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Alcohol Amblyopia - Toxic Optic Neuropathy315 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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Pregnant - 25 weeks - new onset PDR and DME both eyes - Treated with PRP and ozurdex315 views29 year old female. Patient is 25 weeks pregnant and having flare up of retinopathy in both eyes. She states it is worse in the left. Patient has trouble with distant vision. At most recent visit, 1 years ago, VA was 20/20 OU. Two years ago anterior uveitis x 1 episode with normal labs (HLAB27, FTA, ACE, Lyme). 2017-2020 – Lucentis for DME left eye only.
PMHx: Type I DM since teenager, hyperlipidemia
BP was normal
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Ocular Lymphoma - Initially presented like auto-immune retinopathy315 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 - Asymptomatic315 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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Nonproliferative Diabetic Retinopathy and Good Vision315 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)315 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)315 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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315 views
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Punctate inner choroidopathy and CNVM315 views23 year old female noticed vision loss for 4 days.
VA 20/200 OD, 20/25 OS.
VA improved one month later to 20/40 with Avastin. She received a second injection and was lost to follow-up
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Papilledema Lateral Sinus Thrombosis315 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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Severe diabetic tractional retinal detachment one year following diagnosis of type II Diabetes Mellitus315 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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Severe diabetic tractional retinal detachment one year following diagnosis of type II Diabetes Mellitus315 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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Severe diabetic tractional retinal detachment one year following diagnosis of type II Diabetes Mellitus315 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)315 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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Choroidal Excavation left eye315 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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Cotton Wool Spots - Severe Anemia - Acute Lymphocytic Leukemia314 views23 year old just diagnosed with anemia and acute lymphocytic leukemia
: If he covers each eye neither eye is lacking. When he looks to the left he gets double vision when he looks to the right his vision is fine. This started about 2 weeks ago. Since it started it has been variable. He is on a bunch of medications for leukemia and he might be having high sugars. He noticed the vision change after his first blood transfusion in the hospital. He is currently very anemic.
VA OD: sc20/20 NscJ1+
VA OS: sc20/20 NscJ1+
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Elevated Episcleral Venous Pressure and Retinal Hemorrhages in both eyes314 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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Occult Choroidal Neovascular Membrane314 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 Cancer314 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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Bilateral Choroidal Tumors - Metastatic Breast Cancer314 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 pertussis314 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, Diabetes314 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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Macular Scars from Presumed Ocular Histoplasmosis Syndrome314 views85 year old man
He sometimes sees double vision. When he sees people walking they are sometimes double for about 6 months.
VA OD: sc20/25 PH20/20 NccJ3
VA OS: sc20/20-2 NccJ2
IOP: TP: OD:12 OS:14
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Macular Scars from Presumed Ocular Histoplasmosis Syndrome314 views85 year old man
He sometimes sees double vision. When he sees people walking they are sometimes double for about 6 months.
VA OD: sc20/25 PH20/20 NccJ3
VA OS: sc20/20-2 NccJ2
IOP: TP: OD:12 OS:14
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Ocular lymphoma - better following intravitreal methotrexate314 viewsVA improved from LP to 20/200 after 4 injections of methotrexate
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Acute Syphilitic Posterior Placoid Chorioretinitis314 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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Dry AMD - Pigment - AREDS risk score of 4314 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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Optic Disc Melanocytoma - Atypical314 views45 year old female with normal vision and optic nerve lesion in the left eye. VA 20/16 OU. Extensive testing was normal including brain and orbit MRI. The lesion has been stable for 5 years.
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Branch Retinal Vein Occlusion and worsened cystoid macular edema following cataract surgery314 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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Disc drusen 8 year old boy - fluorescein shows no leakage314 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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Pseudoexfoliation Material Peeling.313 viewsPatient comes in for regular eye exam. Last exam was 8-years ago. Complains of decrease in VA. VA was 20/30, right eye and 20/40, left eye. Slit lamp photography shows pseudoexfoliation peeling of the lens within 360-degrees. Pseudoexfoliation ring is present centrally. IOP was normal. Will revisit in 3-months for follow up.
