Daily Eye Story

Common Clinical Cases

in the field of

Ophthalmology

Collected by

Dr. Ahmed Mostafa Mosleh

2019
 Curriculum

Partition I Anterior Segments

1. CORNEA
2. Cataract
3. Lids & Conjunctiva
4. Orbit & Oculoplastic

Partition II Posterior Segments

1. RETINA
2. Uveitis
3. Tumors
4. Post-segment Surgery

Partition III Neuro & Glaucoma

1. NEURO
2. Glaucoma

Partition IV Pediatric & Squint

1. Pediatric
2. Genetic
3. Squint

Partition V Trauma & Systemic

1. Trauma
2. Systemic
 STORY INDEX
(Book Page numbers & Web Site Hyperlinks)

Partition I Anterior Segments

Section I. Cornea and External Disease

1. Acute Follicular Conjunctivitis—3

2. Chronic Follicular Conjunctivitis—7
3. Acute Bacterial Conjunctivitis—10
4. Pterygium—13
5. Recurrent Erosion/Epithelial Basement Membrane Dystrophy—16
6. Fuchs’Corneal Dystrophy—20
7. Keratoconus—23
8. Microbial Keratitis—27
9. Keratoconjunctivitis Sicca—Dry Eye—31
10. Postsurgical Corneal Edema—36
11. Dellen—41
12. Graft Rejection Following Penetrating Keratoplasty—44
13. Blepharitis—47

Section XI. Orbit/Oculoplastics

87. Ptosis—349
88. Thyroid Eye Disease—352
89. Ectropion—355
90. Entropion—357
91. Trichiasis—359
92. Dacryocystitis—361
93. Orbital Pseudotumor—363
94. Orbital Cellulitis—366
95. Dacryoadenitis—369
96. Orbital Tumors of Childhood—371
97. Orbital Tumors in Adults—374
98. Benign Tumors of the Eyelid—378
99. Malignant Tumors of the Eyelid—381

Section II. Lens

14. A Nearly Mature Cataract in a Patient with Glaucoma—53

15. Retained Lens Material After Cataract Extraction—57
16. Fibrin Deposition on Intraocular Lenses—61
17. Subluxated Crystalline Lens—64
18. Congenital Cataract—68

Cornea / External Eye Disease

Acanthamoeba Keratitis
Acute Corneal Hydrops
Adenoviral Conjunctivitis
Adult Chlamydial Conjunctivitis
Atopic Keratoconjunctivitis
Bilateral Corneal Edema Associated with Amantadine Use
Boston Keratoprosthesis
Calcific Band Keratopathy
Chandler Syndrome: A subtle presentation
Cogan's Syndrome
Congenital Aniridia
Conjunctival Melanoma arising from Primary Acquired Melanosis
(PAM)
Conjunctival rhinosporidiosis in a temperate climate
Corneal Endothelial Transplantation
Corneal Marginal Ulcer
Cystinosis: A 12-year-old boy with light sensitivity.
Cystinosis
Deep Lamellar Endothelial Keratoplasty (DLEK) for Fuchs
Descemet’s membrane endothelial keratoplasty (DMEK) for Fuchs’
endothelial dystrophy
Epithelial-Stromal and Stromal Corneal Dystrophies:
Erythema Multiforme:
The Evolution of Surgical Approaches to AlphaCor Keratoprosthesis
Insertion and Associated Complications
Exposure Keratopathy in the Critically Ill:
Fabry Disease:
Fuchs Endothelial Dystrophy
Fungal Keratitis - Fusarium
Granular Corneal Dystrophy Discovered Following LASIK: A
Clinicopathologic Correlation of Granular Corneal Dystrophy Type II
and LASIK.
Herpes Simplex Keratitis:
Infectious Crystalline Keratopathy (ICK):
Lattice Corneal Dystrophy Type II – Meretoja's Syndrome:
Laser Assisted Keratoplasty
Megalocornea
Ocular Cicatricial Pemphigoid
Ocular Manifestations of Stevens-Johnson Syndrome
Ocular Rosacea
Perioperative Corneal Abrasions: Systems-based review and analysis
Peripheral Ulcerative Keratitis (PUK):
Peters Anomaly
Phakic intraocular lenses for high myopia
Phlyctenular Keratoconjunctivitis
Posterior Polymorphous Corneal Dystrophy (PPMD)
Phacoemulsification: Considerations for Astigmatism Management
Pseudophakic Bullous Keratopathy:
Post LASIK Ectasia:
Salzmann's Nodular Corneal Degeneration
Surgical Management of Keratoconus
Superior Limbic Keratitis:
Thygeson's Superficial Punctate Keratitis:
Use of Ophthalmic Medications in Pregnancy:
Vernal Keratoconjunctivitis:
Verticillata
Vision Loss After Contact Lens-Related Pseudomonas Keratitis.
 Oculoplastic Surgery, Orbit, Eyelids, Lacrimal

