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coats disease; exudative retinitis; retinal telangiectasis; leber multiple miliary aneurysm disease1808 viewsclassic coats
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Papilledema - Spectral Domain OCT used for Diagnosis - 14 year old Child - Line Scan over Nerve Shows Retinal Edema1806 views14-year-old was with optic nerve swelling asymptomatic - picked up during routine eye exam. OD 20/20, OS 20/32
SD-OCT is used to differentiate optic disc edema from optic nerve head drusen (which are not yet calcified in children).
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Best Disease - Left Eye Treated Previously, Elsewhere, with PDT and Avastin1785 views11-year-old has Best’s disease that runs in his family on his mothers side. At another retina specialists office, he had photodynamic laser in April of 2009 and Avastin subsequently in June of 2009. Unfortunately with that his vision is substantially declining. OD 20/30, OS 20/100
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Anterior Ischemic Optic Neuropathy - Non-Arteritic - AION1783 views72-year-old woman sudden vision loss in the right eye about four days ago. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers.
OD is 20/80, PH 20/25; OS is 20/25
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Coats' Disease in 14 Year Old Boy Treated with Cryotherapy and Avastin1777 views14 Year Old Boy with Coats Disease
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Acute Posterior Vitreous Detachment - Weiss Ring - Vogt Ring1775 views
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Acute Posterior Vitreous Detachment - Weiss Ring - Vogt Ring1751 views
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Papilledema - Spectral Domain OCT used for Diagnosis - 14 year old Child - Nerve Fiber Layer Scan shows swelling1744 views14-year-old was with optic nerve swelling asymptomatic - picked up during routine eye exam. OD 20/20, OS 20/32
SD-OCT is used to differentiate optic disc edema from optic nerve head drusen (which are not yet calcified in children).
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OU Stereo Pair Optic Disc Drusen1736 viewsText book example of OU optic discs with drusen in stereo.
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Plaquenil Toxicity - Bulls Eye Maculopathy1733 views70-year-old woman with systemic Lupus erythematosus and clotting problems. She was on the Plaquenil for about eight years and then off the Plaquenil for the last eight years because she developed macular toxicity. Although her vision was hazy, it was stable. Recent deceased vision left eye: OD 20/60, OS 20/100. IOP: OD 18, OS 19.
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Background Diabetic Retinopathy1729 viewsPatient with diabetes for over 11-years comes in with blurred vision. Blood sugar control is very poor. VA 20/50- right eye, 20/25-left eye. Fundus exam shows hard exudates with Circinate Rings and edema. Micro-aneurysms and retinal hemorrhage are present in both eyes. Patient will come back for laser treatment.
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Retinoblastoma1726 views
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Gonioscopy, Neovascularization in the Angle1724 viewsNeovascularization in the right eye, temporally. VA is 20/40, right eye with IOP at 25. Patient will proceed with Avastin injection to the right eye.
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Macular Scar1714 viewsFundus photography with Auto Fluorescent shows macular scar centrally, right eye. VA is 20/200 in the right eye.
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Acute Cytomegalovirus Retinitis1704 views45 y/o male presents with newly diagnosed AIDS and retinal infiltrates.
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Papilledema - Spectral Domain OCT used for Diagnosis - 14 year old Child - Line Scan over Nerve Shows Retinal Edema1697 views14-year-old was with optic nerve swelling asymptomatic - picked up during routine eye exam. OD 20/20, OS 20/32
SD-OCT is used to differentiate optic disc edema from optic nerve head drusen (which are not yet calcified in children).
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Retinoschisis with Multiple Outer Layer Holes1690 viewsRetinoschisis with Multiple Outer Layer Holes
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1688 views
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Normal Spectral Domain Optical Coherence Tomography (SD-OCT)1688 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25.
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Corneal Foreign Body 1679 viewsPatient complains of foreign body sensation in the right eye. Slit lamp photos shows a piece of glass metal embedded into the inferior part of the cornea at 7-o'clock in the right eye. Foreign body was removed.
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Fundus Flavimaculatus - Stargardt Disease - 20/50 OD 20/200 OS 61 Year old Color Photo1674 views61-year-old decreasing vision for about the last five years. OD 20/50, OS 20/200.
Pisciform Lesions and Macular Atrophy
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Normal Fundus Autofluorescence1664 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25.
