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Autoimmune Retinopathy

History of Present Illness A 63-year-old woman presents with small light flashes in both eyes (OU) that interfere with her ability to see. The flashes have different color patterns. She especially has difficulty seeing in bright lighting. Exam OD OS Visual acuity 20/25 20/25 Intraocular pressure (IOP) 19 19 Sclera/conjunctiva Normal Normal Cornea Normal Normal Anterior chamber (AC) Normal Normal Iris Normal Normal Lens 1+ nuclear…

Birdshot Retinochoroidopathy (BRC)

History of Present Illness A 53-year-old Caucasian male was referred to a tertiary uveitis care unit for chronic bilateral floaters and blurred vision in both eyes (OU). He noticed the floaters for the first time over a year ago but was not worried until his vision started to drop with concomitant distorted vision, 3 weeks before the consultation. His medical history includes tonsillectomy during childhood (…

Uveitis with Subretinal Fibrosis Syndrome (USF)

History of Present Illness A 33-year-old woman with no significant past medical history presents to the eye clinic complaining of slowly progressive decreased vision over the past 6 months. She notes that it first started in her left eye (OS) with mild sensitivity to light, followed by blurred vision. She has not noticed similar symptoms in her right eye (OD). Because her vision has gotten progressively…

Relentless (Ampiginous) Placoid Chorioretinitis

History of Present Illness A 62-year-old man noticed difficulty shooting his rifle when looking through the mount with his left eye (OS) 1 week ago. Over the next few days he observed floaters and paracentral scotomas OS. Since then he has been testing his vision and noticed that similar changes have occurred in the right eye (OD). He had no history of systemic illness and was…

Serpiginous Choroidits

History of Present Illness A 68-year-old man presents with 2-week history of painless unilateral loss of vision in the left eye (OS). He noticed a paracentral scotoma OS, and while hunting with a shotgun just realized that he has no central vision right eye (OD). He denies photophobia, photopsia, or floaters in either eye . Exam OD OS Visual acuity 5/400 20/40 Intraocular pressure (IOP) (mm…

Multiple Evanescent White Dot Syndrome (MEWDS)

History of Present Illness A 25-year-old woman developed a “flulike” illness 4 weeks ago. In the past 48 hours she suddenly developed painless loss of vision in the left eye (OS) without redness or photophobia. She noticed a small blind spot and shimmering lights (photopsias) in her temporal visual field. The night before her loss of vision, she attended a party and snorted cocaine for the…

Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE)

History of Present Illness A 21-year-old college student was studying for finals in May and noticed a sudden decrease in vision in both eyes (OU). He had never experienced visual problems before and recently finished studying for the Medical College Admission Test (MCAT), so he wondered whether his symptoms were the result of stress. He is athletic and on the college basketball team. Exam OD OS…

Punctate Inner Choroidopathy (PIC)

History of Present Illness A 39-year-old woman with no significant past medical history presents to the eye clinic for the first time complaining of blurred central vision right eye (OD), with photopsias and a central blind spot (scotoma) of 1 week duration. Exam OD OS Visual acuity 20/60 20/20 Intraocular pressure (IOP) 11 10 Sclera/conjunctiva Within normal limits (WNL) WNL Cornea Clear Clear AC No cell…

Sarcoidosis

History of Present Illness A 34-year-old African American female complains of decreasing vision in both eyes (OU) over the past year, with no previous history of ocular disease. She denies ocular redness, pain, or photophobia. However, she does complain of a dry mouth and mild dyspnea when walking up four flights of stairs. Her past history is otherwise unremarkable. Exam OD OS Visual acuity 20/60 20/40…

Common Variable Immunodeficiency with Granulomatous Panuveitis

Cutaneous nodules, granulomatous uveitis and oligoarthritis in child History of Present Illness A 5-year-old girl presented with a complaint of red eye and blurred vision left eye (OS) for the past 4 months. She had a history of pneumonia at 4 years of age, which required hospitalization. Shortly afterward she developed a swollen, painful right knee and left interphalangeal joint. For the past 6 months, erythematous,…