Adenoid cystic carcinoma lacrimal gland:

Allergic Contact Dermatoblepharitis:
ANCA-associated granulomatous vasculitis (Wegener's
granulomatosis):
Basal Cell Carcinoma, Morpheaform subtype:
Bell's Palsy Treated with Facial Nerve Decompression:
Bilateral Nasolacrimal Duct Obstruction after Adjuvant I-131 for
Thyroid Cancer
Blepharospasm and Apraxia of Eyelid opening: "I Can't Open My Eyes":
Canalicular Laceration - Dog Bite:
Capillary Hemangioma:
Carotid Cavernous Fistula:
Cavernous Hemangioma: Painless Proptosis in a 62-year-old female:
Chalazion:
Chronic Progressive External Ophthalmoplegia (CPEO) - Kearns-Sayre
Syndrome:
Churg-Strauss Syndrome with Orbital Inflammation.
Ciliary Body Leiomyoma:
Congenital dacryocystocele with spontaneous resolution:
Congenital Ptosis.
Dermoid Cyst:
Distichiasis:
Enophthalmos Secondary to Metastatic Breast Cancer.
Enucleation and Evisceration: What to Expect:
Facial Nerve Palsy: Ocular Complications and Management.
Fibrous Dysplasia:
Floppy Eyelid Syndrome.
Giant reservoir formation from Ahmed seton valve.
Idiopathic Orbital Myositis:
Invasive Fungal Orbitorhinocerebral Mucormycosis
Involutional ectropion: Options for surgical management of ectropion.
Involutional entropion: options for surgical management of entropion.
Localized Orbital Amyloidosis Presenting as New-Onset Diplopia:
Lymphoma, Orbital.
Meningiomas.
Merkel Cell Carcinoma of the Eyelid.
Multiple endocrine neoplasia type 2B:
Myeloid Sarcoma:
Nasolacrimal duct obstruction secondary to sarcoidosis:
Nodular Basal Cell Carcinoma:
Oculopharyngeal muscular dystrophy:
Spontaneous Retrobulbar Hemorrhage with Subsequent Orbital
Compartment Syndrome.
Orbital Cellulitis in a Child:
Orbital Eosinophilic Granuloma:
Orbital inflammation secondary to bisphosphonate therapy:
Orbital Lymphatic Malformation (Lymphangioma):
Orbital Osteoma:
Periorbital Necrotizing Fasciitis.
Pan-endophthalmitis and Orbital Cellulitis:
Punctal and Canalicular stenosis (dacryostenosis) from Docetaxel
Sarcoidosis Affecting the Lacrimal Gland:
Sebaceous Cell Carcinoma:
Secondary Tumors After Hereditary Retinoblastoma:
Silent Brain Syndrome:
Silent Sinus Syndrome:
White-eyed blowout fracture:

Cataract

Anterior Chamber Cilium

Capsular Block Syndrome: An Unusual Presentation:
Cataract Formation after Pars Plana Vitrectomy.
Communication Issues Following a Post Operative Surprise
Endophthalmitis
Intraoperative Floppy Iris Syndrome:
Intralenticular Foreign Body:
Intraocular Foreign Body
Intraocular Lens "Time Out"
Marfan Syndrome:
Morgagnian Cataract:
Ocular Syphilis Presenting with Posterior Subcapsular Cataract and
Optic Disc Edema
Persistent Fetal Vasculature
Pembrolizumab (Keytruda®) Induced Uveitis in a Patient with
Metastatic Melanoma:
Phacoemulsification: Considerations for Astigmatism Management
Posterior capsular folds creating a Maddox rod effect following
cataract surgery
Posterior Polar Cataract.
Toxic Anterior Segment Syndrome (TASS):
Traumatic Cataract:
True Exfoliation Syndrome:
Partition II Posterior Segments

Section IV. Retina

31. Non-proliferative Diabetic Retinopathy—127

32. Diabetic Macular Edema—130
33. Proliferative Diabetic Retinopathy—134
34. Retinal Arterial Occlusion—138
35. Central Retinal Vein Occlusion—141
36. Branch Retinal Vein Occlusion—144
37. Atrophic Age-Related Macular Degeneration—148
38. Exudative Age-Related Macular Degeneration—152
39. Myopic Degeneration—157
40. Idiopathic Central Serous Chorioretinopathy—161
41. Epiretinal Membrane—165
42. Macular Hole—168
43. Vitreous Hemorrhage—172
44. Retinitis Pigmentosa—175

Section V. Uveitis

45. Choroiditis—181
46. Retinitis—185
47. White Dot Syndromes—188

Section VI. Tumors

48. Vascular Tumor—195

49. Choroidal Melanoma—199
Section VII. Posterior Segment Complications
50. Dislocated Posterior Chamber Intraocular Lens—207
51. Cystoid Macular Edema—211
52. Endophthalmitis—214
53. Suprachoroidal Hemorrhage—217

Retina & Vitreous

Acquired Ocular Toxoplasmosis:

Acquired Peripheral Retinoschisis:
Acute Zonal Occult Outer Retinopathy (AZOOR) and Acute Idiopathic
Blind Spot Enlargement Syndrome (AIBSE):
Age-related Macular Degeneration: Progression from Atrophic to
Proliferative:
Birdshot Choroiditis:
Behcet's Disease:
Branch Retinal Vein Occlusion:
Cat-Scratch neuroretinitis (Ocular bartonellosis):
Cataract Formation after Pars Plana Vitrectomy.
Central Retinal Artery Occlusion (CRAO):
Changing Trends in Sympathetic Ophthalmia:
Choroidal Hemangioma: Central scotoma in the right eye.
Choroidal Malignant Melanoma:
Choroidal Osteoma:
Chorioretinitis Sclopetaria:
Coats Disease:
Congenital Lymphocytic Choriomeningitis Virus (LCMV) infection:
Cytomegalovirus (CMV) Retinitis:
Full-thickness Macular Hole (FTMH):
Hydroxychloroquine (Plaquenil) Toxicity:
Interferon Retinopathy:
Idiopathic Juxtafoveal Telangiectasia Type II (Macular Telangiectasia
type 2):
Malattia Leventinese (Familial Dominant Drusen):
Multiple Evanescent White Dot Syndrome (MEWDS):
Optic Nerve Drusen:
Pattern Dystrophy Associated with Myotonic Dystrophy:
Polypoidal Choroidal Vasculopathy (PCV):
Progression of Proliferative Diabetic Retinopathy During Pregnancy.
Purtscher's Retinopathy:
Presumed Ocular Histoplasmosis (POHS):
Recurrent Neuroretinitis:
Retinal Artery Macroaneurysm (RAMA):
Retinal Dialysis:
Retinochoroidal coloboma:
Serpiginous Choroiditis:
Sickle Cell Retinopathy:
Unilateral Retinitis Pigmentosa:
Valsalva Retinopathy: Vision loss after asthma attack:
Vascular Tufts of the Pupillary Margin:
Vitamin A Deficiency and Nyctalopia:
Vitreous Syneresis: An Impending Posterior Vitreous Detachment
(PVD):
Waldenstrom Macroglobulinema-Associated Retinopathy:

Uveitis

Behcet's Disease:
Birdshot Choroiditis:
Churg-Strauss Syndrome with Orbital Inflammation.
Juvenile Idiopathic Arthritis with Associated Bilateral Anterior Uveitis
in a Four-year-old Girl.
TB Uveitis:
Tubulointerstitial Nephritis and Uveitis Syndrome (TINU)

Tumor / Oncology

Adenoid cystic carcinoma lacrimal gland:

Basal Cell Carcinoma, Morpheaform subtype:
Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP):
Capillary Hemangioma:
Cavernous Hemangioma:
Painless Proptosis in a 62-year-old female)
Ciliary Body Leiomyoma:
Cholesterol Granuloma:
Conjunctival Lymphoma:
Dermoid Cyst:
Enophthalmos Secondary to Metastatic Breast Cancer.
Fungal Endophthalmitis:
Iris-Ciliary Body Melanoma:
Iris Cyst:
Iris Melanoma:
Leiomyosarcoma:
Lymphoma, Orbital:
Melanocytoma of the Iris and Ciliary Body:
Meningiomas:
Merkel Cell Carcinoma of the Eyelid.
Myeloid Sarcoma:
Nodular Basal Cell Carcinoma:
Ocular Surface Squamous Neoplasia
Orbital Eosinophilic Granuloma.
Orbital Osteoma:
Painless Proptosis in a 62-year-old female:
Pituitary Adenoma Causing Compression of the Optic Chiasm:
Retinoblastoma:
Rhabdomyosarcoma:
Sarcoidosis Affecting the Lacrimal Gland:
Sebaceous Cell Carcinoma:
Partition III Neuro & Glaucoma

Section IX. Neuro-Ophthalmology

56. Optic Neuritis—235

57. Optic Disc Edema with Macular Star (Neuro-retinitis)—239
58. Anterior Ischemic Optic Neuropathy—Non-arteritic—241
59. Anterior Ischemic Optic Neuropathy—Arteritic—244
60. Progressive Optic Neuropathy—Tumor—247
61. Papilledema—Pseudotumor Cerebri—249
62. Visual Field Defect—Junctional Scotoma—253
63. Visual Field Defect—Pituitary Lesion—255
64. Visual Field Defect—Homonymous Hemianopia—257
65. Transient Monocular Visual Loss—260
66. Third Nerve Palsy—Ischemic—264
67. Third Nerve Palsy—Aneurysm—267
68. Fourth Nerve Palsy—Congenital—269
69. Sixth Nerve Palsy—272
70. Internuclear Ophthalmoplegia—274
71. Diplopia—Ocular Myasthenia Gravis—277
72. Thyroid Ophthalmopathy—281
73. Anisocoria—Tonic Pupil—285
74. Anisocoria—Horner’s Syndrome—287
75. Anisocoria—Eye Drops—290

Section III. Glaucoma

19. Ocular Hypertension—73

20. Open-Angle Glaucoma—76
21. Primary Angle-Closure Glaucoma—82
22. Pigmentary Glaucoma—87
23. Neovascular Glaucoma—90
24. Inflammatory Glaucoma—93
25. Primary Infantile Glaucoma—97
26. Ocular Hypotony—101
27. Post Trabeculectomy Wound Leak—106
28. Failing Filtering Bleb—110
29. Flat Anterior Chamber—113
30. Persistent Choroidal Detachment—119

