All rights reserved. [video included]. What is the most likely cause? Involutional entropion: options for surgical management of entropion. Communication Issues Following a Post Operative Surprise, Ocular Syphilis Presenting with Posterior Subcapsular Cataract and Optic Disc Edema. Idiopathic Intracranial Hypertension (Pseudotumor Cerebri): 31-year-old obese female presenting with a history of headaches and transient visual obscurations for six months. Phacoemulsification: Considerations for Astigmatism Management, a tutorial and case, Posterior capsular folds creating a Maddox rod effect following cataract surgery: 73-year-old female presents with glare in the right eye 5 months after cataract surgery. Thyroid Eye Disease (Graves' ophthalmopathy): 51-year-old male seen in consultation from the internal medicine service for evaluation and management of "dry and red eyes. Patient had progressive photophobia during outdoor activities. Let us help you find an answer to your question. Posner-Schlossman Syndrome: 63-year-old male was evaluated on an urgent basis for pain, redness, and "elevated eye pressure" in the left eye (OS). your express consent. ", If you have trouble accessing full text, or it is not available, please email us at. Facial Spasms in a Man Recently Released From the Hospital, Sjgren Syndrome-associated ILD Treated With Immunosuppression, A 44-Year-Old With a Headache, Photophobia, and Phonophobia, A 14-Year-Old Boy With Painful Periorbital Edema, A 39-Year-Old Man's Contact Lens Exam Reveals Abnormalities, A 1-Week-Old Baby With Bilateral Cataracts, A 42-Year-Old Woman With a Chronic Productive Cough, A Visual Field Defect in a Patient With History of Seizures, The Woman With Multiple Sclerosis and Blurry Vision, A 19-Year-Old Man With Life-Threatening Obesity, A 63-Year-Old Woman With Decreased Vision, The Infant Who Keeps Turning His Face Leftwards, A 67-Year-Old Woman With Diplopia After Sinus Surgery. The introduction section of the case report must also now provide a full description of the literature search strategy, including the database searched, the search terms (which should match the PICO question), the number of records returned, and the final number of relevant sources reviewed. Tumor Necrosis Factor Alpha Antagonist Precipitating Demyelinating Disease: Unilateral Optic Nerve Hypoplasia in a patient desiring surgical treatment for exotropia. Over the last ten years, she has experienced further painless vision loss OD. WebStage Two downloads: DO and Overarching case scenarios - College of Optometrists Scheme for Registration Find a pre-registration training placement before you enrol with This case features 11 oculoplastic surgery videos. Methods: 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. We would be delighted to see you. A 72-year-old male presents with epiphora of the left eye, present for one year, worsening over the last month. Pan-endophthalmitis and Orbital Cellulitis: 89-year-old female with a history of gradual redness and proptosis, right eye over 3 weeks. Facial Nerve Palsy: Ocular Complications and Management. What is the most likely cause? Phakic intraocular lenses for high myopia: A 24-year-old male with unilateral high myopia presented with anisometropia (unequal refractive error between the eyes) with aniseikonia (binocular differences in image size) and a large right sensory exotropia. What's the diagnosis? Neurofibromatosis Type 1 - Optic Nerve Glioma: 8-year-old white female with acute awareness of complete vision loss, left eye. Non-accommodative Esotropia and Botulinum Toxin Therapy: 7-year-old boy presented with a history of intermittent, alternating eye crossing for one year that had become constant in the past 2 months. Imagine a Milwaukee that is equitable, healthy and thriving for all. Evidence-based case reports should be formatted to include a structured clinical question in the significance section of the abstract and a statement regarding the literature search strategy in the introduction. The patient first noticed the lesion about one month prior to presentation. 