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Alcohol Amblyopia - Toxic Optic Neuropathy331 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 Neuropathy331 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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Age-related macular degeneration - Geographic Atrophy - Intermittent CME left eye from CRVO, Anemia, Diabetes331 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 retinopathy331 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Sectoral Retinitis Pigmentosa - Asymptomatic331 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 child331 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 child331 views12-year-old African American Female A few weeks ago she felt like something was covering the right eye and she couldn't see well. She was told that she had a swollen optic nerve. She had a recent diagnosis of sinus infection. She also recently had onset menarche on August 7th. Eye problem started about a week before menarche. She's been getting some headaches, partly because of sinus infection. They started about a month ago and now are getting better. She is on zytrhomax for the sinus problem. Patient is hypothyroid and is on thyroid supplementation and that has been stable. She has no eye pain.
MEDS: Synthroid, Flonase
PMHx - Thyroid Disease
VA OD: Dcc20/400 PH20/125 NccJ10
VA OS: Dcc20/20 NccJ1+
IOP: TP: OD:14 OS:21
Macular detachments resolved in 1 month with no treatment and vision returned to 20/20 in one month and 20/16 in 2 months
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)331 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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Central Retinal Vein Occlusion following Cataract Surgery331 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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Presumed ocular histoplasmosis syndrome and CNVM - responded to Avastin331 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 Chorioretinitis331 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 Chorioretinitis331 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 - Fluorescein331 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 Mellitus331 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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Choroidal Excavation left eye331 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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Pseudoexfoliation Material Peeling.330 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 Leukemia330 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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Familial Exudative Vitreoretinopathy - FEVR - Stage 1-b both eyes330 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 eyes330 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 Membrane330 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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Bilateral Choroidal Tumors - Metastatic Breast Cancer330 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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Choroidal Neovascular Membrane (CNVM) secondary to laser scar from TTT for choroidal melanoma 20 years earlier330 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, Diabetes330 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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Scleral Buckle Intrusion330 views85 year old woman with 35 year old scleral buckle in the left eye. Her vision has been gradually declining with increasing uveitis and finally a scleral buckle intrusion. Over about 18 months the eye became painful with NLP vision and ultimately was removed.
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Pregnant - 25 weeks - new onset PDR and DME both eyes - Treated with PRP and ozurdex330 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 retinopathy330 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Ocular Lymphoma - Initially presented like auto-immune retinopathy330 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Asymptomatic exudative wet age-related macular degeneration330 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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Asymptomatic exudative wet age-related macular degeneration330 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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Punctate inner choroidopathy and CNVM330 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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Choroidal Hemorrhage following intraocular lens exchange surgery330 views68 year old man Patient is 1 week post IOL exchange with sutured Akreos PCIOL with PST Kenalog. IOP was 12 on POD 1 and 21 today (POD 7). Preop the IOP was 17.
He has a history of retinal detachment repair 12 years ago with PPV, Buckle, Laser and Gas.
VA OD: 20/200, OS: 20/50. IOP 21, 19
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Choroidal Excavation left eye330 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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Branch Retinal Vein Occlusion - Foveal Ischemia Neovascularization Non perfusion330 views38 year old patient with a BRVO who had PRP laser for vitreous hemorrhage. Vision remained 20/160 from foveal ischemia
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BRVO with late onset venous macroaneurysm330 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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RPE tear following single treatment of vabysmo in the left eye330 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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choroidal melanoma329 viewsAn Asian male, 37 years old, choroidal melanoma.
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Intermediate Dry Age-Related Macular Degeneration - Soft Drusen329 views70-year-old Left eye worse than the right. Both eyes see distortion in the amsler grid for a few months
HTN, High Lipids, Osteoporosis
Meds: Lutein once daily, Calcium, Fish oil, Red Yeast Rice, CoQ10, Magnesium, MVI, Xanax
VA 20/16 OU
2+NS cataract
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Retinal Angioma329 views53 year old female with no-symptoms and no significant medical history (or family history)
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Choroidal Neovascular Membrane (CNVM) secondary to laser scar from TTT for choroidal melanoma 20 years earlier329 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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Central Serous Chorioretinopathy in a child329 views12-year-old African American Female A few weeks ago she felt like something was covering the right eye and she couldn't see well. She was told that she had a swollen optic nerve. She had a recent diagnosis of sinus infection. She also recently had onset menarche on August 7th. Eye problem started about a week before menarche. She's been getting some headaches, partly because of sinus infection. They started about a month ago and now are getting better. She is on zytrhomax for the sinus problem. Patient is hypothyroid and is on thyroid supplementation and that has been stable. She has no eye pain.