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Elevated Episcleral Venous Pressure and Retinal Hemorrhages in both eyes313 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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Punctate Inner Choroidopathy and Choroidal Neovascular Membrane (CNVM)313 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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Severe Proliferative Diabetic Retinopathy and Good Vision313 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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Bilateral Choroidal Tumors - Metastatic Breast Cancer313 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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Torpedo Maculopathy - Small Lesion313 viewsAsymptomatic 77 year old female
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Branch Retinal Vein Occlusion with Venous Macroaneurysm (collateral)313 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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Neuroretinitis left eye - recovered with no therapy - possible B pertussis313 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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Neuroretinitis left eye - recovered with no therapy - possible B pertussis313 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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Neuroretinitis left eye - recovered with no therapy - possible B pertussis313 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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Soft Drusen313 views63 year old female with 20/16 vision both eyes
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Ocular Lymphoma - Initially presented like auto-immune retinopathy313 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 retinopathy313 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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Macular Scars from Presumed Ocular Histoplasmosis Syndrome313 views85 year old man
He sometimes sees double vision. When he sees people walking they are sometimes double for about 6 months.
VA OD: sc20/25 PH20/20 NccJ3
VA OS: sc20/20-2 NccJ2
IOP: TP: OD:12 OS:14
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)313 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)313 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 Laser313 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 detachment with choroidal effusions and RPE tear313 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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Cilioretinal Artery Occlusion - non central313 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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Elevated Episcleral Venous Pressure and Retinal Hemorrhages in both eyes312 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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Coats' Disease - 8-year-old boy - Asymptomatic312 viewsNormal vision - Lesion picked up on examination
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Macular Telangiectasis (MacTel) Both Eye - Stage IV - Pigment Spots312 views63 year old female with Type II DM x 4 years. Vision is 20/40 both eyes.
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Punctate Inner Choroidopathy and Choroidal Neovascular Membrane (CNVM)312 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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Coats' Disease - 8-year-old boy - Asymptomatic312 viewsNormal vision - Lesion picked up on examination
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Occult Choroidal Neovascular Membrane312 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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Papilledema following carotid endarterectomy - Cerebral Reperfusion Injury312 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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Dry AMD geographic atrophy and cystoid macular edema312 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 edema312 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 Cancer312 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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Bilateral Choroidal Tumors - Metastatic Breast Cancer312 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 later312 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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Alcohol Amblyopia - Toxic Optic Neuropathy312 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 Neuropathy312 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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Pregnant - 25 weeks - new onset PDR and DME both eyes - Treated with PRP and ozurdex312 views29 year old female. Patient is 25 weeks pregnant and having flare up of retinopathy in both eyes. She states it is worse in the left. Patient has trouble with distant vision. At most recent visit, 1 years ago, VA was 20/20 OU. Two years ago anterior uveitis x 1 episode with normal labs (HLAB27, FTA, ACE, Lyme). 2017-2020 – Lucentis for DME left eye only.
PMHx: Type I DM since teenager, hyperlipidemia
BP was normal
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Sectoral Retinitis Pigmentosa - Asymptomatic312 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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Central Serous Chorioretinopathy in a child312 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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Non-exudative wet AMD - OCT angiogram312 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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Nonproliferative Diabetic Retinopathy and Good Vision312 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)312 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 Laser312 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 Laser312 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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Acute Syphilitic Posterior Placoid Chorioretinitis312 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 Mellitus312 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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Central retinal artery occlusion and paracentral acute middle maculopathy and emboli312 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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Usher Syndrome - USH2A312 views23 year old female Extended HPI: Vision trouble for about five years. She has some trouble with night vision and was told that her retina looked abnormal. There are no family members that are known to have an inherited retinal disease.
Medical Hx: Sensorial Neural Hearing Loss. Chorionic migranes.
Systemic Meds: None.