5-year-old male with unequal vision. Vision in the right eye was starting to "darken." Corneal Endothelial Transplantation: Descemet's Stripping Endothelial Keratoplasty (DSEK), Corneal Marginal Ulcer: Marginal keratitis with ulceration in a 45 year-old male. Accelerated Hypertension : 67-year-old female with hypertension and diabetes mellitus with painless vision loss, Herpes Zoster Post-herpetic Neuralgia: 68-year-old male with decreased vision, Kayser-Fleischer Ring: A Systems Based Review of the Ophthalmologist's Role in the Diagnosis of Wilson's Disease, Kyphotic Patient Presents for Cataract Surgery: A Systems Based Case. Intralenticular Foreign Body: 23-year-old male with staple in the eye, Intraocular Foreign Body: A Classic Case of Metal on Metal Eye Injury, Intraocular Lens "Time Out": A Systems Based Case, Marfan Syndrome: 28-year-old female with Marfan syndrome and decreased vision/glare in both eyes. Iris-Ciliary Body Melanoma: 57-year-old female with iris lesion. Translational scientists turn science and research into improved treatments. Use of Ophthalmic Medications in Pregnancy: A 19-year-old pregnant woman at 19 weeks gestation was referred for evaluation and treatment of suspected Acanthamoeba keratitis. Cystinosis: A 12-year-old boy with light sensitivity. 4-year-old boy originally presented to ophthalmologist at 2 years of age with crossed eyes. Orbital inflammation secondary to bisphosphonate therapy: 80-year-old female with right eyelid swelling, pain, decreased vision, diplopia. For Medical Students. Post LASIK Ectasia: Female patient presented status post bilateral LASIK for myopia. Find primary and specialty care near you. Between visual testing and MRI, can you offer her a diagnosis? Deep Lamellar Endothelial Keratoplasty (DLEK) for Fuchs. date posted; Available from: http://www.eyerounds.org/cases/filename.htm. Case reports are considered below observational studies, experimental studies (e.g., randomized clinical trials), or systematic reviews in the hierarchy of evidence. What's the diagnosis? Multiple endocrine neoplasia type 2B: A 27-year-old male presents with multiple eyelid lesions. You may be trying to access this site from a secured browser on the server. We look forward to receiving your quality case report submissions. This site explains how to work through the EBP Process, and offers online EBP resources and case studies demonstrating use of EBP in action. He did not tolerate contact lenses and was interested in surgical options. The patient was referred because he could not read any of the letters on the chart and showed no improvement with refraction. Multiple Evanescent White Dot Syndrome (MEWDS): 24-year-old female with one week duration of central scotoma, right eye. Cytomegalovirus (CMV) Retinitis: 36-year-old Indian male with HIV and decreasing visual acuity. Orbital Osteoma: 20-year-old female with a 9-month history of left upper lid droopiness. The growing use of contact lenses in children demands our attention with surveillance and case-control studies. She developed mild light sensitivity in both eyes as well as mild, circumferential headaches during the four months leading up to ophthalmologic evaluation. Prospective authors should report cases that illustrate clinical decision making relative to the following: Interventions questions addressing the treatment of an illness or dysfunction, Diagnosis questions on the identification or determination of the nature and cause of a disease or condition, Etiology questions addressing the cause or disease origin, including risk factors for a certain disease or condition, Prognosis questions on the prediction of the course of a disease, Prevention questions related to reducing the chance or impact of disease by identifying and modifying risk factors, screening, and early diagnosis. We have a growing collection of peer review and peer discussion case studies, including case studies for IP optometrists, covering real life Polypoidal Choroidal Vasculopathy (PCV): 57-year-old Caucasian male referred for retinal thickening and subretinal fluid in right eye greater than left eye. Central Retinal Artery Occlusion (CRAO): 81-year-old white male with sudden, painless vision loss left eye. The right eye had a nuclear sclerotic cataract which precluded a good view of the optic nerve head, and a vertical cup:disc ratio (VCDR) of about 0.9, barely visible through the dilated pupil with the binocular indirect A 39-year-old healthy male reported