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Ocular Lymphoma - Initially presented like auto-immune retinopathy331 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Ocular Lymphoma - Initially presented like auto-immune retinopathy331 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Ocular Lymphoma - Initially presented like auto-immune retinopathy331 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Ocular Lymphoma - Initially presented like auto-immune retinopathy331 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Retinal Arterial Macroaneurysm treated with Laser331 views89 year old female with peripapillary CNVM treated with Lucentis. Vision was 20/25 OS 3 weeks ago. She noticed vision loss OS. Vision had dropped to 20/60. She had a fresh MA and was treated with laser.
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Asymptomatic exudative wet age-related macular degeneration331 views78 year old man with scar in the left eye being treated regularly and returns with new lesions in the right eye which is not symptomatic. Vision is 20/25 right eye and 20/125 left eye. The lesion was treated and responded to anti-VEGF therapy
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Combined hamartoma of the retina and retinal pigment epithelium331 views8 year old boy failed vision screening at school. VA 20/20 OD, 20/40 OS
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Punctate Inner Choroidopathy and Choroidal Neovascular Membrane330 views27 year old female with vision loss for 4 months. VA was 20/200. She had a CNVM which was extrafoveal with no subretinal fluid. Her vision improved over 6 months to 20/50 with Ranibizumab injections (she might have improved without treatment)
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Retinitis Pigmentosa - X-linked Recessive330 views60 year old man The vision in the right eye is blurry recently. He has trouble with night vision for about 3 years. His brother has eye disease in Michigan.
VA OD: Dcc20/32-1 PHNI NccJ1-1
VA OS: Dcc20/20 NccJ1+-1
IOP: TP: OD:36 OS:18
He has pseudoexfoliative glaucoma in the right eye.
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Punctate Inner Choroidopathy and Choroidal Neovascular Membrane (CNVM)330 views24 year old female She was doing fine until 4 days ago when the right eye fogged up on her. The left eye is seeing fine. In the end of January (3 months ago) she went to the doctor and got checked for everything and it was negative. She had a bad cough at the time and no fevers that she knows of. Â
VA OD: sc20/200+1, VA OS: sc20/25 - Uveitis work up was negative. VA improved to 20/40 with a single avastin treatment and then the patient was lost to follow-up
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Occult Choroidal Neovascular Membrane330 views66 year old man with vision loss in the left eye for 2 months
VA 20/20 OD, 20/63 OS
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Severe Proliferative Diabetic Retinopathy and Good Vision330 views49 year old man with vision loss in the right eye for 2 weeks. VA 20/40 OD, 20/63 OS. DM x 15 years and HTN.
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Dry AMD geographic atrophy and cystoid macular edema330 views79 year old vision is in for a checkup with no visual complaints in the left eye. This is her better eye. VA 20/200 OD, 20/50 OS. 3 years ago she had a CRVO in the left eye. She is also diabetic for 20 years, has carotid insufficiency and anemia. Left eye shows CME. This was not treated and the vision improved to 20/40 over the next year although mild edema persisted.
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Pan Retinal Laser from original DRS study in the 1970s - 50 years later330 views67 year old female with diabetes since age 8. She had heavy PRP laser to both eyes in the 1970s by Lloyd M. Aiello, M.D, the father of PRP laser. Her vision is poor now, 1/200 OD and 20/200 OS.
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Retinoschisis confirmed with optical coherence tomography (OCT)330 views82 year old man with normal vision and peripheral retinoschisis confirmed with OCT scan.
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Alcohol Amblyopia - Toxic Optic Neuropathy330 views59 year old man HPI: CC: Blurred Vision OU. Duration of Problem: about 7 months. Location: central vision. Context Onset/Aggravation: Started after using Accutane for 1 month. Associated Symptoms: no flashes or floaters.