Multifocal Choroiditis with Panuveitis

History of Present Illness A 25-year-old woman with no past medical history and a long-standing history of myopia presents for the first time to the eye clinic complaining of distorted vision in her right eye (OD). She first noticed that her vision was a little blurry about a month ago, which also coincided with more floaters than she is used to. She had assumed that these…

Posterior Scleritis

History of Present Illness A 75-year-old female with past medical history significant for hypertension, chronic kidney disease, and a prior carotid endarterectomy of the left internal carotid presented with acute-onset blurry vision, tearing, eye pain, and redness of the right eye (OD). Exam OD OS Visual acuity 20/25−2 20/20−2 Intraocular pressure (IOP) 14 14 Sclera/conjunctiva White and quiet White and quiet Cornea Clear Clear Anterior chamber…

Eales Disease

History of Present Illness A 33-year-old male, born in Sri Lanka, who has lived in Switzerland since 2013, presents himself at the eye clinic complaining of vision loss for 4 months in his left eye (OS). He just returned from a holiday in Sri Lanka. When the symptoms started, he noticed blurred vision, followed by floaters and a feeling of pressure in his OS. At the…

Intraocular Foreign Body and Uveitis

History of Present Illness “ CC: I think something is in my left eye!” A backyard gate was closed with a chain and lock. The combination to the lock was lost, and so a 54-year-old man used a hammer and chisel in an attempt to break a link in the chain. After hitting the steel chisel with a hammer, he felt a sharp pain in the…

Retinoblastoma

History of Present Illness A 13-year-old boy presented with a history of decreased vision and pain in the right eye (OD) for the past 2 months. He reported a history of blunt trauma to this eye around the time his symptoms began. He had been treated for a presumed traumatic uveitis for the past 2 months. Exam OD OS Visual acuity 20/30 20/20 Intraocular pressure (IOP)…

Amyloidosis

History of Present Illness A 27-year-old woman complained of decreased vision in both eyes (OU) for the past 30 days, which was gradual in onset and painless. She has also had numbness and a tingling sensation in both feet for about 6 months. She then developed a trophic ulcer in her right foot after painless swelling. Exam OD OS Visual acuity 20/80 20/80 Intraocular pressure (IOP)…

Lyme Disease

History of Present Illness A 28-year-old male presents with gradually worsening vision and floaters in both eyes (OU) for several weeks. There is mild redness, pain, and sensitivity to light. Past medical history is unremarkable except that he recently developed joint and muscle aches after returning from a camping trip in Delaware. Exam OD OS Visual acuity 20/50 20/40 Intraocular pressure (IOP) 12 14 Sclera/conjunctiva Trace…

Pars Planitis

History of Present Illness A 15-year-old healthy boy with no past medical history presents for the first time to the eye clinic complaining of blurred vision in his left eye (OS). He noticed some change about a month ago and now notices a significant difference between the two eyes, especially when he plays football. He also complains of floating spots in the OS ( Figs. 21.1…

Toxic Anterior Segment Syndrome

History of Present Illness (HPI) A 70-year-old woman presents for her postoperative day 1 appointment after cataract surgery right eye (OD). She underwent an uncomplicated phacoemulsification with implantation of a one-piece intraocular lens into the capsular bag. She complains of some foreign body sensation and mild discomfort but otherwise no significant pain. After taking off her shield, she immediately complains that her vision is significantly worse…

Iris Mass and Panuveitis in a Child

History of Present Illness A 4-year-old healthy male with no past medical history presents to the eye clinic complaining of redness of the right eye (OD) for 2 weeks. He had been placed on topical prednisolone four times a day (QID) OD without improvement. Exam OD OS Visual Acuity Fix and follow Fix and follow Intraocular pressure (IOP) 16 14 Sclera/conjunctiva Conjunctival congestion inferiorly White and…