Christine L. Benador-Shen, MD

A 30-year-old man presented to the New England Eye Center for decreased vision with a central black spot in his vision for 1 week. He denied flashes, floaters, pain and headache.

An 8-year-old healthy girl presented to the New England Eye Center retina service for evaluation of a retinal lesion in the right eye.

A 24-year-old African American woman with a medical history of right-sided Bell’s palsy, hidradenitis suppurativa and borderline hypertension was referred to the neuro-ophthalmology clinic at Tufts Medical Center with 3 weeks of right eye discomfort. She initially had a pressure-like discomfort in the right eye that then developed into a dull pain with eye movement. The pain improved somewhat with acetaminophen. She also noticed a blurred spot in the vision of her right eye. Her medications included chlorhexidine skin cleanser, oral contraceptives and artificial tears. She had no known family history of eye or autoimmune disease. She did not smoke cigarettes or drink alcohol. She had no neurologic symptoms and no cough, joint pain or rash.

A 57-year-old Cambodian man with a medical history of diabetes, hypertension, hyperlipidemia and an unknown cardiac procedure presented with 2 weeks of acute blurry vision in the left eye. He reported having the flu 2 weeks prior with severe coughing. He had no eye pain or redness. He had no history of eye trauma or eye surgery. His medications included aspirin, atorvastatin, multiple antihypertensives and warfarin. He had no known family history of eye disease. He was a former cigarette smoker but did not drink alcohol or use illicit drugs.

A 55-year-old Chinese woman with no known medical history was transferred to Tufts Medical Center with bilateral decreased vision. She had not seen a physician in 20 years. However, she reported recurrent episodes of redness in both eyes over the last 2 years that seemed to correlate with consuming shellfish. She treated these episodes with artificial tears. About 3 months ago, she started taking Chinese herbal medicine by mouth for “general inflammation.” Around that time, she noticed gradual loss of vision in the left eye; on presentation, she could only see shadows and movement. About 1 week prior, she also started to have loss of vision in the right eye, which prompted her to seek care.

A 40-year-old woman with a medical history of acute myeloid leukemia treated with bone marrow transplant, complicated by ocular graft-versus-host disease and penetrating keratoplasty in the right eye, urgently presented to the New England Eye Center at Tufts Medical Center due to left ocular pain, redness and photophobia.