intermittent episodes of "objects bouncing up and down" in his vision in his left eye lasting for seconds to minutes for the previous two months. The discussion, although brief, is intended to give you a simple overview of each disease. Optic Neuritis: A 40-year-old female noticed visual loss in her right eye accompanied by pain with eye movements and a dull retro-orbital ache, two weeks prior to her clinic visit. By the time he returned home, he had profound vision loss and right eye protruding. Age-related Macular Degeneration: Progression from Atrophic to Proliferative: Cat-Scratch neuroretinitis (Ocular bartonellosis). This frequently cited monthly Enophthalmos Secondary to Metastatic Breast Cancer. Please try again soon. Due to the rapid onset and severity of the cataract, there was concern for an iatrogenic break in the posterior capsule during vitrectomy. Secondary Open-Angle Glaucoma Treated with Gonioscopy-Assisted Transluminal Trabeculotomy (GATT). WebCase report submissions to Optometry and Vision Science should also now include additional information. Endogenous Endophthalmitis: 33-year-old male presented to an outside hospital for suicidal ideation. Blurry vision in the left eye for 2 weeks, Left eye pain and fuzzy vision 2 days after eye surgery, 2 brief episodes of vision loss in the R eye, Student Ophthalmology Medical Association (SOMA), Dennis P. Han, MD Advanced Ocular Imaging Program, Continuing Professional Development (CME), Advancing a Healthier Wisconsin Endowment, Recognize and describe the typical presentation of common conditions affecting the anterior and posterior segments of the eye, Consider a range of multiple etiologies when examining patients with eye or vision problems, including trauma, infection, congenital abnormalities, autoimmunity, vascular issues, metabolic deficiencies, and environmental causes, Recall the basic pathophysiology underlying numerous ophthalmic conditions, Evaluate the significance of clinical findings in relation to common ophthalmic diseases, Formulate a differential diagnosis after reviewing the patients history and ocular exam, Identify which laboratory tests or exams are appropriate to confirm and evaluate specific ophthalmic diagnoses, Discuss therapeutic options and treatment plans for a number of acute and chronic ophthalmic diseases. 60-year-old male who was evaluated 1 wk ago for "conjunctivitis" left eye by internal medicine. At her latest follow-up, she reports intermittent dyspnea and fatigue. Check the, To narrow your results further:go back to the left column, and under Publication dates choose "5 years. 60-year-old male with a history of simple megalocornea reported visual disturbance while changing head position, his vision worsened with his head bent down.He previously had cataract surgery with an iris-sutured IOL. Pembrolizumab (Keytruda) Induced Uveitis in a Patient with Metastatic Melanoma: 65-year-old male with history of metastatic cutaneous melanoma previously on pembrolizuamb presented to the comprehensive ophthalmology service with blurred vision worse in the left eye for the past 6 months. She attributed the scar to a "fan injury" that she experienced at 20 years of age. 64-year-old male patient noted severe pain in his right eye while in the post-anesthesia care unit shortly after laparoscopic surgery. Conjunctival rhinosporidiosis in a temperate climate. Please enable scripts and reload this page. Fluctuations in vision were first noticed 6 months ago with documented vision as poor as 20/150.She had uneventful cataract surgery 10 years prior with insertion of a Polymethyl methacrylate (PMMA) intraocular lens (IOL) in the capsular bag. A 36-year-old female presented with a "bulging" and apparently swollen left eye noticed about one month prior to her visit. Myopia Myopia Case 1 Oculoplastic Surgery, Orbit, Eyelids, Lacrimal, 28-year-old woman presented with a 1-month history of progressive left upper eyelid pain. 38-year-old male with blurry distance vision and problems seeing at night and significant glare from oncoming headlights when driving at night. Grant syndrome (Syndrome of precipitates on the trabecular meshwork): 60-year-old male referred for evaluation of elevated intraocular pressure (IOP), right eye with corneal edema.Treated with a laser peripheral iridotomy and started on bimatoprost and brimonidine/timolol. Horner's Syndrome (due to Cluster Headache): 46-year-old male presenting with HA and ptosis. Meningiomas. Patient referred from the retina service for dense cataract formation three days following pars plana vitrectomy. The Value of Clinical Case Reports in Evidence-based Practice. Merkel Cell Carcinoma of the Eyelid. The discussion, although brief, is intended to give you a simple overview of each disease. He experienced intermittent, horizontal, binocular diplopia and blurring of his vision while reading, accompanied by fatigue and headaches. 