain, swollen, red left eye and diplopia in all gazes

Orbital Eosinophilic Granuloma. 16 month-old male patient with left-sided periorbital swelling beginning three weeks prior to presentation in the setting of an upper respiratory infection

Prostaglandin-Associated Periorbitopathy: Progressive glaucoma and periorbital changes. 52-year-old woman presented with elevated intraocular pressure (IOP) and visual fields demonstrating progressive field loss despite maximum tolerated medical therapy. She had gradual periorbital changes consisting of a “sunken appearance” with a larger eyelid opening.

Refractive Accommodative Esotropia. 4-year-old boy originally presented to ophthalmologist at 2 years of age with crossed eyes. Discussion of the management of Refractive Accommodative Esotropia.

Retinoblastoma: 4 month old boy with a "blur" in one eye since birth

Rhabdomyosarcoma: Eleven-year-old male with two weeks of blurry vision, headaches, and difficulty moving the right eye for the past two weeks

Unilateral Optic Nerve Hypoplasia in a patient desiring surgical treatment for exotropia. 17-year-old male with a longstanding sensory left exotropiainquiring about strabismus surgery.

Vernal Keratoconjunctivitis: 8-year-old asthmatic male with reduced vision


Professionalism
Retina & Vitreous

Acquired Ocular Toxoplasmosis: 42-year-old female with "fuzzy" vision for two weeks

Acute Zonal Occult Outer Retinopathy (AZOOR) and Acute Idiopathic Blind Spot Enlargement Syndrome (AIBSE): 34-year-old female awoke with painless loss of vision left eye 3 weeks prior to presentation.

Age-related Macular Degeneration: Progression from Atrophic to Proliferative: 76-year-old female with 17-year history of atrophic AMD and increased size of existing central scotoma discovered with home Amsler grid testing

Birdshot Choroiditis: 55-year-old female with persistent vitreous floaters

Cat-Scratch neuroretinitis (Ocular bartonellosis): 44-year-old female with non-specific "blurriness" of vision, left eye.

Central Retinal Artery Occlusion (CRAO): 81-year-old white male with sudden, painless vision loss left eye.

Changing Trends in Sympathetic Ophthalmia: Sympathetic ophthalmia following repeated vitreoretinal surgery with no history of trauma

Choroidal Hemangioma: Central scotoma in the right eye. Patient with reduced vision and oval-shaped central scotoma in the central visual field of the right eye for two months.

Choroidal Malignant Melanoma: 58-year-old female with pigmented retinal lesion and exudative retinal detachment

Choroidal Osteoma: 10-year-old girl presents for annual follow-up. She reports that she recently failed a school screening

Chorioretinitis Sclopetaria: A Systems Based Approach to Eye Injury Prevention. Patient with BB gun injury to right orbit

Congenital Lymphocytic Choriomeningitis Virus (LCMV) infection: 1-week-old male with hydrocephalus and bilateral chorioretinitis

Cytomegalovirus (CMV) Retinitis: 36-year-old Indian male with HIV and decreasing visual acuity.

Hydroxychloroquine (Plaquenil) Toxicity: 57-year-old female with bilateral central photopsias for two years. Currently treated with prednisone and methotrexate for Sjogren syndrome and inflammatory arthritis and was previously treated with hydroxychloroquine for 10 years, stopped one year ago.

Interferon Retinopathy: 60-year-old male with hepatitis C virus infection presents with new floaters in both eyes. Treated with peginterferon and ribavirin for 6 weeks prior to visit.

Idiopathic Juxtafoveal Telangiectasia Type II (Macular Telangiectasia type 2): 43-year-old male with decreased vision and a central scotoma OU for the past 10 years, which has been getting progressively worse

Malattia Leventinese (Familial Dominant Drusen): 30-year-old female with drusen

Multiple Evanescent White Dot Syndrome (MEWDS): 24-year-old female with one week duration of central scotoma, right eye

Optic Nerve Drusen: 19-year-old female with blurred vision

Pattern Dystrophy Associated with Myotonic Dystrophy: 56-year-old female presented with a one-year history of increasingly distorted vision OS described as "crinkled"

Polypoidal Choroidal Vasculopathy (PCV): 57-year-old Caucasian male referred for retinal thickening and subretinal fluid in right eye greater than left eye. The patient noted a stable gray spot and visual distortion OD for the previous several weeks. He had stable chronic floaters but no flashes of light, eye pain, or other ocular symptoms.

