Blog

This patient was toxemic before delivery, with rapid bilateral vision loss and severely elevated blood pressure. When we examined her 10 days postpartum, her vision was counting fingers bilaterally. There are multiple patches of creamy white, ischemic RPE and outer retina scattered throughout both posterior poles. OCT scanning shows normal inner retinal bands extending from… Read More

This 13YO girl was hit in her right eye while playing volleyball. She presented to us several months later with 20/200 vision, an inferotemporal macular scar from resolved commotio retina, and a full-thickness macular hole. The macular hole was closed following successful vitrectomy, and she was 20/100 one month postoperatively. Vision improved to 20/40 three… Read More

This patient has fundus albipunctatus, a rare autosomal recessive form of congenital stationary night blindness. The characteristic numerous small white-yellow specks spare the fovea. Learning Points: Fundus albipunctatus is caused by a mutation in the RDH5 gene, which codes for retinol dehydrogenase, which converts 11-cis retinol to 11-cis retinal within the RPE. The optic disc,… Read More

Progressive outer retinal necrosis (PORN) is a rare form of acute retinal necrosis (ARN) found in patients with severe immunosuppression, such as from HIV/AIDS. This patient was lost to follow-up after the visit at which these images were taken. We are sure he went on to develop bilateral blindness. Learning Points: Both ARN and PORN… Read More

These creamy yellow-white choroidal lesions scattered throughout the posterior pole are characteristic of birdshot chorioretinopathy. Learning Points: This disease was appropriately described and named by Drs. Ryan and Maumenee (Am J Ophthalmol 1980;89:31-45), since the lesions look like shotgun birdshot scattered throughout the fundus. Birdshot is typically chronic and bilateral, with a very high HLA-A29… Read More

This patient came to see us for a second opinion following cataract surgery elsewhere six weeks earlier. He has been on topical steroid drops since his surgery. His pressure was 42 mmHg with significant anterior chamber cell and flare. Virtually the entire cataract was floating in the inferior vitreous. He was scheduled for immediate pars… Read More

This patient presented with a jack-o’-lantern retinal detachment 2 weeks before Halloween.

This is a beautiful example of bilateral streak lesions in a patient with the ocular histoplasmosis syndrome (OHS). Learning Points: The incidence of streak lesions (Schlaegel lines) in OHS is estimated at about 5% (Arch Ophthalmol 1981;99:246-248), and in our experience, they are more common in areas of more extensive peripheral scarring. They appear as… Read More

This is a 68YO male with a likely diagnosis of choroideremia. Vision is remarkably 20/60 OD and 20/50 OS. Note the areas of patchy RPE and chorioretinal atrophy in both eyes. Learning Points: Choroideremia is an X-linked recessive chorioretinal dystrophy caused by a mutation in the CHM gene. Some female carriers can still develop choroideremia… Read More

This patient has a vortex vein varix, a benign dilatation that can simulate a choroidal tumor. The diagnosis is clinched when gentle digital pressure on the globe collapses the varix, making it temporarily disappear. Learning Points: The vortex veins provide the major venous outflow for the choroid, subsequently draining into the superior and inferior ophthalmic… Read More