HX TECH: EA
VA OD: sc20/100 PH20/80+1 Nsc20/400 PAM20/50+2
VA OS: sc20/100 PH20/80-2 NscJ16 PAM20/50+1
IOP 24 OD, 26 OS
B-12 and Folate were normal - Presumed ETOH amblyopia - improved to 20/63,20/80 after one year of B-12 supplements
IOP: TP: OD:24 OS:26 Time:02:08 PM
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Ocular Lymphoma - Initially presented like auto-immune retinopathy330 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Nonproliferative Diabetic Retinopathy and Good Vision330 views59 year old man Vision is good. Just referred following annual eye examination
PMHx: Type II DM, HTN, Cholesterol,
MEDS: Lantus, Metformin, lisinopril, atorvastatin, gabapentin
VA 20/20 OU
2+ NS OU
Observation
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)330 views67 year old man
The patient started noticing dimming of the vision in November of 2020. He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021. The vision did not improve with the cataract surgery. On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss. The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss. He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.  A retinal evaluation showed subretinal fluid and vision loss.  The peripheral vision and central vision were pretty good. The vision did seem to get better off the nivolumab. Then when the patient returned to Florida in September and now the vision is getting worse. The patient did not have any treatments in either eye. The patient is now off the oncology treatment. He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month. It was stopped because of a skin rash and reactions. Â
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
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Dry AMD - Pigment - AREDS risk score of 4330 views65 year old woman with 20/32 vision. A little blurred. Pigment and large drusen in each eye. AREDS risk score of four.
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Disc drusen 8 year old boy - fluorescein shows no leakage330 views8 year old boy with headache and nausea. He had a negative MRI. Images show hyper FAF from drusen and no leakage on FA. No spinal tap was done. VA was 20/40 both eyes.
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329 views
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Bilateral Acute Central Serous Chorioretinopathy - Evidence of old disease OS329 views64 year old man noticed in the right eye that is a black spot 4 days ago. Also vertical lines in his kitchen were a little wavy. He is not on any steroid medications. He has vertigo.
VA OD: Dcc20/25-2 NccJ1+-3
VA OS: Dcc20/32-1 PHNI NccJ5-1
IOP: TP: OD:12 OS:15
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Elevated Episcleral Venous Pressure and Retinal Hemorrhages in both eyes329 views78 year old female with chronic red eye. The eyes are red all the time now. She is on Xeralto because of a history of blood clots in her lungs (2005 about). She has not had problems since. She has had floaters for many years. Ever since her eyes got funny she sees more floaters in both eyes. She had a brain scan over 6 months ago which was OK. She also had double vision when this first started which went away. She could not drive for a few months.
VA OD: Dcc20/32-1
VA OS: Dcc20/125
IOP: TP: OD:17 OS:16
Neuroimaging did not show a CC fistula
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Elevated Episcleral Venous Pressure and Retinal Hemorrhages in both eyes329 views78 year old female with chronic red eye. The eyes are red all the time now. She is on Xeralto because of a history of blood clots in her lungs (2005 about). She has not had problems since. She has had floaters for many years. Ever since her eyes got funny she sees more floaters in both eyes. She had a brain scan over 6 months ago which was OK. She also had double vision when this first started which went away. She could not drive for a few months.
VA OD: Dcc20/32-1
VA OS: Dcc20/125
IOP: TP: OD:17 OS:16
Neuroimaging did not show a CC fistula
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Elevated Episcleral Venous Pressure and Retinal Hemorrhages in both eyes329 views78 year old female with chronic red eye. The eyes are red all the time now. She is on Xeralto because of a history of blood clots in her lungs (2005 about). She has not had problems since. She has had floaters for many years. Ever since her eyes got funny she sees more floaters in both eyes. She had a brain scan over 6 months ago which was OK. She also had double vision when this first started which went away. She could not drive for a few months.
VA OD: Dcc20/32-1
VA OS: Dcc20/125
IOP: TP: OD:17 OS:16
Neuroimaging did not show a CC fistula
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Intermediate Dry Age-Related Macular Degeneration - Soft Drusen329 views70-year-old Left eye worse than the right. Both eyes see distortion in the amsler grid for a few months
HTN, High Lipids, Osteoporosis
Meds: Lutein once daily, Calcium, Fish oil, Red Yeast Rice, CoQ10, Magnesium, MVI, Xanax
VA 20/16 OU
2+NS cataract
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Occult Choroidal Neovascular Membrane329 views66 year old man with vision loss in the left eye for 2 months
VA 20/20 OD, 20/63 OS
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Amelanotic Choroidal Nevus329 views60 year old man. Nevus is stable over 6 years. Images are Photo, FAF, OCT, FA, ICG, and B-Scan
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Ocular Lymphoma - Initially presented like auto-immune retinopathy329 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Central Serous Chorioretinopathy in a child329 views12-year-old African American Female A few weeks ago she felt like something was covering the right eye and she couldn't see well. She was told that she had a swollen optic nerve. She had a recent diagnosis of sinus infection. She also recently had onset menarche on August 7th. Eye problem started about a week before menarche. She's been getting some headaches, partly because of sinus infection. They started about a month ago and now are getting better. She is on zytrhomax for the sinus problem. Patient is hypothyroid and is on thyroid supplementation and that has been stable. She has no eye pain.