MEDS: Synthroid, Flonase
PMHx - Thyroid Disease
VA OD: Dcc20/400 PH20/125 NccJ10
VA OS: Dcc20/20 NccJ1+
IOP: TP: OD:14 OS:21
Macular detachments resolved in 1 month with no treatment and vision returned to 20/20 in one month and 20/16 in 2 months
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Central Serous Chorioretinopathy in a child329 views12-year-old African American Female A few weeks ago she felt like something was covering the right eye and she couldn't see well. She was told that she had a swollen optic nerve. She had a recent diagnosis of sinus infection. She also recently had onset menarche on August 7th. Eye problem started about a week before menarche. She's been getting some headaches, partly because of sinus infection. They started about a month ago and now are getting better. She is on zytrhomax for the sinus problem. Patient is hypothyroid and is on thyroid supplementation and that has been stable. She has no eye pain.
MEDS: Synthroid, Flonase
PMHx - Thyroid Disease
VA OD: Dcc20/400 PH20/125 NccJ10
VA OS: Dcc20/20 NccJ1+
IOP: TP: OD:14 OS:21
Macular detachments resolved in 1 month with no treatment and vision returned to 20/20 in one month and 20/16 in 2 months
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)329 views67 year old man
The patient started noticing dimming of the vision in November of 2020. He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021. The vision did not improve with the cataract surgery. On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss. The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss. He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.  A retinal evaluation showed subretinal fluid and vision loss.  The peripheral vision and central vision were pretty good. The vision did seem to get better off the nivolumab. Then when the patient returned to Florida in September and now the vision is getting worse. The patient did not have any treatments in either eye. The patient is now off the oncology treatment. He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month. It was stopped because of a skin rash and reactions. Â
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)329 views67 year old man
The patient started noticing dimming of the vision in November of 2020. He had rapidly worsening cataracts. He had the cataract surgery done in both eyes in April of 2021. The vision did not improve with the cataract surgery. On June 1 of 2021 he had immunotherapy for his renal cell carcinoma and then developed severe vision loss. The patient noticed that one of the commercials for nivolumab (checkpoint inhibitor targeting programmed death receptor-1) said it may cause vision loss. He recalled that he started the nivolumab in October of 2020 and had vision loss starting then.  A retinal evaluation showed subretinal fluid and vision loss.  The peripheral vision and central vision were pretty good. The vision did seem to get better off the nivolumab. Then when the patient returned to Florida in September and now the vision is getting worse. The patient did not have any treatments in either eye. The patient is now off the oncology treatment. He was then started on a TKI cabometex for the cancer which was dosed in mid June through mid July just for a month. It was stopped because of a skin rash and reactions. Â
VA OD: Dcc20/200-2 PHNI Ncc20/800
VA OS: Dcc20/63 PHNI NccJ7 He has been off the checkpoint inhibitor for a year.
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Retinal Arterial Macroaneurysm treated with Laser329 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 Laser329 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 Laser329 views89 year old female with peripapillary CNVM treated with Lucentis. Vision was 20/25 OS 3 weeks ago. She noticed vision loss OS. Vision had dropped to 20/60. She had a fresh MA and was treated with laser.
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Asymptomatic exudative wet age-related macular degeneration329 views78 year old man with scar in the left eye being treated regularly and returns with new lesions in the right eye which is not symptomatic. Vision is 20/25 right eye and 20/125 left eye. The lesion was treated and responded to anti-VEGF therapy
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Combined hamartoma of the retina and retinal pigment epithelium329 views8 year old boy failed vision screening at school. VA 20/20 OD, 20/40 OS
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Acute Syphilitic Posterior Placoid Chorioretinitis329 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 4329 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 emboli329 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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Massive subretinal hemorrhage right eye - polypoidal choroidal vasculopathy329 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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Choroidal nevus329 viewsStable for 8 years.
