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Choroidal Neovascular Membrane (CNVM) secondary to laser scar from TTT for choroidal melanoma 20 years earlier319 views71-year old female - Vision loss in the right eye for 1 week. She had transpupillary thermotherapy 20 years ago in the right eye for choroidal melanoma.
VA 4/200 OD, 20/20 OS
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Choroidal Neovascular Membrane (CNVM) secondary to laser scar from TTT for choroidal melanoma 20 years earlier319 views71-year old female - Vision loss in the right eye for 1 week. She had transpupillary thermotherapy 20 years ago in the right eye for choroidal melanoma.
VA 4/200 OD, 20/20 OS
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Ocular Lymphoma - Initially presented like auto-immune retinopathy319 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 - Asymptomatic319 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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Sectoral Retinitis Pigmentosa - Asymptomatic319 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 child319 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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Central Serous Chorioretinopathy in a child319 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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Macular Scars from Presumed Ocular Histoplasmosis Syndrome319 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)319 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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Asymptomatic exudative wet age-related macular degeneration319 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 tear319 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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Combined hamartoma of the retina and retinal pigment epithelium319 views8 year old boy failed vision screening at school. VA 20/20 OD, 20/40 OS
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Combined hamartoma of the retina and retinal pigment epithelium319 views8 year old boy failed vision screening at school. VA 20/20 OD, 20/40 OS
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Sticklers syndrome with Pierre Robin Sequence319 views9 year old child with father who had retinal detachment at age 10. History of cleft palate repair and teeth removal. VA 20/40 OU. Images show perivascular RPE and retinal changes especially nasally
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Presumed ocular histoplasmosis syndrome and CNVM - responded to Avastin319 views62 year old female with 3 days of vision loss in the right eye. Vision is 20/40 OD, 5/200 OS. Left eye had been treated years ago elsewhere. She grew up in the Mississippi River valley.
She was treated with Avastin and the vision improved to 20/20 in 4 months. She continues, 3 years later, on every 2 months Avastin.
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Acute Syphilitic Posterior Placoid Chorioretinitis319 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 4319 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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Central retinal artery occlusion and paracentral acute middle maculopathy and emboli319 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 Excavation left eye319 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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BRVO with late onset venous macroaneurysm319 viewsThe vision improved on presentation from 20/160 - 20/32 with Avastin, Then a few years later, he developed a venous Macroaneurysm which was lasered . Avastin shots were then stopped.
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CNV outcomes318 viewsFibrotic scar in choroidal neovascularization after anti-VEGF treatment
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Familial Exudative Vitreoretinopathy - FEVR - Stage 1-b both eyes318 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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Punctate Inner Choroidopathy and Choroidal Neovascular Membrane (CNVM)318 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 Membrane318 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 Vision318 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 Vision318 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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Choroidal Neovascular Membrane (CNVM) secondary to laser scar from TTT for choroidal melanoma 20 years earlier318 views71-year old female - Vision loss in the right eye for 1 week. She had transpupillary thermotherapy 20 years ago in the right eye for choroidal melanoma.
VA 4/200 OD, 20/20 OS
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Age-related macular degeneration - Geographic Atrophy - Intermittent CME left eye from CRVO, Anemia, Diabetes318 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 retinopathy318 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 retinopathy318 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 retinopathy318 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 Retinal Vein Occlusion following Cataract Surgery318 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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Sticklers syndrome with Pierre Robin Sequence318 views9 year old child with father who had retinal detachment at age 10. History of cleft palate repair and teeth removal. VA 20/40 OU. Images show perivascular RPE and retinal changes especially nasally
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Acute Syphilitic Posterior Placoid Chorioretinitis318 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 4318 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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Iris Arteriovenous Malformation318 views
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Cilioretinal artery occlusion following cataract surgery318 views60 year old man noticed new scotoma in the right eye immediately after cataract surgery. Vision is 20/60
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Retinal Arterial Macroaneursym318 views69 year old female with vision loss for a few months in the right eye. Images show a macroaneurysm in the right eye. The lesion had bled and FA showed no leakage. No treatment was done. VA improved from 20/40 - 20/32
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Pseudoexfoliation Material Peeling.317 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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Cotton Wool Spots - Severe Anemia - Acute Lymphocytic Leukemia317 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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PDR and Vitreous hemorrhage - Second FA is following PRP laser317 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 Retinopathy317 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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Bilateral Acute Central Serous Chorioretinopathy - Evidence of old disease OS317 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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Coats' Disease - 8-year-old boy - Asymptomatic317 viewsNormal vision - Lesion picked up on examination
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Dry AMD geographic atrophy and cystoid macular edema317 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 Cancer317 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 Cancer317 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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Alcohol Amblyopia - Toxic Optic Neuropathy317 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 ozurdex317 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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Central Serous Chorioretinopathy in a child317 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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Macular Scars from Presumed Ocular Histoplasmosis Syndrome317 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 Syndrome317 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 Syndrome317 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 Syndrome317 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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Nonproliferative Diabetic Retinopathy and Good Vision317 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)317 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 Laser317 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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Combined hamartoma of the retina and retinal pigment epithelium317 views8 year old boy failed vision screening at school. VA 20/20 OD, 20/40 OS
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Acute Syphilitic Posterior Placoid Chorioretinitis317 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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Acute Syphilitic Posterior Placoid Chorioretinitis317 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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Stage V (neovascular) Macular Telangiectasia - Fluorescein317 views67 year old female with vision in only the left eye. She has mild CNVM which is treated with Avastin and does well over several years.