MEDS: Synthroid, Flonase
PMHx - Thyroid Disease
VA OD: Dcc20/400 PH20/125 NccJ10
VA OS: Dcc20/20 NccJ1+
IOP: TP: OD:14 OS:21
Macular detachments resolved in 1 month with no treatment and vision returned to 20/20 in one month and 20/16 in 2 months
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)329 views67 year old man
The patient started noticing dimming of the vision in November of 2020. He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021. The vision did not improve with the cataract surgery. On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss. The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss. He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.  A retinal evaluation showed subretinal fluid and vision loss.  The peripheral vision and central vision were pretty good. The vision did seem to get better off the nivolumab. Then when the patient returned to Florida in September and now the vision is getting worse. The patient did not have any treatments in either eye. The patient is now off the oncology treatment. He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month. It was stopped because of a skin rash and reactions. Â
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
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Retinoschisis - Confirmed with optical coherence tomography (OCT)329 views70 year old female with no visual complaints. Retinoschisis is confirmed with OCT. Eyes were stable when checked 8 months later.
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Hydroxychloroquine (plaquenil) Toxicity - Advanced329 views78 year old female No visual complaints referred for evaluation
Medical Hx: Rheumatoid Arthritis. Atrial Fibrillation. Benign Intracranial Hypertension. Sjogrens Syndrome. Osteoporosis.
Systemic Meds: PLAQUENIL (Stopped 2 months ago). Leflunomide. Lidocaine. Gabapentin. Vitamin D. Multaq. DILTIAZEM.
VA OD: Dcc20/32-2 NccJ2
VA OS: Dcc20/25+1 NccJ1-1
IOP: TP: OD:14 OS:15
Color Ishihara OD 9/11 correct, OS 9.5/11 correct
Weight 100 lbs, Height 4’ 2†tall.
1993 Plaquenil Initially 400 mg /day (9 mg/kg/day x 18 years) then 2011 200 mg daily - (4.6 mg/kg/day x 10 years) STOPPED 3/2021
The patient weighs 100 lbs and is 4’ 2†tall - Images are from 3/2021 and 5/2022
There was no progression 1 year after stopping plaquenil in this patient.
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Cilioretinal artery occlusion following cataract surgery329 views60 year old man noticed new scotoma in the right eye immediately after cataract surgery. Vision is 20/60
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Familial Exudative Vitreoretinopathy - FEVR - Stage 1-b both eyes328 viewsShe was born at term.   No family history of eye disease.
VA OD: Dcc20/25, VA OS: Dcc20/200+1 Ncc20/400
Anterior segment normal – clear lenses
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Retinal Tear before and after laser treatment328 views67 year old female Notices poor vision in the left eye following cataract surgery about 1 year ago. Fluctuating floaters. NO acute symptoms
VA 20/32 OD, 20/25 OS
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Central Retinal Artery Occlusion - Fluorescein Angiogram Video328 views63 year old man Sudden severe vision loss in the left eye for 3 days. Six months following macula off retinal detachment repair, Pneumatic then PPV, then PPV buckle. VA was 20/63 on 4/2021 (3 months post RD repair).