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Cilioretinal artery occlusion following cataract surgery329 views60 year old man noticed new scotoma in the right eye immediately after cataract surgery. Vision is 20/60
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Retinal Arterial Macroaneursym329 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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Branch Retinal Vein Occlusion - Foveal Ischemia Neovascularization Non perfusion329 views38 year old patient with a BRVO who had PRP laser for vitreous hemorrhage. Vision remained 20/160 from foveal ischemia
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Twig (Macular) Branch Retinal Vein Occlusion with no symptoms329 views73 year old female with 20/25 vision and no symptoms
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328 views
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Cotton Wool Spots - Severe Anemia - Acute Lymphocytic Leukemia328 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 laser328 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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Elevated Episcleral Venous Pressure and Retinal Hemorrhages in both eyes328 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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Familial Exudative Vitreoretinopathy - FEVR - Stage 1-b both eyes328 viewsShe was born at term.   No family history of eye disease.
VA OD: Dcc20/25, VA OS: Dcc20/200+1 Ncc20/400
Anterior segment normal – clear lenses
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Wet age-related macular degeneration - Classic Juxtafoveal Choroidal Neovascular Membrane328 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 Membrane328 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 Vision328 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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Pan Retinal Laser from original DRS study in the 1970s - 50 years later328 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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Ocular Lymphoma - Initially presented like auto-immune retinopathy328 views43 year old man: initial presentation - The vision in the left eye is blurry and opaque for about 2 weeks. In the central of the vision, when he covers the right eye, in the center of the left eye there is a film with a light in the middle. This has never happened before. He has not been sick for the last few months. A few weeks ago he saw waves on the floor when looking down but that has gone away. Since the vision loss started the vision has not changed much. The central vision is not getting better. Â
PMHx – Borderline HTN
VA OD: Dcc20/20
VA OS: Dcc20/40-1 IOP: TP: OD:15 OS:19
1+ NS
No uveitis
Labs normal. One positive antiretinal antibody - Arrestin
VA improved over 2 months to normal. Then the patient had 2 more episodes of self-limited vision loss (no treatment). Then 2 years later he presented with a diagnosis of CNS lymphoma and later developed subretinal deposits (last images)
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Sectoral Retinitis Pigmentosa - Asymptomatic328 views56-year-old female - The patient was in for an annual checkup because of her diabetes. No visual complaints (no night vision trouble)
PMHx DM sine 2015, Asthma, Thyroid Disease, HTN
MEDS: Metformin, Levothyroxine, Lisinopril,, Inhaler
ROS Negative
VA OD: sc20/32-1 VA OS: sc20/32-1
IOP: TP: OD:18 OS:17
293 Invitae genetic panel - negative
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Bilateral Diffuse Melanocytic Proliferation (BDUMP)328 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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Central Retinal Vein Occlusion following Cataract Surgery328 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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Retinal detachment with choroidal effusions and RPE tear328 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 central328 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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Cilioretinal Artery Occlusion - non central328 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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Sticklers syndrome with Pierre Robin Sequence328 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 Avastin328 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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Central Serous Retinopathy - Female on steroids328 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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Acute Syphilitic Posterior Placoid Chorioretinitis328 views40 year old man About 10 days ago the patient woke up with a dark circle in the middle of the left eye that blocks his vision. He thought it might be from fatigue. The month of March was very stressful. After a few days the spot in the left eye got darker and he could not drive at night. During the last week while not going to work and sleeping more his vision is better but not normal. He has never had vision loss in the past. Â
PMHx: Benign, Meds: Multivitamin
VA OD: sc20/16 NscJ1+VA OS: sc20/32+2 NscJ4
IOP: TP: OD:12 OS:12
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Severe diabetic tractional retinal detachment one year following diagnosis of type II Diabetes Mellitus328 views44 year old man The vision in the left eye started to decline about 4 days ago. Prior to that the left eye was the better eye. He was diagnosed with diabetes a year ago.Â
VA OD: Dcc20/50-1 OS: Dcc20/125-2, TP: OD:12 OS:13
Following two surgeries in each eye, silicone oil remaining forever, monthly anti-VEGF for severe DME - BCVA OU 20/200 at 3 years
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Optic Disc Melanocytoma - Atypical328 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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Choroidal Excavation left eye328 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 Leukemia327 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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Traction retinal detachment both eyes. Proliferative Diabetic Retinopathy327 views40 year old man came in with vision loss OD and rubeosis in both eyes. Was treated with Avastin monthly and laser OD then lost to follow-up for 6 months. Came back with table top traction in the left macula (second set of images). Vision had dropped OS from 20/20 to HM. He had PPV ERM peel OS and vision improved to 5/200.