3-year-old male who was referred to the cornea clinic after failing a KidSight screening and was found to have bilateral corneal opacities when evaluated by his optometrist. Canalicular Laceration - Dog Bite: 5-year-old white female presenting with dog bite to left side of face. She also noted decreased perception of color and contrast. 3. Peters Anomaly: 2-day-old infant evaluated for bilateral corneal opacity noted at the time of delivery. WebCase Report Format AMERICAN ACADEMY OF OPTOMETRY There is a 4,000 character limit (including spaces and the bibliography). Enhancing learning, research, patient care and the health of the community. The intervention is intense pulsed light therapy, and the outcome measure is the recovery time. Eight years prior to presentation he underwent Laser-assisted in situ keratomileusis (LASIK) in both eyes. However, this was not practical for ongoing management as base-in prisms do not train the eyes to improve convergence or fusion. Waldenstrom Macroglobulinema-Associated Retinopathy: Kyphotic Patient Presents for Cataract Surgery, Ocular Syphilis Presenting with Posterior Subcapsular Cataract and Optic Disc Edema, Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP), Painless Proptosis in a 62-year-old female. A boy comes to your clinic with myopia in the right eye. With decreased red reflex and a family history of cataracts, this newborn is in need of a diagnosis. {Related Case: Communicating with patients about alternative therapies: A case of optic nerve hypoplasia in a 14-year-old male with poor vision since birth}. Recently, he became symptomatic indoors. History. Case reports have provided historically important information on new medications (e.g., penicillin), emerging diseases (Zika virus), and evolving guidance on medical interventions (hydroxychloroquine retinopathy).1Optometry and Vision Science will focus on new guidelines to help bridge the space between evidence-based practice and case reports. A woman with type 1 diabetes was evaluated, one week after an otherwise uncomplicated cesarian section, for decreased vision and multiple new floaters in both eyes. Acute Corneal Hydrops: 51-year-old male with keratoconus and history of rigid gas permeable (RGP) contact lens wear in the left eye presented with left eye redness, pain, light sensitivity, and tearing for 1 week. This should be supported by key findings from the literature search and a critical appraisal of the relevant existing evidence. An ophthalmologist confirmed the narrow angles and placed her on medications to successfully lower her intraocular pressure. Each case report is required to begin with Epithelial-Stromal and Stromal Corneal Dystrophies: Exposure Keratopathy in the Critically Ill: Granular Corneal Dystrophy Discovered Following LASIK: A Clinicopathologic Correlation of Granular Corneal Dystrophy Type II and LASIK. Interstitial keratitis secondary to Herpes Simplex Virus (HSV): 22- year-old white man with a history of asthma, vitamin D deficiency, and blepharitis presented to the cornea clinic with gradual onset blurred vision in the right eye and photophobia over 6 weeks. 17-year-old male with a longstanding sensory left exotropiainquiring about strabismus surgery. 27-year-old male was referred for evaluation of a left medial canthal lesion. Sarcoidosis Affecting the Lacrimal Gland: 39-year-old female with left upper eyelid swelling of 4 months duration, Sebaceous Cell Carcinoma: A Masquerade Syndrome. Intraoperative Floppy Iris Syndrome: IFIS presents problems during cataract surgeries by decreasing the size of the work field and increasing the rate of complications such as iris trauma, posterior capsule rupture, and vitreous loss. Surgical Management of Keratoconus: A 22-year-old male with a history of progressive keratoconus. 