PMHx – HTN. Meds: HCT, Meloxicam
VA OD 20/25, OS HM
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Ocular Lymphoma - Initially presented like auto-immune retinopathy328 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Sectoral Retinitis Pigmentosa - Asymptomatic328 views56-year-old female - The patient was in for an annual checkup because of her diabetes. No visual complaints (no night vision trouble)
PMHx DM sine 2015, Asthma, Thyroid Disease, HTN
MEDS: Metformin, Levothyroxine, Lisinopril,, Inhaler
ROS Negative
VA OD: sc20/32-1 VA OS: sc20/32-1
IOP: TP: OD:18 OS:17
293 Invitae genetic panel - negative
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Acute Syphilitic Posterior Placoid Chorioretinitis328 views40 year old man About 10 days ago the patient woke up with a dark circle in the middle of the left eye that blocks his vision. He thought it might be from fatigue. The month of March was very stressful. After a few days the spot in the left eye got darker and he could not drive at night. During the last week while not going to work and sleeping more his vision is better but not normal. He has never had vision loss in the past. Â
PMHx: Benign, Meds: Multivitamin
VA OD: sc20/16 NscJ1+VA OS: sc20/32+2 NscJ4
IOP: TP: OD:12 OS:12
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Severe diabetic tractional retinal detachment one year following diagnosis of type II Diabetes Mellitus328 views44 year old man The vision in the left eye started to decline about 4 days ago. Prior to that the left eye was the better eye. He was diagnosed with diabetes a year ago.Â
VA OD: Dcc20/50-1 OS: Dcc20/125-2, TP: OD:12 OS:13
Following two surgeries in each eye, silicone oil remaining forever, monthly anti-VEGF for severe DME - BCVA OU 20/200 at 3 years
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Retinoschisis - Confirmed with optical coherence tomography (OCT)328 views70 year old female with no visual complaints. Retinoschisis is confirmed with OCT. Eyes were stable when checked 8 months later.
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Cataract Morgagnian328 views
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Traction retinal detachment both eyes. Proliferative Diabetic Retinopathy327 views40 year old man came in with vision loss OD and rubeosis in both eyes. Was treated with Avastin monthly and laser OD then lost to follow-up for 6 months. Came back with table top traction in the left macula (second set of images). Vision had dropped OS from 20/20 to HM. He had PPV ERM peel OS and vision improved to 5/200.
OD stabilized to 20/20 with PRP laser. Now on 6 month checks.
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Traction retinal detachment both eyes. Proliferative Diabetic Retinopathy327 views40 year old man came in with vision loss OD and rubeosis in both eyes. Was treated with Avastin monthly and laser OD then lost to follow-up for 6 months. Came back with table top traction in the left macula (second set of images). Vision had dropped OS from 20/20 to HM. He had PPV ERM peel OS and vision improved to 5/200.
OD stabilized to 20/20 with PRP laser. Now on 6 month checks.
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Elevated Episcleral Venous Pressure and Retinal Hemorrhages in both eyes327 views78 year old female with chronic red eye. The eyes are red all the time now. She is on Xeralto because of a history of blood clots in her lungs (2005 about). She has not had problems since. She has had floaters for many years. Ever since her eyes got funny she sees more floaters in both eyes. She had a brain scan over 6 months ago which was OK. She also had double vision when this first started which went away. She could not drive for a few months.
VA OD: Dcc20/32-1
VA OS: Dcc20/125
IOP: TP: OD:17 OS:16
Neuroimaging did not show a CC fistula
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Geographic Atrophy with recent vision loss left eye327 views80 year old Recent vision loss in the left eye for about 6 weeks.
Hyperlipidemia, HTN, Angina, history of TIA’s
ASA daily
VA 20/25 OD, 20/63 OS (was 20/40 5/3/21 at patients first visit)
AC pseudophakic
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Occult Choroidal Neovascular Membrane327 views66 year old man with vision loss in the left eye for 2 months
VA 20/20 OD, 20/63 OS
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Bilateral Choroidal Tumors - Metastatic Breast Cancer327 views51 year old female. First 3 sets of images show lesions growing despite systemic chemotherapy. She eventually had external beam radiation x 15 sessions and the tumors shrunk in the last two sets of images
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Pan Retinal Laser from original DRS study in the 1970s - 50 years later327 views67 year old female with diabetes since age 8. She had heavy PRP laser to both eyes in the 1970s by Lloyd M. Aiello, M.D, the father of PRP laser. Her vision is poor now, 1/200 OD and 20/200 OS.
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Neuroretinitis left eye - recovered with no therapy - possible B pertussis327 views57 year old female The patient has had blurred vision in the left eye and there is a haze across the top of the vision. This started about 2 weeks ago. The right eye is OK. She has sleep apnea and uses the machine. The left eye is becoming more and more painful for the last two weeks. The pain is like a stabbing in the eye that comes and goes. She also has some pain on eye movement. The patient has been going to Moffit for possible reconstructive surgery for the lymphedema.