OD stabilized to 20/20 with PRP laser. Now on 6 month checks.
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Familial Exudative Vitreoretinopathy - FEVR - Stage 1-b both eyes327 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 eyes327 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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Idiopathic Intracranial Hypertension - Papilledema327 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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Bilateral Choroidal Tumors - Metastatic Breast Cancer327 views51 year old female. First 3 sets of images show lesions growing despite systemic chemotherapy. She eventually had external beam radiation x 15 sessions and the tumors shrunk in the last two sets of images
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Nonproliferative Diabetic Retinopathy and Good Vision327 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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Choroidal Effusions following IOL exchange327 views67 year old man 10 years ago had retinal detachment with buckle, vitrectomy, laser, gas. Vision was 20/25 post-op. 2 months ago had sudden vision loss in the right eye from a dislocated PCIOL (in the bag). 3 weeks ago had a vitrectomy, remove IOL and scleral suture fixation of Akreos AO60 PCIOL with gortex sutures. IOP was 12 on post-op day 1 with a vitreous hemorrhage. Post-op day 7, vitreous hemorrhage cleared.
PMhx: HTN, High Cholesterol.
Med: Amlodipine, ASA, Atorvastatin, Metoprolol
Vision 20/200,
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Cilioretinal Artery Occlusion - non central327 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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Severe Syphilitic Placoid Chorioretinitis327 views68 year old man 3 months ago the vision started fading in both eyes. Just sitting here he can see some light out of his right eye. The patient denies any recent illness or travel.
VA: OD: LP, OS: 4/200
IOP: 9, 13
Anterior segment: 1+ cell/ 2+ flare OU and 2+ NS and anterior vitreous cells
Labs Reactive RPR 1:256, FTA-ABS - reactive - Patient was admitted to hospital for IV PCN and recovered vision almost completely in the left eye and some in the right eye.
See line scans for recovery
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Presumed ocular histoplasmosis syndrome and CNVM - responded to Avastin327 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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Toxoplasmosis right eye with diffuse retinal vascular whitening PCR confirmed327 views66 year old man The patient was doing fine until about 2-3 months ago. He woke up with shadows and spots in the right eye. Every blue moon he gets some pain in the right eye. He has been getting treated with eye drops in the right eye. Since this happened the vision is mostly the same. Sometimes he sees better than other times. He has not been treated with oral medications. Â
Medical history: none – Medications: none, ROS negative
VA OD: sc20/63-1 OS: sc20/20
IOP: TP: OD:15 OS:20Â
Negative labs: ACE, Lysozyme, RPR, HLA B27, Quant TB Gold, ESR (slight elevation of CRP)
PCR anterior chamber: negative herpes virus (HSV, VZV, CMV)
Positive for toxoplasmosis
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Central retinal artery occlusion and paracentral acute middle maculopathy and emboli327 views86 year old female with sudden vision loss a week ago and imaging shows PAMM lesions and emboli. Her vision is 20/200 in the left eye
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Oculocutaneous albinism327 views62 year old female. Testing shows an absence of a fovea. Vision was 20/50 and she has nystagmus.
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Uveitis Glaucoma Hyphema (UGH) syndrome327 views65 year old female with intraocular lens half in the sulcus, iris atrophy, and recurrent uveitis since cataract surgery. She has a mild case and has been managed with topical steroids as needed.
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Cilioretinal artery occlusion following cataract surgery327 views60 year old man noticed new scotoma in the right eye immediately after cataract surgery. Vision is 20/60
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Cilioretinal artery occlusion following cataract surgery327 views60 year old man noticed new scotoma in the right eye immediately after cataract surgery. Vision is 20/60
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326 views
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Macular Telangiectasis (MacTel) Both Eye - Stage IV - Pigment Spots326 views63 year old female with Type II DM x 4 years. Vision is 20/40 both eyes.
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Occult Choroidal Neovascular Membrane326 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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