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Optos color imaging shows an amelanotic subretinal lesion in the right inferotemporal midperiphery. Swept-source OCT through this lesion shows hyperreflective scleral thickening, which compresses the overlying choroid. Learning Points: Focal scleral nodule (previously known as solitary idiopathic choroiditis [SIC] and unifocal helioid choroiditis), presents as a single, yellow-white, elevated nodular, avascular subretinal lesion. On OCT… Read More

During vitrectomy for a macular pucker, this intraoperative photo shows an incidental finding of 3-4 pars plana cysts in the superior quadrant found on scleral depression. The cysts were oval, and the inner cyst walls appeared smooth and transparent. Anteriorly, they extended variably over about one-half of the pars plana towards the ciliary processes. Learning… Read More

This 50YO male presented on 9/16/22 with 20/50 vision in his left eye from a macular branch retinal vein occlusion with edema. Although we recommended anti-VEGF injections, he reported that a similar episode improved without treatment about 10 years earlier. He therefore asked if we could initially refrain from treatment. The occlusion and edema slowly… Read More

This healthy 10YO boy presented with a 5-year history of blindness in his right eye. His mother said that he injured his eye after falling while playing at school. Color imaging of his right eye shows a white nerve and retinal vessels, a variably pigmented macular scar, and a moth-eaten appearance to the RPE outside… Read More

This 79YO female presented for a routine examination. ‘Successful’ macular hole surgery was performed elsewhere at least several years earlier. Optos color imaging shows multiple atrophic scars in the temporal macula with a smaller scar nasally. Swept-source OCT scanning through the most superior, larger scar shows outer retinal atrophy. OCT scans through each of the… Read More

This 61YO healthy female presented with sudden blurred vision immediately following forceful blowing of her nose 3 days earlier. Vision was 20/25 OU. Optos imaging shows bilateral superior suprachoroidal blood, which extends into the right macula and temporal periphery. Swept-source OCT through the macula hemorrhage shows hyporeflective suprachoroidal elevation. Observation was recommended, and we expect… Read More

This 40YO male developed sudden loss of vision in his left eye after sneezing 4 days earlier. Vision was 20/1200 OS. Fundus imaging shows a large sub-internal limiting membrane (ILM) hemorrhage covering the left macula. There is a rim of surrounding nerve fiber layer vs Henle’s blood. He underwent a YAG laser hyaloidotomy on the… Read More

This 10YO boy presented on 12/4/22 with acute blurred vision in his right eye. He was hospitalized 2 weeks earlier for a viral illness with musculoskeletal pain and fever. Vision was counting fingers OD and 20/20 OS. An afferent pupillary defect was noted OD. The right disc was moderately swollen, and milder disc swelling was… Read More

During a routine glaucoma examination, this 61YO male was found to have a halo choroidal nevus in his right eye. The nevus was hyperpigmented centrally, then encircled by relative depigmentation, and finally surrounded by a hyperpigmented rim. The lesion was clinically minimally thickened and measured about 2-3 disc diameters. The nevus was barely visible with… Read More

This 81YO female presented with 1 week of a temporal paracentral scotoma in her left eye. Vision was 20/50 OS. Color imaging shows an area of inner retinal opacification in the nasal macula. This area is hyperreflective on swept-source OCT. En face imaging shows another perspective for this lesion. Two months later, the retinal opacification… Read More