PMHx – Sleep apnea, Breast Cancer, Adult lymphedema,
Meds: GabapentinÂ
VA OD: Dcc20/25-1
VA OS: Dcc20/100-2
AC quiet OU. 1 + NS cataract OU
IOP: TP: OD:15 OS:17
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Alcohol Amblyopia - Toxic Optic Neuropathy327 views59 year old man HPI: CC: Blurred Vision OU. Duration of Problem: about 7 months. Location: central vision. Context Onset/Aggravation: Started after using Accutane for 1 month. Associated Symptoms: no flashes or floaters.
HX TECH: EA
VA OD: sc20/100 PH20/80+1 Nsc20/400 PAM20/50+2
VA OS: sc20/100 PH20/80-2 NscJ16 PAM20/50+1
IOP 24 OD, 26 OS
B-12 and Folate were normal - Presumed ETOH amblyopia - improved to 20/63,20/80 after one year of B-12 supplements
IOP: TP: OD:24 OS:26 Time:02:08 PM
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Alcohol Amblyopia - Toxic Optic Neuropathy327 views59 year old man HPI: CC: Blurred Vision OU. Duration of Problem: about 7 months. Location: central vision. Context Onset/Aggravation: Started after using Accutane for 1 month. Associated Symptoms: no flashes or floaters.
HX TECH: EA
VA OD: sc20/100 PH20/80+1 Nsc20/400 PAM20/50+2
VA OS: sc20/100 PH20/80-2 NscJ16 PAM20/50+1
IOP 24 OD, 26 OS
B-12 and Folate were normal - Presumed ETOH amblyopia - improved to 20/63,20/80 after one year of B-12 supplements
IOP: TP: OD:24 OS:26 Time:02:08 PM
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)327 views67 year old man
The patient started noticing dimming of the vision in November of 2020. He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021. The vision did not improve with the cataract surgery. On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss. The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss. He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.  A retinal evaluation showed subretinal fluid and vision loss.  The peripheral vision and central vision were pretty good. The vision did seem to get better off the nivolumab. Then when the patient returned to Florida in September and now the vision is getting worse. The patient did not have any treatments in either eye. The patient is now off the oncology treatment. He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month. It was stopped because of a skin rash and reactions. Â
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)327 views67 year old man
The patient started noticing dimming of the vision in November of 2020. He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021. The vision did not improve with the cataract surgery. On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss. The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss. He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.  A retinal evaluation showed subretinal fluid and vision loss.  The peripheral vision and central vision were pretty good. The vision did seem to get better off the nivolumab. Then when the patient returned to Florida in September and now the vision is getting worse. The patient did not have any treatments in either eye. The patient is now off the oncology treatment. He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month. It was stopped because of a skin rash and reactions. Â
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
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Retinal Arterial Macroaneurysm treated with Laser327 views89 year old female with peripapillary CNVM treated with Lucentis. Vision was 20/25 OS 3 weeks ago. She noticed vision loss OS. Vision had dropped to 20/60. She had a fresh MA and was treated with laser.
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Papilledema Lateral Sinus Thrombosis327 views35 year old female Noticed blurred vision when waking up in the morning. Also, vision blacks out for a few seconds when she gets up quickly. About 3 months ago she had a history of intermittent vomiting.
VA 20/20 OD, 20/25 OS
MRI normal, MRA showed lateral sinus thrombosis. Lupus anticoagulant was positive
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Central retinal artery occlusion and paracentral acute middle maculopathy and emboli327 views86 year old female with sudden vision loss a week ago and imaging shows PAMM lesions and emboli. Her vision is 20/200 in the left eye
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Choroidal Metastatic Breast Cancer with Exudative Detachment327 views58 year old female presented with 20/200 vision. Had 10 sessions of radiation and tumor shrank. The exudative detachment took almost a year to resolve. The vision improved to 20/40.
