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Jun 13 2019 by Prithvi Chandrakanth

42-year-old, male came with chief complaints of diminished vision and floaters in right eye for past one week. On fundus examination noted to have subretinal haemorrhage and edema at the posterior pole and a subretinal live mobile worm at the periphery. Laser photocoagulation done followed by pars plana vitrectomy.

Photographer: Dr.PRITHVI CHANDRAKANTH, Dr.CHANDRAKANTH MALABAR NETHRALAYA, KOZHIKODE

Imaging device: TRASH TO TREASURE RETCAM - SMARTPHONE FUNDUS CAMERA DEVICE

Condition/keywords: laser photocoagulation, smartphone fundus photography, subretinal hemorrhage, uveitis, worm

Jun 12 2019 by Feyene Art

This is an oil on canvas painting inspired by a fundus photograph of a congenital prepaillary arterial loop with figure of eight configuration by Tammy Mclaughlin at the Carolina Retina Center. (https://imagebank.asrs.org/file/29690/congenital-prepapillary-arterial-loop-with-a-figure-of-eight-configuration).

Photographer: Feyene Art

Imaging device: Oil on Canvas Painting

Condition/keywords: arterial loop, congenital

Jun 12 2019 by Unnati Shukla, M. S. Ophthalmology, DNB, FVRS.

A young female patient of Indian origin on oral contraceptive medication presenting with central retinal artery occlusion with cilioretinal artery sparing.

Photographer: Unnati Shukla, C.H. Nagri Eye Hospital, NHL medical college, Ahmedabad,Gujarat,India.

Condition/keywords: central retinal artery occlusion (CRAO), cherry red spot, cilioretinal sparing

Jun 10 2019 by Prithvi Chandrakanth

Asymptomatic 65-year-old female, an incidental finding of inferior retinal detachment on evaluation for cataract surgery.

Photographer: Dr.Prithvi Chandrakanth, Dr.Chandrakanth Malabar Nethralaya, Kozhikode, India.

Imaging device: TRASH TO TREASURE RETCAM

Condition/keywords: retina, retinal detachment, smartphone fundus photography

Jun 4 2019 by Unnati Shukla, M. S. Ophthalmology, DNB, FVRS.

A young female patient of Indian origin on Oral Contraceptive medication presenting with Central Retinal Artery Occlusion with Cilioretinal artery Sparing.

Photographer: Unnati Shukla, C.H. Nagri Eye Hospital, NHL medical college, Ahmedabad,Gujarat,India.

Condition/keywords: central retinal artery occlusion (CRAO), cherry red spot, cilioretinal sparing, pale retina

Jun 3 2019 by Nelson Chamma Capelanes, MD

SD-OCT of a 32-year-old woman showing a subfoveal choroidal excavation associated with chronic central serous chorioretinopathy.

Photographer: NELSON CHAMMA CAPELANES, PROMACULA, BRAZIL

Imaging device: HEIDELBERG SPECTRALIS

Condition/keywords: central serous chorioretinopathy (CSCR), choroidal excavation, pachychoroid

Jun 2 2019 by Nelson Chamma Capelanes, MD

SD-OCT of a 32-year-old woman showing a subfoveal choroidal excavation associated with chronic central serous chorioretinopathy.

Photographer: Nelson Chamma Capelanes, Promacula, Brazil

Imaging device: Heidelberg Spectralis SD-OCT

Condition/keywords: choroidal excavation, chronic central serous chorioretinopathy (CSCR), pachychoroid

Jun 1 2019 by John S. King, MD

39-year-old African American female with central scotoma two days since blunt head injury in MVA, sent for evaluation of macular hole. 20/150 OS with IOP 12 and no RAPD. No macular hole present. Macular findings include commotio retinae and subfoveal hemorrhage.

Photographer: Stacey Coleman

Imaging device: Topcon

Condition/keywords: blunt trauma, commotio retinae, macular pseudohole, subretinal hemorrhage

Jun 1 2019 by John S. King, MD

18-year-old African American female with increased BMI with a history of headaches, nausea, transient diplopia and vision loss that she notices when getting up from her bed (and goes away after standing upright) for the last two weeks. Went to PCP and was treated for the flu, and after no improvement and visual symptoms known, was sent to ED. MRI did not show any masses and showed empty sella turcia. Vision 20/30 OD and 20/20 OS; no RAPD; IOP 15OU; no anterior segment or vitreous inflammation; discs are elevated with obscuration of the disc margins and some of the smaller vessels; there are no SVPs; there are mild Patton's lines temporally (see initial photos). The optic disc cube shows 360 degrees of RNFL thickening (see OCT). Was referred to near-ophthalmologist, Dr. Doyle. She obtained additional work-up, and LP opening pressure was high, and MRV showed bilateral transverse sinus stenosis. Patient showed steady improvement with medical therapy, that included weight loss and oral diamox. On her last visit with Dr. Doyle, vision has remained stable at 20/20-20/25 without an enlarged blindspot; there are SVPs and optic disc edema has resolved (see post treatment photos); she is currently on 1000 mg of diamox and has lost 15 pounds, and no stinting procedure needed.