Neuro-Ophthalmology

Acute Demyelinating Encephalomyelitis (ADEM) with associated optic

neuritis
All-trans retinoic acid (ATRA) induced intracranial hypertension in a
patient with acute promyelocytic leukemia:
ANCA-associated granulomatous vasculitis (Wegener's
granulomatosis):
Bilateral optic nerve hypoplasia, 2-month-old with:
Cavernous Sinus Syndrome Secondary to Pituitary Apoplexy:
Cranial Nerve IV (Trochlear Nerve) Palsy:
Dorsal Midbrain Syndrome (Parinaud's Syndrome) with Bilateral
Superior Oblique Palsy:
Dramatic Visual Recovery in Untreated Indirect Traumatic Optic
Neuropathy:
Ethambutol Toxicity and Optic Neuropathy:
Facial Nerve Palsy: Ocular Complications and Management.
Functional Visual Loss:
Horner's Syndrome (due to Cluster Headache):
Idiopathic Intracranial Hypertension (Pseudotumor Cerebri):
Idiopathic Orbital Myositis:
Internuclear Ophthalmoplegia:
Leber Hereditary Optic Neuropathy:
Myasthenia Gravis:
Neurofibromatosis Type 1 - Optic Nerve Glioma:
Nutritional Optic Neuropathy:
Ocular Tilt Reaction:
Ophthalmoplegic Migraine:
Optic Nerve Drusen:
Optic Nerve Hypoplasia:
Communicating with patients about alternative therapies:
Optic Neuritis:
Orbital inflammation secondary to bisphosphonate therapy:
Parkinson's disease: a review of the ophthalmological features:
Pituitary Adenoma Causing Compression of the Optic Chiasm:
Posterior Ischemic Optic Neuropathy:
Progressive Supranuclear Palsy in a Patient with Progressive Nonfluent
Aphasia:
Pseudoabducens palsy:
Recurrent Neuroretinitis:
Sarcoidosis:
Ocular Sarcoidosis
See-Saw Nystagmus:
Spinocerebellar Ataxia with Ophthalmoplegia:
Thyroid Eye Disease (Graves' ophthalmopathy):
Successive Presentation of Arteritic and Non-arteritic Anterior Ischemic
Optic Neuropathy:
Tumor Necrosis Factor Alpha Antagonist Precipitating Demyelinating
Disease:
Unilateral Optic Nerve Hypoplasia in a patient desiring surgical
treatment for exotropia.
Vertical Oscillopsia: A Case of Superior Oblique Myokymia.

Glaucoma / Iris

Aphakic Glaucoma:
Aqueous Misdirection:
Bilateral sequential aqueous misdirection: an overview of medical and
surgical management
Blebitis:
Cogan-Reese Syndrome: A Rare Case of Unilateral Glaucoma:
Competition Leads to Healthcare Savings:
Giant reservoir formation from Ahmed seton valve
Grant syndrome (Syndrome of precipitates on the trabecular
meshwork):
Hypotony: Late hypotony from trabeculectomy and Ahmed seton with
resulting hypotony maculopathy:
Iris Cyst:
Iris Melanoma:
Iridocorneal Endothelial Syndrome (ICE) - essential iris atrophy:
Juvenile open-angle glaucoma:
Melanocytoma of the Iris and Ciliary Body:
Neovascular Glaucoma:
Normal Tension Glaucoma:
Pigmentary Glaucoma:
Phacolytic Glaucoma:
Plateau Iris:
Posner-Schlossman Syndrome:
Primary Congenital Glaucoma (Infantile Glaucoma)
Pseudoexfoliation Glaucoma
Refractory Primary Open-Angle Glaucoma Treated with Ab Interno
Canaloplasty (ABiC):
Secondary Open-Angle Glaucoma Treated with Gonioscopy-Assisted
Transluminal Trabeculotomy (GATT).
Seton Infection
Sturge-Weber Syndrome:
Partition IV Pediatric & Squint

Section X. Pediatrics

76. Leukocoria—295
77. The Child Who Sees Poorly Out of One Eye—299
78. Childhood Torticollis—304
79. Aniridia—309
80. Retinopathy of Prematurity—313
81. Childhood Esotropia—318
82. Childhood Exotropia—324
83. Childhood Ptosis—329
84. The Apparently Blind Infant—334
85. Optic Nerve Hypoplasia—338
86. Childhood Optic Pathway Glioma—342

Pediatric Ophthalmology & Strabismus

Acute Acquired Brown Syndrome:

Anisometropic Amblyopia.
2-month-old with bilateral optic nerve hypoplasia:
Capillary Hemangioma:
Chalazion:
Coats Disease:
Congenital dacryocystocele with spontaneous resolution:
Congenital Lymphocytic Choriomeningitis Virus (LCMV) infection:
Congenital Ptosis.
Convergence Insufficiency:
Dermoid Cyst:
Down Syndrome:
Duane Retraction Syndrome:
Goldenhar Syndrome (Oculo-Auriculo-Vertebral Spectrum):
Holoprosencephaly and Strabismus.
Infantile (Congenital) Esotropia:
Juvenile Idiopathic Arthritis with Associated Bilateral Anterior Uveitis
in a Four-year-old Girl.
Localized Orbital Amyloidosis Presenting as New-Onset Diplopia:
Management of Amblyopia:
Monofixation Syndrome:
Non-accidental Trauma:
Non-accommodative Esotropia and Botulinum Toxin Therapy:
Orbital Cellulitis in a Child:
Orbital Eosinophilic Granuloma.
Orbital Lymphatic Malformation (Lymphangioma):
Parkinson's disease: a review of the ophthalmological features:
Prostaglandin-Associated Periorbitopathy: Progressive glaucoma and
periorbital changes.
Refractive Accommodative Esotropia.
Retinoblastoma:
Rhabdomyosarcoma:
Sagging Eye Syndrome.
Unilateral Optic Nerve Hypoplasia in a patient desiring surgical
treatment for exotropia.
Vernal Keratoconjunctivitis:

Genetic Eye Disease

Autosomal Dominant Optic Atrophy

Best Vitelliform Macular Dystrophy
Homocystinuria:
Juvenile open-angle glaucoma:
Lattice Corneal Dystrophy Type II – Meretoja's Syndrome:
Leber Hereditary Optic Neuropathy:
Malattia Leventinese (Familial Dominant Drusen):
Pattern Dystrophy Associated with Myotonic Dystrophy
RPE65-associated Leber Congenital Amaurosis
Unilateral Retinitis Pigmentosa
Partition V Trauma & Systemic

Section VIII. Trauma

54. Ruptured Globe—223
55. Intraocular Foreign Body—227

Trauma

Canalicular Laceration - Dog Bite:

Carotid Cavernous Fistula:
Chorioretinitis Sclopetaria:
Firework-Related Ocular Injuries:
Intralenticular Foreign Body:
Intraocular Foreign Body:
Patient Non-Compliance:
Purtscher's Retinopathy:
Traumatic Cataract:
White-eyed blowout fracture:

Systemic Disorders

Accelerated Hypertension :
Congenital Lymphocytic Choriomeningitis Virus (LCMV) infection:
Cystinosis: A 12-year-old boy with light sensitivity.
Herpes Zoster Post-herpetic Neuralgia:
Interferon Retinopathy:
Invasive Fungal Orbitorhinocerebral Mucormycosis
Juvenile Idiopathic Arthritis with Associated Bilateral Anterior Uveitis
in a Four-year-old Girl.
Kayser-Fleischer Ring:
Kyphotic Patient Presents for Cataract Surgery:
Metastatic Choroidal Lesion:
Minocycline-Induced Hyperpigmentation.
Multiple endocrine neoplasia type 2B:
Myasthenia Gravis:
Ocular Rosacea:
Ocular Sarcoidosis:
Sarcoidosis
Ocular Syphilis Presenting with Posterior Subcapsular Cataract and
Optic Disc Edema:
Orbital inflammation secondary to bisphosphonate therapy:
Sarcoidosis Affecting the Lacrimal Gland:
TTP-HUS:
Unilateral Optic Nerve Granuloma:
Vitamin A Deficiency and Nyctalopia:

Vascular Disorders

ANCA-associated granulomatous vasculitis (Wegener's

granulomatosis):
Carotid Cavernous Fistula:
Cavernous Hemangioma: Painless Proptosis in a 62-year-old female:
Retinal Artery Macroaneurysm (RAMA):

The END