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326 views
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326 views
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Punctate Inner Choroidopathy and Choroidal Neovascular Membrane (CNVM)326 views24 year old female She was doing fine until 4 days ago when the right eye fogged up on her. The left eye is seeing fine. In the end of January (3 months ago) she went to the doctor and got checked for everything and it was negative. She had a bad cough at the time and no fevers that she knows of. Â
VA OD: sc20/200+1, VA OS: sc20/25 - Uveitis work up was negative. VA improved to 20/40 with a single avastin treatment and then the patient was lost to follow-up
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Papilledema following carotid endarterectomy - Cerebral Reperfusion Injury326 views77 year old man His vision has been a little fuzzy for the last few weeks. He was examined by another eye doctor who was concerned about the optic nerves. The patient has also had double vision for 6 weeks which is improving
PMHx – HTN,
Surgery – Carotic Endarterectomy 6 weeks ago (both sides)
VA 20/25 OD, 20/20 OS
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Papilledema following carotid endarterectomy - Cerebral Reperfusion Injury326 views77 year old man His vision has been a little fuzzy for the last few weeks. He was examined by another eye doctor who was concerned about the optic nerves. The patient has also had double vision for 6 weeks which is improving
PMHx – HTN,
Surgery – Carotic Endarterectomy 6 weeks ago (both sides)
VA 20/25 OD, 20/20 OS
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Severe Proliferative Diabetic Retinopathy and Good Vision326 views49 year old man with vision loss in the right eye for 2 weeks. VA 20/40 OD, 20/63 OS. DM x 15 years and HTN.
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Severe Proliferative Diabetic Retinopathy and Good Vision326 views49 year old man with vision loss in the right eye for 2 weeks. VA 20/40 OD, 20/63 OS. DM x 15 years and HTN.
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Dry AMD geographic atrophy and cystoid macular edema326 views79 year old vision is in for a checkup with no visual complaints in the left eye. This is her better eye. VA 20/200 OD, 20/50 OS. 3 years ago she had a CRVO in the left eye. She is also diabetic for 20 years, has carotid insufficiency and anemia. Left eye shows CME. This was not treated and the vision improved to 20/40 over the next year although mild edema persisted.
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Dry AMD geographic atrophy and cystoid macular edema326 views79 year old vision is in for a checkup with no visual complaints in the left eye. This is her better eye. VA 20/200 OD, 20/50 OS. 3 years ago she had a CRVO in the left eye. She is also diabetic for 20 years, has carotid insufficiency and anemia. Left eye shows CME. This was not treated and the vision improved to 20/40 over the next year although mild edema persisted.
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Bilateral Choroidal Tumors - Metastatic Breast Cancer326 views51 year old female. First 3 sets of images show lesions growing despite systemic chemotherapy. She eventually had external beam radiation x 15 sessions and the tumors shrunk in the last two sets of images
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Neuroretinitis left eye - recovered with no therapy - possible B pertussis326 views57 year old female The patient has had blurred vision in the left eye and there is a haze across the top of the vision. This started about 2 weeks ago. The right eye is OK. She has sleep apnea and uses the machine. The left eye is becoming more and more painful for the last two weeks. The pain is like a stabbing in the eye that comes and goes. She also has some pain on eye movement. The patient has been going to Moffit for possible reconstructive surgery for the lymphedema.
PMHx – Sleep apnea, Breast Cancer, Adult lymphedema,
Meds: GabapentinÂ
VA OD: Dcc20/25-1
VA OS: Dcc20/100-2
AC quiet OU. 1 + NS cataract OU
IOP: TP: OD:15 OS:17
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Age-related macular degeneration - Geographic Atrophy - Intermittent CME left eye from CRVO, Anemia, Diabetes326 views79 year old female - 3 years post CRVO in the left eye (20/32 VA) with intermittent CME. Left eye is the better eye. Vision is stable since 2 years ago
PMHx: Type II DM x 20 years, Chronic Anemia, Hyperlipidemia
VA 20/200 OD, 20/50 OS (usually 20/40)
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Age-related macular degeneration - Geographic Atrophy - Intermittent CME left eye from CRVO, Anemia, Diabetes326 views79 year old female - 3 years post CRVO in the left eye (20/32 VA) with intermittent CME. Left eye is the better eye. Vision is stable since 2 years ago
PMHx: Type II DM x 20 years, Chronic Anemia, Hyperlipidemia
VA 20/200 OD, 20/50 OS (usually 20/40)
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Ocular Lymphoma - Initially presented like auto-immune retinopathy326 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Non-exudative wet AMD - OCT angiogram326 views85 year old female with minimal visual complaints.
