A 19-year-old male patient needed to wear glasses for 15 years due to high hyperopia and being affected by Basedow's syndrome. Upon evaluation with a slit lamp, deep stromal opacity areas interspersed with clear corneal areas are observed in both eyes (Fig A, B). Corneal top…

A 6-month-old was investigated for leukocoria; on examination under anesthesia he was found to have persistent fetal vasculature (PFV) with total retinal detachment. PFV is a common cause of leukocoria and results from failure of degeneration of hyaloid vessels and the tunic…

The figure shows an incidental finding of bilateral juvenile retinoschisis with a partial macula-off retinal detachment found in a non-verbal, developmentally delayed, 5-year-old male during a baseline exam under anesthesia.

Bilateral nonspecific orbital inflammation (orbital pseudotumor) in an 11-year old boy with a 1-week history of eye pain. Ocular rotation was markedly limited in all directions. CT confirmed proptosis and showed enlargement of all extraocular muscles. Laboratory workup was…

Dystopia canthorum in a patient with Waardenburg syndrome. Notice that the vertical lines drawn through the puncta intersect the cornea.

Identify the defective structure-lens or zonules? Lens colobomas develop due to defective zonules in any segment, leading to a lack of tension on the lens capsule in this region and corresponding flattening of lens equator. The term lens coloboma is thus a misnomer as it is…

Recognition visual acuity testing. A, LEA optotypes; screenshot of an American Association for Pediatric Ophthalmology and Strabismus iPad application for visual acuity screening. B, Crowding bars around a single-letter optotype displayed on a clinic monitor for distance vis…

Fluorescein angiography of a 66 year-old patient presenting with an iris racemose hemangioma.

All meibomian orifices open onto the palpebral conjunctiva with anteriorization of the mucocutaneous junction.

Primary acquired melanosis (PAM)/conjunctival melanocytic intraepithelial neoplasia (C‑MIN). A, Mild PAM, involving 1 clock-hour of conjunctiva; unlikely to harbor atypia and may be observed. B, Histology of PAM (C-MIN) without atypia. H&E stain (top) shows melanocytic proli…

Handheld and stand magnifiers.

Multifocal IOLs. A, Hoffer split bifocal IOL (left) and an early photograph of a lens implanted in a patient (right). B, Three-zone multifocal design. C, Diffractive multifocal IOL; the cross-section of the central portion is magnified. (The depth of the grooves is exaggerat…

In order to optimize image quality for both straight-ahead viewing and downgaze (as for reading), eyeglass frames typically rotate the plane of the lenses downward, a correction known as pantoscopic tilt. Values of about 7° are typical.

Refraction by a single curved surface. The incident ray emanating from an object (o) located at a given distance (u) undergoes refraction by a single curved surface (eg, a simple plus lens of negligible thickness). The refracted ray is directed toward an image point (i), whi…

Occluding the left side of the phoropter: A, Opaque occluder (arrow). B, +1.50 D “R” accessory lens (arrow). Notice the settings of the accessory wheel for the right eye, at the top left of the photos. C, Accessory wheel.