Purtscher's Retinopathy: 22-year-old male with vision loss after trauma

Presumed Ocular Histoplasmosis (POHS): 30-year-old male with blurred central vision

Recurrent Neuroretinitis: 29-year-old white female with progressively worsened vision, right eye, diminished central vision, and pain with eye movements.

Retinal Artery Macroaneurysm (RAMA): Sudden painless decreased vision in the right eye.

Retinochoroidal coloboma: 54-year-old female with blurred vision

Serpiginous Choroiditis: 60-year-old male with 15 year history of serpiginous choroiditis reports a 2 day history of a new scotoma noticed on Amsler Grid testing of his right eye.

Unilateral Retinitis Pigmentosa: Visual field changes in a 31-year-old female

Valsalva Retinopathy: Vision loss after asthma attack: 32-year-old female patient presented with a "black spot" in the vision of her left eye.

Vitamin A Deficiency and Nyctalopia: 55-year-old male with gradual onset of night blindness


Systemic Disorders

Accelerated Hypertension : 67-year-old female with hypertension and diabetes mellitus with painless vision loss

Congenital Lymphocytic Choriomeningitis Virus (LCMV) infection: 1-week-old male with hydrocephalus and bilateral chorioretinitis

Herpes Zoster Post-herpetic Neuralgia: 68-year-old male with decreased vision

Invasive Fungal Orbitorhinocerebral Mucormycosis

Juvenile Idiopathic Arthritis with Associated Bilateral Anterior Uveitis in a Four-year-old Girl. Routine preschool screening found central posterior synechiae in both eyes. Patient was found to have macular edema and was referred to rheumatology for systemic evaluation with suspicion of inflammatory etiology.

Kayser-Fleischer Ring: A Systems Based Review of the Ophthalmologist's Role in the Diagnosis of Wilson's Disease

Kyphotic Patient Presents for Cataract Surgery: A Systems Based Case. Patient unable to assume typical supine position used for cataract surgery

Metastatic Choroidal Lesion: 61-year-old male presents with pain and blurry vision, right eye

Myasthenia Gravis: 32-year-old female with progressive LUL ptosis for several years

Herpes Zoster Post-herpetic Neuralgia : 68-year-old male with decreased vision

Interferon Retinopathy: 60-year-old male with hepatitis C virus infection presents with new floaters in both eyes. Treated with peginterferon and ribavirin for 6 weeks prior to visit

Ocular Rosacea: 62-year-old female with blurry vision and red, itchy eyes

Ocular Sarcoidosis: A systems-based approach to diagnosis and treatment (also see Sarcoidosis)

Ocular Syphilis Presenting with Posterior Subcapsular Cataract and Optic Disc Edema: 30-year-old female with progressive bilateral vision loss

Orbital inflammation secondary to bisphosphonate therapy: 80-year-old female with right eyelid swelling, pain, decreased vision, diplopia

Sarcoidosis Affecting the Lacrimal Gland: 39-year-old female with left upper eyelid swelling of 4 months duration

TTP-HUS: 29-year-old male with HA, hematuria, and visual obscurations.

Vitamin A Deficiency and Nyctalopia: 55-year-old male with gradual onset of night blindness


Trauma

Canalicular Laceration - Dog Bite: 5-year-old white female presenting with dog bite to left side of face.

Carotid Cavernous Fistula: 46-year-old female patient reporting double vision and visual distortion

Chorioretinitis Sclopetaria: A Systems Based Approach to Eye Injury Prevention. Patient presenting with decreased vision after BB gun injury to right orbit

Intralenticular Foreign Body: 23-year-old male with staple in the eye

Intraocular Foreign Body: A Classic Case of Metal on Metal Eye Injury

Patient Non-Compliance: Physician responsibility. 50-year-old male with penetrating globe injury

Purtscher's Retinopathy: 22-year-old male with vision loss after trauma

Traumatic Cataract: 11-year-old boy with glass injury to the right eye

White-eyed blowout fracture: 17-year-old male with diplopia, pain with eye movement, nausea and vomiting after blunt trauma to the left eye


Tumor / Oncology

Basal Cell Carcinoma, Morpheaform subtype: 78-year-old male with complaints of enlarging left lower lid lesion.