VA OD: sc20/80+1 PHNI NccJ3
VA OS: sc20/40-2 PH20/32+1 NccJ3
IOP: TP: OD:14 OS:16
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Asymptomatic exudative wet age-related macular degeneration326 views78 year old man with scar in the left eye being treated regularly and returns with new lesions in the right eye which is not symptomatic. Vision is 20/25 right eye and 20/125 left eye. The lesion was treated and responded to anti-VEGF therapy
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Retinal detachment with choroidal effusions and RPE tear326 views83 year old man with chronic glaucoma presented with 10 days of vision loss in the left eye and a retinal detachment. He also has choroidal effusions and and RPE tear. He had a history of bladder cancer in remission. I did a biopsy of the choroidal lesions at the time of surgery which showed no cancer. Initial vision was HM and final vision was 20/80. The choroidal effusions may have occurred because of his age and prior history of glaucoma.
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Severe diabetic tractional retinal detachment one year following diagnosis of type II Diabetes Mellitus326 views44 year old man The vision in the left eye started to decline about 4 days ago. Prior to that the left eye was the better eye. He was diagnosed with diabetes a year ago.Â
VA OD: Dcc20/50-1 OS: Dcc20/125-2, TP: OD:12 OS:13
Following two surgeries in each eye, silicone oil remaining forever, monthly anti-VEGF for severe DME - BCVA OU 20/200 at 3 years
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Branch Retinal Vein Occlusion and worsened cystoid macular edema following cataract surgery326 views51 year old female The patient noticed gradual vision loss in both eyes starting possibly after her last cataract surgery in May of 2022 (3 months ago). She had ECCE 3/2022 OD and 5/2022 OS. She does not have diabetes. She had glaucoma shunts placed about 2017. She has been on latanoprost and timolol. She is now getting ready to start Combigan and Bromfenac. She is also staring xidra for dry eye. She stopped the latanorpost on 8/15/22. She has had macular edema before for which she had intraocular injections which worked. She has had no injections lately. When she was getting treated for macular edema in the past she had an IOP of 60.
Medical Hx: Hypertension, Systemic. Glaucoma. Arthritis. Vertigo. Stroke.
Systemic Meds: Trimfya. NAPROXEN. LISINOPRIL.
VA OD: sc20/63-1
VA OS: sc20/50
IOP: TP: OD:12 OS:12
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Hydroxychloroquine (plaquenil) Toxicity - Advanced326 views78 year old female No visual complaints referred for evaluation
Medical Hx: Rheumatoid Arthritis. Atrial Fibrillation. Benign Intracranial Hypertension. Sjogrens Syndrome. Osteoporosis.
Systemic Meds: PLAQUENIL (Stopped 2 months ago). Leflunomide. Lidocaine. Gabapentin. Vitamin D. Multaq. DILTIAZEM.
VA OD: Dcc20/32-2 NccJ2
VA OS: Dcc20/25+1 NccJ1-1
IOP: TP: OD:14 OS:15
Color Ishihara OD 9/11 correct, OS 9.5/11 correct
Weight 100 lbs, Height 4’ 2†tall.
1993 Plaquenil Initially 400 mg /day (9 mg/kg/day x 18 years) then 2011 200 mg daily - (4.6 mg/kg/day x 10 years) STOPPED 3/2021
The patient weighs 100 lbs and is 4’ 2†tall - Images are from 3/2021 and 5/2022
There was no progression 1 year after stopping plaquenil in this patient.
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Choroidal Excavation left eye326 views63 year old vision with right eye vision loss at age 27 possibly from histoplasmosis. Left eye has a choroidal excavation
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Pucker325 views64female pucker
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Traction retinal detachment both eyes. Proliferative Diabetic Retinopathy325 views40 year old man came in with vision loss OD and rubeosis in both eyes. Was treated with Avastin monthly and laser OD then lost to follow-up for 6 months. Came back with table top traction in the left macula (second set of images). Vision had dropped OS from 20/20 to HM. He had PPV ERM peel OS and vision improved to 5/200.
OD stabilized to 20/20 with PRP laser. Now on 6 month checks.
