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This unknown shows extensive and unusual, radial and circumferential scarring of the posterior pole in this 37 YO male’s left eye. The right eye (not pictured) had a failed retinal detachment repair at an outside practice many years earlier, resulting in no light perception vision and an opaque, white cornea. Since the radial changes seem… Read More

This 78YO female presented with diffuse intraretinal hemorrhages in the inferior half of her posterior pole from an inferior hemiretinal vein occlusion. She had a long history of uncontrolled hypertension, although her blood pressure had not been acutely elevated. Fluorescein angiography shows good perfusion, some areas of vascular staining/leakage, and some telangiectasia at the border… Read More

Here is a preoperative Optos photo of a giant retinal tear extending from about 9:30 to 1 o’clock. This patient underwent successful pars plana vitrectomy surgery with C3F8 (perflouropropane) gas tamponade. Learning Points: By definition, giant retinal tears extend at least 3 clock hours. Surgical repair is greatly facilitated by the use of Perfluoron liquid… Read More

This patient presented with counting-finger vision and classic findings of a white retina and a cherry-red spot from an acute central retinal artery occlusion (CRAO). The cherry red spot is caused by the unaffected foveal retina (receiving intact choroidal blood flow) being surrounded by more distal white and ischemic retina no longer receiving circulation from… Read More

This is a 55YO diabetic patient who had been treated with complete panretinal photocoagulation (PRP). Vision was 20/40. Despite PRP, the patient still had significant residual posterior neovascularization. Since it is not uncommon for neovascularization to persist following full laser, we are observing for now. Learning Points: Panretinal photocoagulation has been around since the 1960s… Read More

This 69YO female came in for a routine exam with a few months of vision loss in her left eye. There is a new small area of subfoveal pigment adjacent to an old curvilinear scar more temporally. Although this temporal scar appeared to represent a choroidal rupture, she denied any prior trauma. Axial length is… Read More

This patient presented with diplopia from bilateral esotropia and reduced abduction in each eye due to sixth nerve palsies. There were no headaches or visual disturbances. Her nerves showed severe papilledema with severe retinal nerve fiber layer thickening on OCT. An MRI showed no mass lesions, but her lumbar puncture opening pressure was 41 cm… Read More

This patient with acute myeloid leukemia (AML) was referred by their oncologist for an eye examination following a failed allogeneic stem cell transplant due to graft versus host disease. Vision was 20/30 OD and 20/25 OS. His WBC was 14.7 (with 32% marrow myeloblasts), hemoglobin was 8.2, and platelet count was 23,000. This patient has… Read More

This patient had a large area of myelinated nerve fiber layer (NFL) in the distal inferotemporal left macula. OCT scanning through this area showed marked inner retinal hyperreflectivity. Learning Points:  Myelinated NFL is a relatively uncommon and usually isolated finding present at birth. Most patients are asymptomatic, although some may have a corresponding relative scotoma…. Read More

This patient with a known history of tuberous sclerosis was referred for an asymptomatic, slightly thickened whitish inner retinal lesion. OCT scanning showed an elevated, hyperreflective nerve fiber layer lesion. Learning Points: A retinal astrocytic hamartoma is a benign tumor composed of spindle-shaped fibrous astrocytes located in the nerve fiber layer, most commonly associated with… Read More