Condition/keywords: idiopathic intracranial hypertension, transverse sinus stenosis

Jun 1 2019 by John S. King, MD

18-year-old African American female with increased BMI with a history of headaches, nausea, transient diplopia and vision loss that she notices when getting up from her bed (and goes away after standing upright) for the last two weeks. Went to PCP and was treated for the flu, and after no improvement and visual symptoms known, was sent to ED. MRI did not show any masses and showed empty sella turcia. Vision 20/30 OD and 20/20 OS; no RAPD; IOP 15OU; no anterior segment or vitreous inflammation; discs are elevated with obscuration of the disc margins and some of the smaller vessels; there are no SVPs; there are mild Patton's lines temporally (see initial photos). The optic disc cube shows 360 degrees of RNFL thickening (see OCT). Was referred to near-ophthalmologist, Dr. Doyle. She obtained additional work-up, and LP opening pressure was high, and MRV showed bilateral transverse sinus stenosis. Patient showed steady improvement with medical therapy, that included weight loss and oral diamox. On her last visit with Dr. Doyle, vision has remained stable at 20/20-20/25 without an enlarged blindspot; there are SVPs and optic disc edema has resolved (see post treatment photos); she is currently on 1000 mg of diamox and has lost 15 pounds, and no stinting procedure needed.

Condition/keywords: idiopathic intracranial hypertension, transverse sinus stenosis

Jun 1 2019 by John S. King, MD

84-year-old white female with acute loss of vision in the left eye one day ago was sent here after going to the ED per primary eye provider. She described vision loss as a grey curtain that became total darkness. She had left sided temporal tenderness and some left sided neck pain. In the ED the cardiac work-up was u/r, the ESR and CRP were normal, and the CTH showed some non-specific opacification in the L ethmoid sinus. Acuity was HM OS with RAPD, normal EOMs, no proptosis or ptosis, posteriorly no SVPs were noted; the optic discs were pink and flat; no emboli or retinal whitening present; some bear tracks located nasally (see photo). She was referred to Dr. Doyle, who ordered an MRI, which showed a large mucocele with bony erosion into the left orbit, along with some ON enhancement possibly from compression (see images). She was operated that night and later recovered to 20/40 in that eye with a residual, inferior arcuate scotoma.

Condition/keywords: bear tracks, optic neuropathy

Jun 1 2019 by John S. King, MD

84-year-old white female with acute loss of vision in the left eye one day ago was sent here after going to the ED per primary eye provider. She described vision loss as a grey curtain that became total darkness. She had left sided temporal tenderness and some left sided neck pain. In the ED the cardiac work-up was u/r, the ESR and CRP were normal, and the CTH showed some non-specific opacification in the L ethmoid sinus. Acuity was HM OS with RAPD, normal EOMs, no proptosis or ptosis, posteriorly no SVPs were noted; the optic discs were pink and flat; no emboli or retinal whitening present; some bear tracks located nasally (see photo). She was referred to Dr. Doyle, who ordered an MRI, which showed a large mucocele with bony erosion into the left orbit, along with some ON enhancement possibly from compression (see Images). She was operated that night and later recovered to 20/40 in that eye with a residual, inferior arcuate scotoma.

Condition/keywords: bear tracks, optic neuropathy

Jun 1 2019 by John S. King, MD

84-year-old white female with acute loss of vision in the left eye one day ago was sent here after going to the ED per primary eye provider. She described vision loss as a grey curtain that became total darkness. She had left sided temporal tenderness and some left sided neck pain. In the ED the cardiac work-up was u/r, the ESR and CRP were normal, and the CTH showed some non-specific opacification in the L ethmoid sinus. Acuity was HM OS with RAPD, normal EOMs, no proptosis or ptosis, posteriorly no SVPs were noted; the optic discs were pink and flat; no emboli or retinal whitening present; some bear tracks located nasally (see photo). She was referred to Dr. Doyle, who ordered an MRI, which showed a large mucocele with bony erosion into the left orbit, along with some ON enhancement possibly from compression (see images). She was operated that night and later recovered to 20/40 in that eye with a residual, inferior arcuate scotoma.

Photographer: Karin Aletter

Imaging device: Topcon 50

Condition/keywords: bear tracks, optic neuropathy

May 27 2019 by John S. King, MD

Two small, yellow, choroidal lesions can be seen above the nerve and IT arcade can be seen that have regressed compared to the initial photos. Vision 20/20.

