Corneal scar from impact of a branch while gardening. This image was taken on day 3, after the surface was well-healed.

Internal Hordeolum

Patient entered with a complaint of her right lower eyelid being painful, swollen, and red. Main differentials based on location of the event included preseptal cellulitis, lacrimal canaliculitis, and hordeolum. Flipping of the lower eyelid revealed an internal hordeolum within a meibomian gland adjacent to the lacrimal canaliculus. 

SEROUS RETINAL DETACHMENT FROM POSSIBLE CHOROIDAL NEOVASCULAR NET

In the picture below, the photo on the right is from March 2018.  The one on the left is from January 2019.  Visual acuity is unaffected.  There is an unchanged chorioretinal scar near the macula.  But where the arrows point, there is more subretinal fluid in the current photo.  

Fundus Autofluorescence below demonstrates an increasing amount of hyperautofluorescence over the area of concern. 

A cross-line OCT focused on the area of concern demonstrates a focal sub-RPE lesion pushing inward, a serous retinal detachment surrounding it, and a thin line demonstrating the vitreous membrane.

WEISS' RING FROM POSTERIOR VITREOUS DETACHMENT

The arrow shows a Weiss' Ring.  There is a clear vitreous membrane that detaches off the retina at some point in most people's lives.  A Weiss' Ring is where that membrane was attached to the optic nerve. 

HORSESHOE RETINAL TEAR WITH RETINAL DETACHMENT

Below is a photo of the left eye of a 46 year old male patient who presented with the chief complaint of some haziness in his left eye vision.  He has a retinal horseshoe tear with a macula-on detachment that required immediate referral to a retinal specialist for surgery. 

CENTRAL SEROUS RETINOPATHY (CSR) BEFORE AND AFTER

These are photos of central serious retinopathy in the right eye of a patient in his 30's, taken one year apart.   The best visual acuity when the CSR presented was 20/60 and one year later is 20/20.  He reports some subjective change in color perception that likely will remain permanent.  You can see that there is some residual pigment mottling left over. 

The photos below are the autofluorescent photos captured at the same times.  There is mild hyperautofluorescence at initial presentation and some hypoautofluorescence remaining the long-term effect on the retina of the CSR.

PAN-RETINAL PHOTOCOAGULATION