50-year-old male with penetrating globe injury. The lesion has been present on the left lower lid for about one month.It has grown rapidly in size over the previous two weeks and is now obstructing her vision, Ocular Surface Squamous Neoplasia (OSSN): 22-year-old male with concerns of a new, enlarging conjunctival/corneal mass on his left eye, Orbital Eosinophilic Granuloma. 16-month-old male patient with left-sided periorbital swelling beginning three weeks prior to presentation in the setting of an upper respiratory infection. Author. Case Studies The case studies are presented in a question-and-answer format. Authors will be required to articulate a specific clinical question. Prior to presentation, patient was followed by an otolaryngologist for his sinus disease and nosebleeds. Why is this 65-year-old patient with relapsing-remitting MS having decreased vision in her right eye? Fibrous Dysplasia: 43-year-old female was referred to the University of Iowa Oculoplastics Clinic by her comprehensive ophthalmologist for the evaluation of worsening right-sided proptosis. What's causing the decline in his eyesight? 87-year-old female with orbital cellulitis resistant to broad-spectrum antibiotics was referred to UIHC. Bilateral optic nerve hypoplasia, 2-month-old with: Highlighting the importance of a multi-disciplinary approach. The questions at the end of each case are a good review for M3 Ophthalmology rotation final examination. Recurrent Neuroretinitis: 29-year-old white female with progressively worsened vision, right eye, diminished central vision, and pain with eye movements. Holoprosencephaly and Strabismus. Lymphoma, Orbital. CASE STUDY: Doug Choroidal Malignant Melanoma: 58-year-old female with pigmented retinal lesion and exudative retinal detachment, Choroidal Osteoma: 10-year-old girl presents for annual follow-up. A 94-year-old female is referred for an evaluation for possible skin cancer on the nasal aspect of her left lower lid. Carotid Cavernous Fistula: 46-year-old female patient presented twith double vision and visual distortion. Vertical Oscillopsia: A Case of Superior Oblique Myokymia. Dispensing Case Studies. Each case report is required to begin with an abstract, limited to 35 words (present tense), describing the uniqueness of the case that merits presen-tation at the Grand Rounds. Also experiencing a foreign body sensation in both eyes and redness along the left lower eyelid. With a diagnosis that changes over time, can you identify what's at the root of the issue and treat it accordingly? Ocular Manifestations of Stevens-Johnson Syndrome: 13-year-old female treated with trimethoprim-sulfamethoxazole developed mucosal and dermatologic eruptions with ocular involvement. Can you provide it? Purtscher's Retinopathy: 22-year-old male with vision loss after trauma, Presumed Ocular Histoplasmosis (POHS): 30-year-old male with blurred central vision, Punctate Inner Choroidopathy with Choroidal Neovascular Membrane. Infectious Crystalline Keratopathy (ICK): 72-year-old female with decreased vision. From the start of Optometry school, professors and supervisors preached that a patients chief complaint and case history should direct your exam. After thoroughly reviewing these case studies, the learner will be able to: We've included a listing of commonly used ophthalmic abbreviations for your review. She reports that she recently failed a school screening, Chorioretinitis Sclopetaria: A Systems Based Approach to Eye Injury Prevention. Acute Retinal Necrosis: 84-year-old man with Alzheimers dementia presented with floaters and decreased vision in both eyes (OU). Anterior Chamber Cilium: 81-year-old male with intraocular cilium and dislocated intraocular lens. 1. 52-year-old woman presented with elevated intraocular pressure (IOP) and visual fields demonstrating progressive field loss despite maximum tolerated medical therapy. He also has research interests in contact lens and surgical correction of presbyopia. Orbital Lymphatic Malformation (Lymphangioma): 5 year-old female complained of an intermittent frontal headache.
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