Photographer: Shelly Blair

Imaging device: Optos CA

Condition/keywords: choroidal metastasis, lung cancer metastasis

May 27 2019 by John S. King, MD

60-year-old white male non-smoker presented to Dr. Zocchi with acute transient decreased vision in the right eye. Background history includes metastatic NSCLC (adenocarcinoma). Acuity OD 20/60, and posterior segment had two small, yellow, choroidal lesions, above the nerve and IT arcade (these had a fairly smooth and dome shaped appearance on the OCT, and top lesion had mild SRF) (see photo)

Photographer: Shelly Blair

Imaging device: Optos CA

Condition/keywords: choroidal metastasis, lung cancer metastasis

May 27 2019 by John S. King, MD

14-year-old African American female who is asymptomatic, without any hx/fhx of FAP. One lesion seen in the mid-periphery of the right eye that is oval in shape, and has a "tail" (points to ora), and has the appearance and size of lesions described by Dr. Shields as torpedo maculopathy. I did ask Dr. Carol Shields about the case, and she said it is possible that this is a similar lesion in an odd location and noted that Gass published on one superiorly.

Photographer: Shelly Blair

Imaging device: Optos CA

Condition/keywords: lesion, torpedo maculopathy

May 27 2019 by John S. King, MD

45-year-old female with a history of gastric bypass surgery, who was referred to Dr. Zocchi for as a possible choroidal dystrophy; patient had severe nyctalopia that had progressed over a year; acuity was 20/20 OU with normal IOP and A/C findings. The posterior segment showed multiple yellow-white punctate dots in the mid-periphery and periphery (see photo). Findings were consistent with probable vitamin A deficiency. Patient was started on Vit A, and levels were found to be very low. Follow up is in a month.

Photographer: Shelly Blair

Imaging device: Optos CA

Condition/keywords: fleck retinopathy, malabsorption, nyctalopia, vitamin A deficiency, xerophthalmia

May 27 2019 by John S. King, MD

45-year-old female with a history of gastric bypass surgery, who was referred to Dr. Zocchi for as a possible choroidal dystrophy; patient had severe nyctalopia that had progressed over a year; acuity was 20/20 OU with normal IOP and A/C findings. The posterior segment showed multiple yellow-white punctate dots in the mid-periphery and periphery (see photo). Findings were consistent with probable vitamin A deficiency. Patient is getting vitamin levels checked by PCP and started on vitamin A, and will be seen back in a month.

Photographer: Shelly Blair

Imaging device: Optos CA

Condition/keywords: fleck retinopathy, malabsorption, nyctalopia, vitamin A deficiency, xerophthalmia

May 27 2019 by John S. King, MD

60-year-old African American female who had been treated for iridocyclitis for at least a week sent in for vitritis and a nasal fundus lesion. Complaints included redness, floaters, photophobia, and decreased vision. Husband had recent shingles. Acuity was 20/60-2 with IOP of 12, and small KP in Art's triangel, 1-2+ a/c cell, 2-3+ ant vit cell, diffuse arteriolar sheathing, multiple areas of retinal whitening in periphery and mid-periphery (see Photo #1). PCR of a/c was performed, and intravitreal GCV administered, and VACV 2g qid and ASA started.... PCR positive for HZV, pred taper was started two days after presentation as the infection had begun to stablize..... Five days from presentation the vision was 20/60, inflammation and areas of retinal whitening had improved (see Photo #2).... One week later acuity was 20/30, the a/c was quiet and KP resolved; ant vitreous cell decreased; and there was further improvement in retinal appearance without any signs of retinal holes or detachment; she is now on low dose maint VACV (see photo#3)

Photographer: Maysee Yang

Imaging device: Optos CA

Condition/keywords: acute retinal necrosis, Herpes zoster

May 27 2019 by John S. King, MD

60-year-old African American female who had been treated for iridocyclitis for at least a week sent in for vitritis and a nasal fundus lesion. Complaints included redness, floaters, photophobia, and decreased vision. Husband had recent shingles. Acuity was 20/60-2 with IOP of 12, and small KP in Art's triangel, 1-2+ a/c cell, 2-3+ ant vit cell, diffuse arteriolar sheathing, multiple areas of retinal whitening in periphery and mid-periphery (see Photo #1). PCR of a/c was performed, and intravitreal GCV administered, and VACV 2g qid and ASA started.... PCR positive for HZV, pred taper was started two days after presentation as the infection had begun to stablize..... Five days from presentation the vision was 20/60, inflammation and areas of retinal whitening had improved (see Photo #2).... One week later acuity was 20/30, the a/c was quiet and KP resolved; ant vitreous cell decreased; and there was further improvement in retinal appearance without any signs of retinal holes or detachment; she is now on low dose maint VACV (see photo#3)

Photographer: Maysee Yang

Imaging device: Optos CA

Condition/keywords: acute retinal necrosis, Herpes zoster