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This 42YO state trooper presented with a few months of vision loss in his right eye, including significant glare with headlights. He reported a history of excellent vision throughout his life. Vision was 20/200 OD and 20/20 OS. He had 3+ nuclear/cortical spoke cataracts consistent with this vision loss. Slit lamp examination shows an inferior… Read More

This 34YO male was referred for relatively asymptomatic retinal findings. He had complained of some blurred distance vision for several years. Vision was 20/25 OU. Optos color imaging shows fairly normal maculas with midperipheral encircling pigment loss and intraretinal pigment migration. Fundus autofluorescence (FAF) shows a bull’s-eye-shaped area of macular hyper-FAF, and areas of midperipheral… Read More

This 69YO male presented with asymptomatic vision loss in his left eye. Vision was 20/30 OD and counting fingers OS. A small central scar with fluid was present in the left macula (initial photo not shown). OCT scanning shows a shallowly elevated type 1 macular neovascularization with associated subretinal fluid. An intravitreal Avastin injection was… Read More

The preretinal blood in this 70YO male with proliferative diabetic retinopathy (PDR) has multiple layers. The red arrow highlights subhyaloid blood, while the yellow arrow shows the yellowing, devitalized subhyaloid blood just above. The blue arrow shows subhyaloid blood emanating from disc neovascularization. Last but not least, the twister of blood within the vitreous gives… Read More

This 72YO male presented with unilateral asteroid hyalosis in his left eye. Vision was 20/40 OS with mildly symptomatic floaters. Retinal examination was extremely difficult due to the dense asteroid, although the fundus appeared normal. Learning Points: Asteroid hyalosis is caused by calcium-lipid complexes suspended throughout the vitreous. The condition gets its name from the… Read More

This healthy 34YO male presented with this relatively asymptomatic central retinal vein occlusion (CRVO). Vision was 20/20 OU. Color imaging shows large temporal nonperfused retinal vessels with old inferior yellow vitreous hemorrhage. The retinal vessels are diffusely dilated and tortuous. OCT B-scan shows a remarkably normal central macula with some distal inner retinal thinning. Fluorescein… Read More

This 56YO male presented with a long history of vision loss and night blindness. Vision was counting fingers bilaterally. Optos imaging shows severe, bilateral diffuse chorioretinal atrophy with some scattered large clumps of pigmentation. OCT scanning of the right eye shows diffuse thinned, disorganized retina and no choroidal structures. OCT scan of the left eye… Read More

This 83YO female underwent cataract extraction for a hypermature lens. The posterior capsule tore, and a large lens fragment fell posteriorly. A 3 piece intraocular lens was successfully placed in the sulcus at the time of surgery. She had previously received multiple intravitreal injections from multiple outside providers for exudative macular degeneration. We have no… Read More

This 34YO female presented with a symptomatic ruptured retinal arterial macroaneurysm (RAM). Vision was counting fingers due to the inferior sub-internal limiting membrane blood obscuring the underlying fovea. More peripherally, blood is staining the surrounding nerve fiber layer. The fibrosed RAM is visible superiorly. Learning Points: A RAM is thought to occur in a weakened… Read More

This is just a great image of a melanocytoma! Unfortunately, we don’t have any clinical information for this patient. Learning Points: Melanocytomas are benign melanocytic tumors intrinsic to the optic nerve. They are intensely pigmented with feathery margins, sometimes spreading into the adjacent retina and choroid. Although they may enlarge over time, malignant transformation is… Read More