Capillary Hemangioma: 4 month-old female with occlusive vascular lesion of right upper eyelid

Cavernous Hemangioma: 31-year-old caucasian female with a painless, "dark spot" in her left visual field. (also see: Painless Proptosis in a 62-year-old female)

Ciliary Body Leiomyoma: Clinicopathologic Correlation

Dermoid Cyst: 6 month-old male was referred by his pediatrician for evaluation of a right upper eyelid mass.

Enophthalmos Secondary to Metastatic Breast Cancer. 63-year-old female presenting with progressive double vision and a droopy right eyelid.

Iris-Ciliary Body Melanoma: 57-year-old female with iris lesion

Iris Cyst: 38-year-old female with iris lesion and gradual decrease in vision

Iris Melanoma: 47-year-old male referred in 1997 for evaluation of iris lesion OS.

Leiomyosarcoma: 53-year-old male with a bump along his left upper eyelid accompanied by mild discharge, but no pain, duration of one month. Patient's ocular history is significant for bilateral retinoblastoma diagnosed at the age of 2 years, at which time he underwent bilateral enucleation followed by 6 weeks of radiation.

Lymphoma, Orbital: 60-year-old male who was evaluated 1 wk ago for "conjunctivitis" OS by internal medicine.

Meningiomas: a case and review. A 36-year-old female presented with a "bulging" and apparently swollen left eye noticed about one month prior to her visit.

Myeloid Sarcoma: 20-year-old female with a history of intermittent binocular diplopia that worsened with right head tilt and a six week history of progressive fullness of the right upper eyelid. Medical History is notable for Acute Myelogenous Leukemia reported to be in remission.

Nodular Basal Cell Carcinoma: 49-year-old female with left lower lid lesion

Ocular Surface Squamous Neoplasia (OSSN): 22-year-old male with concerns of a new, enlarging conjunctival/corneal mass on his left eye

Orbital Eosinophilic Granuloma. 16-month-old male patient with left-sided periorbital swelling beginning three weeks prior to presentation in the setting of an upper respiratory infection

Orbital Osteoma: 20-year-old female with a 9-month history of left upper lid droopiness.

Painless Proptosis in a 62-year-old female: Patient states that over the last year she has noticed that her right pupil is higher than her left (case presentation: Cavernous hemangioma

Pituitary Adenoma Causing Compression of the Optic Chiasm: 49-year-old white female with painless progressive vision loss.

Retinoblastoma: 4 month old boy with a "blur" in one eye since birth

Rhabdomyosarcoma: Eleven-year-old male with two weeks of blurry vision, headaches, and difficulty moving the right eye for the past two weeks

Sarcoidosis Affecting the Lacrimal Gland: 39-year-old female with left upper eyelid swelling of 4 months duration

Sebaceous Cell Carcinoma: A Masquerade Syndrome


Uveitis

Birdshot Choroiditis: 55-year-old female with persistent vitreous floaters

Churg-Strauss Syndrome with Orbital Inflammation. 56-year-old male with two-month history of progressive proptosis & drooping of the left upper eyelid and binocular diplopia for several weeks

Juvenile Idiopathic Arthritis with Associated Bilateral Anterior Uveitis in a Four-year-old Girl. Routine preschool screening found central posterior synechiae in both eyes. Patient was found to have macular edema and was referred to rheumatology for systemic evaluation with suspicion of inflammatory etiology.

TB Uveitis: 48-year-old A female with complaint of photophobia, tearing, and eye pain in both eyes.


Vascular Disorders

ANCA-associated granulomatous vasculitis (Wegener's granulomatosis): 54-year-old male with binocular vertical diplopia 4 months prior to presentation and progressively worsening. Vision in the right eye was starting to "darken." Prior to presentation, patient was followed by an otolaryngologist for his sinus disease and nosebleeds.

Carotid Cavernous Fistula: 46-year-old female patient presented to the Oculoplastics Clinic reporting double vision and visual distortion.

Cavernous Hemangioma: Painless Proptosis in a 62-year-old female: Patient states that over the last year she has noticed that her right pupil is higher than her left

Retinal Artery Macroaneurysm (RAMA): Sudden painless decreased vision in the right eye.


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Suggested citation format for EyeRounds cases

Author. Title. EyeRounds.org. date posted; Available from: http://www.eyerounds.org/cases/filename.htm.

example: Mullaney S, Vislisel J, Maltry A, Boldt HC. Choroidal Malignant Melanoma: 58-year-old female with pigmented retinal lesion and exudative retinal detachment. EyeRounds.org. July 8, 2014; available from http://EyeRounds.org/cases/190-choroidal-malignant-Melanoma.htm