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Gonioscopy; Scattered Peripheral Anterior Synechiae1664 viewsPatient comes in for evaluation for glaucoma. Patient also has a history of Uveitis. Last flare up was back in 1990. Patient's VA was 20/30, Right eye and 20/40-1, Left eye. Slit Lamp Gonioscopy reveals iris bow with scattered PAS around the angles of the anterior chamber. You can also see pigmentation in the trabecular meshwork. Patient will follow up in 3-months.
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Proliferative Diabetic Retinopathy - Preretinal Hemorrhage1663 viewsPreretinal Hemorrhage secondary to Proliferative Diabetic Retinopathy (PDR)
James L. Perron, C.R.A.
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Berlin's Edema - Post Bungee Cord Injury Right Eye1660 views20/50 vision - 2 days post-injury
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CHRPE - Gardner Syndrome - FAMILIAL COLORECTAL POLYPOSIS - 11 year old female1659 views11-year-old child with CHRPE OS has six undescended adult teeth and also she has had a cyst removed from her arm pit and she has three more in her arm pit and one on her face and she is seeing a dermatologist for that in the near future. The mother reports no health problems, however, the patient’s grandmother does have a history of intestinal polyps, as does the patient’s grandmother’s brothers son.
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Retinitis Pigmentosa1656 viewsPatient comes in with cloudy vision. VA is 20/200 in both eyes. Patient has had retinal pigmentosa since 1986. Patient to consider cataract surgery to help her visual symptoms...
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Plaquenil Toxicity both Eyes - Partial Bull's Eye - Discontinued 6 Years ago SD-OCT (Spectral domain optical coherence tomography)1654 views82-year-old woman was on Plaquenil from 1976 from 2005, 200 mg a day. It was discontinued because of abnormal visual fields 6 years ago. OD 20/32, OS 20/40
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Retinal Arterial Macroaneurysm - Recurrent Hemorrhage 6 months post laser1652 views6 months post laser: Her vision had improved, but then three weeks ago it worsened again. She is not on any blood thinners. She wasn’t doing any heavy lifting or straining.
VISUAL ACUITY: OD 3/200
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1650 viewsPHPV - right eye - optic nerve
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Normal Spectral Domain Optical Coherence Tomography (SD-OCT)1649 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25.
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Amelanotic Choroidal Nevus 1647 views45-year-old man OD 20/20, OS 20/20. 5x5 mm flat, yellow choroidal lesion just inferonasal to the optic nerve, two disc-diameters from the nerve with scalloped edges. It looks like a confluent drusen, but it is not elevated.
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Aplastic anemia1647 views29 y.o.m. with aplastic anemia OD VA 20/25.
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Diabetic Macular Edema and Hypertensive Retinopathy - Circinate Exudate (Ring Exudate) 1645 views55-year-old woman diabetic for fifteen years and high blood pressure, especially over the last few months. She has had problems with nosebleeds, headaches, and there has been some difficulty bringing her blood pressure down. She said now the blood pressure is under control but it was running 220/120 mmHg for some time. Her vision in the right eye has been poor for four weeks with a spot in the central vision and both eyes have been blurred.
VISUAL ACUITY: Vision OD is 20/160, OS is 20/60
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Coloboma of the optic Nerve1642 viewsColoboma
James L. Perron
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Toxoplasmosis Macular Scar (acquired not congenital) 31 Year Old Man- Recent Vision Change - Creeping Scar1641 views31-year-old man had an episode of toxoplasmosis in the left eye, where unfortunately it adversely affected his central vision that was back in 2004 (7 years ago)
He did notice recently a change in his visual function. He plays softball, he was getting hit by the ball and having trouble seeing and he said that is how he noticed the toxoplasmosis when it first occurred and he was concerned it might have recurred.
OD 20/16, OS 20/80.
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360-Degree Scleral Buckle1640 viewsPatient comes in with double vision from recent retinal detachment surgery. Optos shows 360 degree scleral buckle with retina attached. No holes or breaks visible. Patient had fresnel prism added on to lens to correct the double vision.
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Macular Choroidal Nevus1636 views78-year-old woman has choroidal nevus in the macula of the left eye. You asked her to come in here for an evaluation and nevus was noted in the past about 7 years ago. She has not noticed any change in vision in that eye.
VISUAL ACUITY: OU 20/30.
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Optic Nerve Drusen - - Fundus Autofluorescence - FAF1636 views72-year-old woman has had optic nerve drusen for sometime and has visual field abnormalities. OD 20/32, OS 20/32.
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Gonioscopy- Pigmentary Glaucoma Suspect1636 viewsPatient with no family history of glaucoma, comes in with elevated IOP. During Gonioscopy exam. brown pigment overlying the trabecular meshwork. Also, trans-illumination defects on the iris.