VA 20/32 OD, 20/25 OS
Color vision normal
Heterozygous for USH2A pathological mutation and for an USH2A VUS
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Dome Shaped Macula Left Eye312 views73 year old female Diagnosed with POHS in the past and treated with laser in the right eye in 1994 with vision loss. She moved from Tampa to Largo in 2017 and started seeing Dr. Cohen. She had her last injection in the left eye 2015 prior to moving to Largo. She has been treated intermittently in the left eye and has been resistant to Anti-VEGF injections. Her vision is good in the left eye. Images are from April 2023 one month following a Vabysmo injection in the left eye.
PMHx- thyroid disease
Meds: Synthroid
VA 20/200 OD, 20/25 OS
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Pseudoexfoliation Material Peeling.311 viewsPatient comes in for regular eye exam. Last exam was 8-years ago. Complains of decrease in VA. VA was 20/30, right eye and 20/40, left eye. Slit lamp photography shows pseudoexfoliation peeling of the lens within 360-degrees. Pseudoexfoliation ring is present centrally. IOP was normal. Will revisit in 3-months for follow up.
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PDR and Vitreous hemorrhage - Second FA is following PRP laser311 views42 year old man (date 2018): Prior to 2 months ago the vision in the right eye was good. This started with a glob in the vision and then the vision got better. Then the string came back down and is getting bigger and bigger. The last time he had bleeding in the left eye he had surgery in 2009. The left eye is now doing OK other than there is a cataract. The right eye had some laser treatment done in 2009. The vitrectomy and laser were done at William Beaumont.
VA OD: sc3'/200 NscUnable
VA OS: sc20/40 NscJ2-1
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Traction retinal detachment both eyes. Proliferative Diabetic Retinopathy311 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 eyes311 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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Recurrent Toxoplasmosis - Extramacular311 viewsFirst episode 2016, recurrence in 2020 57 year old man with multiple myeloma
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Wet age-related macular degeneration - Classic Juxtafoveal Choroidal Neovascular Membrane311 views80 year old female with mild vision loss. 20/40 OD, 20/25 OS. Avastin controlled disease. VA improved to 20/25 after 2 injections. At 1 year she is getting every 2 months treatment
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Occult Choroidal Neovascular Membrane311 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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Papilledema following carotid endarterectomy - Cerebral Reperfusion Injury311 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 Vision311 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 Vision311 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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Bilateral Choroidal Tumors - Metastatic Breast Cancer311 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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Torpedo Maculopathy - Small Lesion311 viewsAsymptomatic 77 year old female
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Neuroretinitis left eye - recovered with no therapy - possible B pertussis311 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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Neuroretinitis left eye - recovered with no therapy - possible B pertussis311 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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Central Retinal Artery Occlusion - Fluorescein Angiogram Video311 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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Pregnant - 25 weeks - new onset PDR and DME both eyes - Treated with PRP and ozurdex311 views29 year old female. Patient is 25 weeks pregnant and having flare up of retinopathy in both eyes. She states it is worse in the left. Patient has trouble with distant vision. At most recent visit, 1 years ago, VA was 20/20 OU. Two years ago anterior uveitis x 1 episode with normal labs (HLAB27, FTA, ACE, Lyme). 2017-2020 – Lucentis for DME left eye only.
PMHx: Type I DM since teenager, hyperlipidemia
BP was normal
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Ocular Lymphoma - Initially presented like auto-immune retinopathy311 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 - Asymptomatic311 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 angiogram311 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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Retinal Arterial Macroaneurysm treated with Laser311 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 Laser311 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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Central Retinal Vein Occlusion following Cataract Surgery311 views79 year old man with decreased vision The patient had cataract surgery in the right eye 9 days ago and in the left eye 21 days ago and presents with vision loss in the right eye.
Meds: HCTZ, Garlic, Tumeric
VA 20/60 OD, 20/25 OS
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Multiple Evanescent White Dot Syndrome - 13-year-old female311 viewsVision is 20/60 but recovered to 20/20 in about 2 months. This episode was post viral syndrome
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Punctate inner choroidopathy and CNVM311 views23 year old female noticed vision loss for 4 days.
VA 20/200 OD, 20/25 OS.
VA improved one month later to 20/40 with Avastin. She received a second injection and was lost to follow-up
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