Mitchell B. Strominger, MD

A 6-day-old male infant born full term was transferred to the Tufts Medical Center emergency department from an outside hospital with worsening redness, swelling and discharge of the left eye over the past 2 days. He was born to homeless parents, and his mother was incarcerated for the first 6 months of pregnancy. His mother had a history of intravenous drug use and was seropositive for hepatitis C. She reportedly had two negative tests for sexually transmitted infections during her pregnancy, with the most recent testing occurring 3 months before delivery. She did have trichomoniasis and recurrent yeast infections during pregnancy. The infant received erythromycin prophylaxis after delivery. The infant’s urine and serum toxicology screens were negative at birth. The infant was otherwise healthy with no known medical history. The infant was in the care of a foster mother.

A 2-year-old girl presented to the New England Eye Center because her parents were concerned about her eyesight. Her parents noticed that she was holding her toys close to her face and that she seemed to have trouble tracking objects. They observed that she did not seem to make direct eye contact with people speaking to her although she did look in their general direction. She also seemed to be fearful of other children. The aforementioned behavior prompted the parents to seek an evaluation for possible autism, which revealed normal social behavior.

A 13-year-old girl was referred from an outside ophthalmologist with a complaint of a “gray line going straight through” the visual field in her left eye that began 2 days before presentation. One day before presentation, she began having a “dull, heavy” sensation behind her left eye, with a severity of 8 out of 10, as well as expansion of her visual field defect peripherally, described as “the gray blob spread.”

A 6-year-old boy was referred to the New England Eye Center with symptoms of intermittent headaches for the last 3 months. The patient and his mother described the headaches as occurring three to four times per week, located primarily frontal and “on top of the head,” that would become progressively severe, lasting 1 to 2 hours, occasionally associated with nausea. Initially, it was thought the headaches may be related to concentrated activities such as reading. However, the pain was now occurring more often without any notable aggravating factors.

A 15-year-old girl presented to the eye clinic at the New England Eye Center for a second opinion regarding reduced vision in both eyes since infancy.

A 73-year-old woman presented to the New England Eye Center for an evaluation of progressive esotropia of her left eye. She reported that her left eye had been turning inward for the past 40 years but had gotten progressively worse over the past 3 years. She denied any sudden changes in vision or diplopia. She denied having esotropia as a child. She required glasses for myopia in her left eye as a child but denied patching or previous eye surgery.

An 8-year-old girl presented to Tufts Medical Center with complaints of a persistent headache and new-onset binocular diplopia. She was initially seen by her primary care provider 1 week earlier for her headache and ultimately diagnosed with sinusitis and started on oral amoxicillin. However, 2 days after starting oral antibiotics, she developed fevers, intermittent nausea and binocular diplopia. She otherwise felt well and had no history of headaches. She had no significant medical or ocular history.

An otherwise healthy 12-year-old girl was urgently referred from a New Hampshire optometry office to the New England Eye Center in Boston for 3 weeks of decreased visual acuity in the right eye with recent progression. Her initial symptom was pain with eye movement followed by peripheral vision loss that progressed to include central vision. She reported having nausea for the past 2 days but denied headache, fevers, chills, rashes, joint pain, shortness of breath or recent weight change.

An otherwise healthy 13-week-old infant was initially referred to our clinic in 2009 for drifting eyes since birth. He was also noted to have a preference for a right head turn. There was a positive family history of strabismus.

A 5-year-old girl presented to our eye clinic with complaints of pain, photophobia and blurry vision in her right eye for 2 weeks. She was being treated with erythromycin ophthalmic ointment four times a day in the right eye. The patient had no other significant medical or ocular history.