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Asymptomatic progressing retinal detachment 27 year old man317 viewsThis detachment was followed for one month, progressed, and was repaired with a scleral buckle.
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Branch Retinal Vein Occlusion and worsened cystoid macular edema following cataract surgery317 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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Central retinal artery occlusion and paracentral acute middle maculopathy and emboli317 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 Excavation left eye317 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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Punctate Inner Choroidopathy and Choroidal Neovascular Membrane316 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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PDR and Vitreous hemorrhage - Second FA is following PRP laser316 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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Familial Exudative Vitreoretinopathy - FEVR - Stage 1-b both eyes316 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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Familial Exudative Vitreoretinopathy - FEVR - Stage 1-b both eyes316 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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Macular Telangiectasis (MacTel) Both Eye - Stage IV - Pigment Spots316 views63 year old female with Type II DM x 4 years. Vision is 20/40 both eyes.
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Occult Choroidal Neovascular Membrane316 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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Occult Choroidal Neovascular Membrane316 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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Idiopathic Intracranial Hypertension - Papilledema316 views37 year old obese female Was on for an eye examination and a problem was noted. Her vision is normal. She has mild headaches which are from TMJ.
PMhx: Polycystic Ovary Syndrome (not diabetic)
Meds: Metformin, Vitamin D, Spironolactone
VA 20/12 OD, 20/16 OS
Opening ICP on spinal tap was 30 CM water.
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Severe Proliferative Diabetic Retinopathy and Good Vision316 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 Cancer316 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 Cancer316 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 later316 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 Neuropathy316 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 ozurdex316 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 retinopathy316 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 child316 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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Macular Scars from Presumed Ocular Histoplasmosis Syndrome316 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)316 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 Laser316 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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Punctate inner choroidopathy and CNVM316 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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Punctate inner choroidopathy and CNVM316 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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Central Serous Retinopathy - Female on steroids316 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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Stage V (neovascular) Macular Telangiectasia - Fluorescein316 views67 year old female with vision in only the left eye. She has mild CNVM which is treated with Avastin and does well over several years.
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Severe diabetic tractional retinal detachment one year following diagnosis of type II Diabetes Mellitus316 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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Massive subretinal hemorrhage right eye - polypoidal choroidal vasculopathy316 viewsPatient had sudden vision loss right eye. Had vitrectomy. The left eye had IPCV not responsive to avastin but he did respond to PDT. See album notes for more detail.
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RPE tear following single treatment of vabysmo in the left eye316 views80 year old patient with HemiCRVO and wet AMD in the left eye. The right eye has recent vision loss from 20/40 - 20/100. She has a high PED and wet AMD. She was given one treatment of half-dose vabysmo and presented next visit with a PED tear and vision of 4/200.
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central retinal vein occlusion - a lot of hemorrhage - on coumadin316 views84 year old man with severe vision loss left eye for 2 weeks. VA 5/200 OS - Patient on Warfarin for valve replacement.
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315 views
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Traction retinal detachment both eyes. Proliferative Diabetic Retinopathy315 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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Familial Exudative Vitreoretinopathy - FEVR - Stage 1-b both eyes315 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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Familial Exudative Vitreoretinopathy - FEVR - Stage 1-b both eyes315 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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Wet age-related macular degeneration - Classic Juxtafoveal Choroidal Neovascular Membrane315 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 Membrane315 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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Idiopathic Intracranial Hypertension - Papilledema315 views37 year old obese female Was on for an eye examination and a problem was noted. Her vision is normal. She has mild headaches which are from TMJ.
PMhx: Polycystic Ovary Syndrome (not diabetic)
Meds: Metformin, Vitamin D, Spironolactone
VA 20/12 OD, 20/16 OS
Opening ICP on spinal tap was 30 CM water.
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Choroidal Neovascular Membrane (CNVM) secondary to laser scar from TTT for choroidal melanoma 20 years earlier315 views71-year old female - Vision loss in the right eye for 1 week. She had transpupillary thermotherapy 20 years ago in the right eye for choroidal melanoma.
VA 4/200 OD, 20/20 OS
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