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Psuedo-retinitis Pigmentosa - Bone Spicules One Eye - Probably Acute Zonal Occult Outer Retinopathy (AZOOR)1632 views65-year-old woman has pseudoretinitis pigmentosa in the right eye only, most likely from acute zonal occult outer retinopathy. OD 20/25, OS 20/25
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Fundus Flavimaculatus - Stargardt Disease - 20/50 OD 20/200 OS 61 Year old Fundus Autofluorescence os1630 views61-year-old decreasing vision for about the last five years. OD 20/50, OS 20/200.
Pisciform Lesions and Macular Atrophy
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Choroidal Nevus with Overlying Drusen1626 views48-year-old woman Vision OD is 20/16, OS is 20/20.
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Anterior Ischemic Optic Neuropathy - Non-Arteritic - AION1623 views72-year-old woman sudden vision loss in the right eye about four days ago. She also has noticed that things are dim out of that eye. She has no headaches. She does feel a little tired. She has no pain in her jaw when she chews and she has no fevers.
OD is 20/80, PH 20/25; OS is 20/25
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Pigmented Peripheral Retinal Degeneration1620 views42-year old male comes in for routine eye exam and to follow up on peripheral retinal degeneration in both eyes. VA is 20/20, right eye and 20/25, left eye. Patient is asymptomatic with no visual complaints.
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Normal Spectral Domain Optical Coherence Tomography (SD-OCT) - Prefoveal Vitreous Liquifaction1617 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25.
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Optic Nerve Head Drusen B-Scan 1616 views57-year-old woman has optic nerve drusen in both eyes.
VISUAL ACUITY: OU 20/20.
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Gonioscopy; Scattered Peripheral Anterior Synechiae1613 viewsPatient comes in for evaluation for glaucoma. Patient also has a history of Uveitis. Last flare up was back in 1990. Patient's VA was 20/30, Right eye and 20/40-1, Left eye. Slit Lamp Gonioscopy reveals iris bow with scattered PAS around the angles of the anterior chamber. You can also see pigmentation in the trabecular meshwork. Patient will follow up in 3-months.
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CHRPE - Gardner Syndrome - FAMILIAL COLORECTAL POLYPOSIS - 11 year old female1612 views11-year-old child with CHRPE OS has six undescended adult teeth and also she has had a cyst removed from her arm pit and she has three more in her arm pit and one on her face and she is seeing a dermatologist for that in the near future. The mother reports no health problems, however, the patient’s grandmother does have a history of intestinal polyps, as does the patient’s grandmother’s brothers son.
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Basal Laminar Drusen - Cuticular Drusen - Equatorial Drusen - 70 Year Old Woman - Macular Photo Right Eye1612 views70 year old woman has had macular drusen since her thirties and she said her sister has a similar problem. Recently the vision in the left eye has substantially declined. OD 20/16, OS 10/200.
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Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fundus Photo - Color1609 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
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Optic Nerve Head Drusen Right Eye1608 views57-year-old woman has optic nerve drusen in both eyes.
VISUAL ACUITY: OU 20/20.
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"Jelly Bumps" Soft Contact Lens1606 viewsYoung female patient comes in wearing overnight contact lenses. Complains of irritation in both eyes. Denies sleeping in SCL. Slit lamp exam shows little jelly bumps underneath the contact lens in both eyes. Was issued a new pair and lectured on handling them.
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Psuedo-retinitis Pigmentosa - Bone Spicules One Eye - Probably Acute Zonal Occult Outer Retinopathy (AZOOR)1605 views65-year-old woman has pseudoretinitis pigmentosa in the right eye only, most likely from acute zonal occult outer retinopathy. OD 20/25, OS 20/25
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Hyphema1605 viewsHyphema
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Diabetic Macular Edema and Hypertensive Retinopathy - Circinate Exudate (Ring Exudate) 1604 views55-year-old woman diabetic for fifteen years and high blood pressure, especially over the last few months. She has had problems with nosebleeds, headaches, and there has been some difficulty bringing her blood pressure down. She said now the blood pressure is under control but it was running 220/120 mmHg for some time. Her vision in the right eye has been poor for four weeks with a spot in the central vision and both eyes have been blurred.
VISUAL ACUITY: Vision OD is 20/160, OS is 20/60
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Grouped pigmentation - Bear Tracks1601 views71 year old caucasian woman with incidental finding of extensive grouped RPE hypertrophy. Routine colonoscopy performed in the preceding year was normal.
