RETENTION CYST

This is a fluid-filled, thin-walled cyst in the underside of the eyelid. It is benign, causes no harm, and usually does not need to be treated. It can be drained if it is bothersome to the patient.

LUPUS

Lupus is an autoimmune disease that can cause vasculitis as pictured here. It is inflammation in the blood vessels of the eye that can cause lack of oxygen getting to the retina. This results in loss of vision.

CONJUNCTIVAL GRANULOMA

This lesion under the eyelid caused this patient to literally cry blood from their eye. It is a painless, harmless, vascularized lesion that can be easily removed.

GLAUCOMA

This is the optic nerve of one of my favorite patients. She has severe glaucoma with visual field loss. She is quite young and so must be treated very aggressively. Unfortunately she recently became sensitive to one of the most common glaucoma drops. But this can be managed with other options.

The crater in the middle of the optic nerve is called the optic "cup". The worse the glaucoma the deeper the cup. This is a very deep cup. The picture really doesn't do it justice because you would have to see it in 3-D.

CHRPE

This is CHRPE which stands for congenital hypertrophy of the retinal pigment epithelium. It is just a pigment spot on the inside wall of the eye. There is no risk of conversion to melanoma. It is just an interesting looking spot on the eye.

IRIS STRAND

This is an interesting finding in the same patient below. This is an iris strand that goes from one end of the iris, across the pupil, to the other end. It's sort of like a cobweb. It will not cause any harm and is not associated with any diseases of the eye as far as I know. It's just cool!

CORNEAL BLOOD VESSEL GROWTH

This is another case of a patient who overwears their contact lenses. They do not have a back up pair of glasses that they like. These blood vessels should not be growing here, and if nothing changes, eventually she may have problems with corneal ulcers and episodes of severe pain and light sensitivity. This patient got good glasses to wear. On a follow-up 6 months down the road, if the blood vessels aren't better, we'll go to the highest O2 breathing lens.

TILTED OPTIC NERVE

The bottom picture is of the optic nerve in the right eye of this young patient. The top one is the left eye. The one on top is tilted because the optic nerve enters the eyeball obliquely. This will cause no harm to the patient, except she see's 20/20 at distance with the right and 20/400 in the left. She is really near sighted in the left eye however but see's 20/20 up close in that eye. If her eyes don't change, she'll never need bifocals when she's past 45 years old.

PINGUECULA

This is a pinguecula. It is a type of scar tissue that develops from chonic exposure to UV light, dust, and wind. It is believed that it is mostly light from the side that causes this, so it is very important to have good sunglasses that wrap around and block the sides. We carry Kaenons and Rudy Projects as well as others, like Ray Bans, and Maui Jims. Kaenons are the best! Lightweight, really stylish, polarized, with anti-reflection on back side so you don't see your eyes.

HYPHEMA

This patient got hit by a pellet gun, causing a laceration (or abrasion) on the conjunctiva and a hyphema (bleeding in the anterior chamber).

OCULAR HYPERTENSION, GLAUCOMA SUSPICION

These are the right and left optic nerves of a patient with intraocular pressures of 25mmHg in each eye. Average pressure in a person's eye is 15mmHg. This patient has slightly thicker corneas than average, indicating that true intraocular pressure is a little bit lower than clinically measured intraocular pressure. The deeper and width of the cupping of the optic nerve, which corresponds a little beyond the whitened center in the photos below, the higher the risk or suspicion of glaucoma. This patient requires a visual field test and possibly some other tests to determine if the optic nerve is having any damage from the higher intraocular pressure. Those tests should be performed within 3 months for this patient.

MILD OR EARLY MACULAR DEGENERATION

There are a few small pigment spots in the "macular" area of this retina. There is no vision loss in this patient.

MARGINAL KERATITIS

Here you can see a subepithelial infiltrate which is a collection of white blood cells in response to inflammation. This is in a contact lens wearer who slept in non-extended wear contact lenses overnight. Most contact lens wearers with these problems do not have eyeglasses that are suitable for their lifestyle, therefore they depend on their contact lenses almost entirely. Patients tend to overwear their contact lenses when they don't have nice glasses that match their lifestyle.

In this case, it was the beginning of peripheral ulceration with multiple subepithelial infiltrates, therefore it was deemed inflammatory in nature. A combination antibiotic/anti-inflammatory was prescribed along with contact lens discontinuation during the healing period and close follow-up.

LATTICE DEGENERATION

These two images are or lattice degeneration. It was difficult to get a great photo of it because of the movements in the eyes when a patient looks in extreme gaze, and also because this patient was wearing a contact lens and I was looking half through the non-optical portion of the lens.

Lattice degeneration occurs when there's thinning of the peripheral retina. Patients will often see flashes of light as this patient did. Oftentimes holes can develop within or near lattice degeneration. This patient was educated about the symptoms of retinal tears or a detachment and should be dilated on a yearly basis.

HEALING CORNEAL ABRASION

This is the same patient with the corneal abrasion below, but a couple days after treatment. Treatment consisted of topical antibiotic and high oxygen permeable bandage contact lens.