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Choroidal Folds - Idiopathic (hyperope)325 views75 year old female with no visual complaints
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Coats' Disease - 8-year-old boy - Asymptomatic325 viewsNormal vision - Lesion picked up on examination
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Amelanotic Choroidal Nevus325 views60 year old man. Nevus is stable over 6 years. Images are Photo, FAF, OCT, FA, ICG, and B-Scan
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Severe Proliferative Diabetic Retinopathy and Good Vision325 views49 year old man with vision loss in the right eye for 2 weeks. VA 20/40 OD, 20/63 OS. DM x 15 years and HTN.
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Severe Proliferative Diabetic Retinopathy and Good Vision325 views49 year old man with vision loss in the right eye for 2 weeks. VA 20/40 OD, 20/63 OS. DM x 15 years and HTN.
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Dry AMD geographic atrophy and cystoid macular edema325 views79 year old vision is in for a checkup with no visual complaints in the left eye. This is her better eye. VA 20/200 OD, 20/50 OS. 3 years ago she had a CRVO in the left eye. She is also diabetic for 20 years, has carotid insufficiency and anemia. Left eye shows CME. This was not treated and the vision improved to 20/40 over the next year although mild edema persisted.
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Bilateral Choroidal Tumors - Metastatic Breast Cancer325 views51 year old female. First 3 sets of images show lesions growing despite systemic chemotherapy. She eventually had external beam radiation x 15 sessions and the tumors shrunk in the last two sets of images
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Branch Retinal Vein Occlusion with Venous Macroaneurysm (collateral)325 views66 year old female Did not notice vision loss in the right eye. The right eye has been a little worse than the left but now is much worse. Picked up during annual eye examination. VA had been 20/20 in 5 years ago.
History of brain and spinal cord radiation 1986 for T-cell lymphoma. Now with breast cancer, ablation for tachycardia, HTN
VA OD 6/200, OS 20/32
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Ocular Lymphoma - Initially presented like auto-immune retinopathy325 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Sectoral Retinitis Pigmentosa - Asymptomatic325 views56-year-old female - The patient was in for an annual checkup because of her diabetes. No visual complaints (no night vision trouble)
PMHx DM sine 2015, Asthma, Thyroid Disease, HTN
MEDS: Metformin, Levothyroxine, Lisinopril,, Inhaler
ROS Negative
VA OD: sc20/32-1 VA OS: sc20/32-1
IOP: TP: OD:18 OS:17
293 Invitae genetic panel - negative
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Non-exudative wet AMD - OCT angiogram325 views85 year old female with minimal visual complaints.
VA OD: sc20/80+1 PHNI NccJ3
VA OS: sc20/40-2 PH20/32+1 NccJ3
IOP: TP: OD:14 OS:16
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)325 views67 year old man
The patient started noticing dimming of the vision in November of 2020. He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021. The vision did not improve with the cataract surgery. On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss. The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss. He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.  A retinal evaluation showed subretinal fluid and vision loss.  The peripheral vision and central vision were pretty good. The vision did seem to get better off the nivolumab. Then when the patient returned to Florida in September and now the vision is getting worse. The patient did not have any treatments in either eye. The patient is now off the oncology treatment. He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month. It was stopped because of a skin rash and reactions. Â
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)325 views67 year old man
Vision is better after 14 plasma exchanges, OD 20/160, OS 20/32
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Retinal Arterial Macroaneurysm treated with Laser325 views89 year old female with peripapillary CNVM treated with Lucentis. Vision was 20/25 OS 3 weeks ago. She noticed vision loss OS. Vision had dropped to 20/60. She had a fresh MA and was treated with laser.
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Retinal Arterial Macroaneurysm treated with Laser325 views89 year old female with peripapillary CNVM treated with Lucentis. Vision was 20/25 OS 3 weeks ago. She noticed vision loss OS. Vision had dropped to 20/60. She had a fresh MA and was treated with laser.
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Cilioretinal Artery Occlusion - non central325 views81 year old female She noticed sudden vision loss in the right eye just before Christmas while watching television. This was about one week ago. She noticed when she closed her left eye and looked out of her right eye there was a darkness in the vision. The left eye is OK. She has no history of stroke and no neurological problems. She had a few headaches recently but they went away. Â
PMHx: HTN, Breast Cancer
Meds: HCTZ, Atorvastatin, Atenolol, Anastrozole
VA 20/80 OD, 20/32 OS
VA improved to 20/40 in one month in the involved eye
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