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Reticular Macular Disease - Reticular Pseudodrusen and Soft Macular Drusen - 57 Year Old Woman1600 views57-year-old woman was seen in the office on 2/22/2011. She has macular drusen in both eyes. I saw her back in 2006. Since then she does notice slight increased distortion. OD is 20/25, OS is 20/25
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Central Retinal Artery Occlusion - 2 months old by history1597 views77-year-old man was doing fine. His left eye was a little worse than the right eye, and then in the 2 months ago he had sudden severe vision loss in the right eye. Vision OD is 3/200; OS is 20/60. IOP: OD 30, OS 15.
OD: Vertical C/D ratio is 0.4. The macula is white from ischemia. The arteries are narrow.
Photos confirm clinical findings.
OCT SCAN: OCT scan of the right eye shows retinal thickening, consistent with macular edema associated with a central retinal artery occlusion. The left eye has severe inferior retinal thinning, consistent with an old hemicentral retinal artery occlusion in the left eye. The fovea in the left eye is a little bit thin but not too bad.
IMPRESSION: 1. CENTRAL RETINAL ARTERY OCCLUSION RIGHT EYE
2 OLD HEMICENTRAL RETINAL ARTERY OCCLUSION LEFT EYE
3 DIABETES WITHOUT RETINOPATHY
4 ELEVATED INTRAOCULAR PRESSURE RIGHT EYE STATUS POST INJECTION RIGHT EYE A WEEK AGO
DISCUSSION: I explained to the patient that the right eye unfortunately has had a central retinal artery and unfortunately we do not have anything to treat that. His vision will probably improve some over time. He needs to be watched though. It is possible he is developing rubeotic glaucoma, although it is probable the intraocular pressure is high from the injection last week. I asked him to restart the Alphagan, to stop the other two drops, and to return here in three weeks to make sure his pressure is more acceptable.
At this point, having lost almost all the retinal circulation in the right eye and half of the retinal circulation in the left eye, he only has half a retina in the left eye he is working off of. I told him it is very important he keep seeing you and anything that can be done to keep his blood pressure low and his cholesterol reasonable would be helpful to what remains of his retinal circulation.
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 1596 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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1594 viewsAdult male with trauma to the right eye and orbital floor fracture. Hemorrhage with Choroidal Rupture.
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Reticular peripheral pigment degeneration1592 views
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Normal Fellow Eye (Berlin's Edema)1588 views
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Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1587 views
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Central Retinal Artery Occlusion1586 views60 year old male with LP vision due to extensive blood flow loss.
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Chorioretinal Scar1583 views21 year old male with a chorioretinal scar OD
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Retinal Tear Before Laser1581 views65-year-old woman new onset floaters for 1 week. She initially saw flashing lights and then the flashing lights subsided and then she had the floaters VISUAL ACUITY: OD 20/25, OS 20/50
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Angle Closure/ UBM & Gonioscopy1581 viewsPatient comes in a day after dilation with severe headache and nausea. Patient's IOP was 64 in the right eye. Patient ended up having angle closure attack. Promoted severe nausea and eye pain. Peripheral Iridotomy was performed and IOP dropped slowly. Patient was followed up the next morning and will be seen 2-days after that.
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Peripheral Bullous Retinoschisis Fundus Photo (superotemporal)1579 views64-year-old man with peripheral retinal problem noted during comprehensive eye examination. OD 20/32, OS 20/25
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Weiss Ring -Vogt Ring - Posterior Vitreous Detachment1576 viewsChronic Floater - 10 years
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Asteroid Hyalosis - Benign Calcified Deposits in the Vitreous1575 views75 year old woman with 20/30 vision and dense asteroid haylosis
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Giant Retinal Tear1572 views
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Punctate Inner Choroidopathy - PIC and Choroidal Neovascular Membrane - Right Eye - Color Fundus Photograph1570 views34-year-old woman with a change in vision in the right eye about eight days ago. Her vision was hazy and she saw waviness in the vision. She does have a history of aches and pains and she was diagnosed with Sjogren’s and 2 months ago she had some fevers and some sinus drainage and that went on for about two months. She is a moderate myope. OD 20/25, OS 20/20.
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Ectopia Lentis - Marfan's Syndrome - Intermittent Pupillary Block Glaucoma Right Eye1564 views41-year-old woman decreased vision right eye and intermittent pupillary block glaucoma for 6 months from a dislocated natural lens in the eye, probably associated with Marfan syndrome.Vision OD is 20/160, PH 20/40; OS is 20/30, PH 20/25
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Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1552 viewsElschnig Spots are pigment spots in periphery
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Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1551 views
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Ozurdex Implant in AC1550 views79 yr old male presents with Blurry vison with slight discomfort x 1 in OD. Pt is S/P Ozurdex Implant x 2 mos which has now surfaced in the Anterior Chamber.
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Fuchs Heterochromic Iridocyclitis - Left eye has inflammation1547 viewsThe right eye is darker than the left eye which has chronic iritis
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Choroidal Hemorrhage1546 viewsHemorrhagic Choroidal Effusion
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Retinal Artery Occlusion1528 viewsPatient comes in for eval on artery occlusions in both eyes. VA is 20/400, right eye and NLP, left eye. Fundus photos show paniretinal scars in the right eye with arterial narrowing and the left eye has arterial narrowing as well.
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Optic Nerve (Disc) Drusen - Fundus Autofluorescence1525 views34 Year Old woman no headaches normal vision
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Cilio-Retinal Artery Occlusion with "Box Carring" and Cherry Red Spot1519 viewsCilioretinal Artery Occlusion with Cherry Red Spot
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Commotio Retinae - One Day following Basketball to Eye1516 views43-year-old man was playing basketball last night. He was hit straight in the left eye with the ball. Initially he had darkness in his inferior vision and now he has darkness inferonasally in the left eye.
Vision OD is 20/16, vision OS is 20/32
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Inferotemporal and Inferonasal BRAO1514 viewsBranch Retinal Artery Occlusions - Multiple
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Choroidal Nevus with Overlying Drusen1512 views48-year-old woman Vision OD is 20/16, OS is 20/20.
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Optic Nerve Drusen in 7 Year Old Child - Miminal Calcification1506 views7-year-old child difficulty seeing the blackboard in school. She was checked for glasses and it was noted at that time that she had unusual looking optic nerves. Vision OU is 20/50.
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Myelinated Nerve Fiber Layer Right Eye (white area)1506 views62-year-old man myelinated nerve fiber layer in the right eye. OD 20/25, OS 20/30.
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Small vessel vasculitis causing cystoid macular edema - right eye - late frame fluorescein angiography 1505 views36 year old female with no significant past medical history noted painless, progressive loss of vision over one month. BCVA was 20/100 in her right eye. Dilated fundus exam, OCT and FA identified small vessel vasculitis associated with cystoid macular edema. Left eye was also involved with less marked findings.
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Gonioscopy; Scattered Peripheral Anterior Synechiae1505 viewsPatient comes in for evaluation for glaucoma. Patient also has a history of Uveitis. Last flare up was back in 1990. Patient's VA was 20/30, Right eye and 20/40-1, Left eye. Slit Lamp Gonioscopy reveals iris bow with scattered PAS around the angles of the anterior chamber. You can also see pigmentation in the trabecular meshwork. Patient will follow up in 3-months.
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Melanoma1503 views40 Year old male
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Emulsified silicone oil in anterior chamger1503 views
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Normal Spectral Domain Optical Coherence Tomography (SD-OCT)1502 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25.
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Floating Vitreous Cyst1499 viewsFloating Vitreous Cyst
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram - Antimated .GIF1498 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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Swollen Nerve with Hemorraghe1491 views
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Macular Demarcation line and Symptomatic Distortion 3 years following Asymptomatic Retinal Detachment Repair1490 views 41-year-old man had an asymptomatic retinal detachment repair in the left eye on New Years Eve in December of 2007 in Wake Forest, North Carolina (3 years ago). Since then he has had problems with distortion and pinching. When he looks at long words, the very center letters are abnormal.
OD is 20/20, OS is 20/80
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360-Degree's Pseudoexfoliation1490 viewsFollow-up on glaucoma. Patient has sever pseudoexfoliation in the right eye. VA is 20/25 with IOP at 27. Patient will return in 6-months for re-evaluation.
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Plaquenil Toxicity both Eyes - Partial Bull's Eye - Discontinued 6 Years ago 1487 views82-year-old woman was on Plaquenil from 1976 from 2005, 200 mg a day. It was discontinued because of abnormal visual fields 6 years ago. OD 20/32, OS 20/40
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Choroidal Melanoma1487 views
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Clinically Significant Diabetic Macular Edema both Eyes with Exudates1486 views56-year-old woman with diabetes for twelve years. She has noticed blurring of the vision in the right eye for about six months. OD is 20/70, OS is 20/25.
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