Interesting Retinal Cases

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05/27/2026

By
With
At

05/22/2026

I am wearing color Navy blue.
πŸ‘•: All-day scrub zip polo
πŸ‘–: All-shift scrub jogger

By
With
At

05/14/2026

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Oxidative stress drives AMD
β€’ Key triggers: UV exposure, smoking, and poor diet.
β€’ Guide patients on prevention: Advise quitting smoking, consistent UV protection, and encouraging a diet rich in leafy greens for long-term eye health.

By
With
At

05/11/2026

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β€’ Location of drusen
Normal aging: may be outside the macula, scattered in peripheral retina
Dry AMD: drusen primarily within the macula

β€’ Laterality
Normal aging: can be unilateral or asymmetric
Dry AMD: typically bilateral (often asymmetric)

β€’ Size / appearance
Normal aging: small, isolated drusen
AMD: larger, more numerous drusen often with RPE changes

β€’ Macular involvement
Normal aging: macula unaffected
AMD: macular pathology present β†’ central retinal involvement

β€’ Visual impact
Normal aging: usually asymptomatic
AMD: gradual ↓ central vision, reduced contrast sensitivity

β€’ Associated findings
Normal aging: no significant pigmentary abnormalities
AMD: RPE mottling, pigment migration, geographic atrophy (advanced cases)

β€’ Progression
Normal aging: often stable over time
Dry AMD: progressive degenerative macular disease

β€’ Key clinical pearl
Not all drusen = dry AMD
Small clusters of extramacular, unilateral drusen without macular changes may simply represent normal age-related retinal changes rather than dry AMD.

By 🩺
With πŸ‘©πŸΌβ€πŸŽ“
At πŸ₯

05/08/2026

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β€’ Definition
Progressive corneal ectasia β†’ stromal thinning + anterior protrusion β†’ irregular astigmatism

β€’ Epidemiology
β†’ onset: teens to early adulthood
β†’ often bilateral, asymmetric

β€’ Pathophysiology
β†’ structural weakening of corneal collagen
β†’ non-inflammatory

β€’ Risk factors
β†’ eye rubbing
β†’ atopy (allergies, eczema, asthma)
β†’ family history
β†’ connective tissue disorders

β€’ Symptoms
β†’ progressive blur
β†’ increasing astigmatism
β†’ frequent Rx changes
β†’ ghosting, halos, monocular diplopia

β€’ Refraction clues
β†’ increasing cyl
β†’ irregular astigmatism
β†’ reduced BCVA with glasses
β†’ scissors reflex on retinoscopy

β€’ Slit lamp signs
β†’ Vogt’s striae (fine vertical stress lines)
β†’ Fleischer ring (iron deposition)
β†’ corneal thinning, conical protrusion
β†’ Β± apical scarring (advanced)

β€’ Topography / Tomography
β†’ inferior steepening
β†’ asymmetric bow-tie
β†’ posterior elevation (early detection)

β€’ Complication
β†’ acute corneal hydrops (Descemet break β†’ stromal edema)

β€’ Management
Early: glasses / soft toric CL
Moderate: RGP / scleral lenses
Progression: corneal cross-linking (CXL)
Advanced: INTACS or corneal transplant

β€’ Key clinical pearl
Young patient with changing astigmatism + ↓ BCVA β†’ think keratoconus and get topography early

By 🩺
With πŸ‘©πŸΌβ€πŸŽ“
At πŸ₯

05/06/2026

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β€’ Anatomic location
Preseptal: infection anterior to orbital septum (eyelid/periorbital tissues)
Orbital: infection posterior to septum (orbit)

β€’ Common source
Preseptal: skin trauma, insect bite, chalazion/hordeolum
Orbital: sinusitis (especially ethmoid) β†’ direct spread

β€’ Pain
Preseptal: localized, anterior (eyelid), no pain with EOMs
Orbital: deep orbital pain + pain with EOMs

β€’ Eye movements
Preseptal: full, painless
Orbital: restricted, painful EOMs

β€’ Vision
Preseptal: normal
Orbital: ↓ VA possible, Β± RAPD

β€’ Proptosis
Preseptal: absent
Orbital: present

β€’ Systemic signs
Preseptal: mild or none
Orbital: patient looks systemically ill, not just a swollen eyelid

β€’ Anterior segment
Preseptal: lid edema/erythema only
Orbital: may have chemosis, conjunctival injection

β€’ Imaging
Preseptal: not routinely needed
Orbital: CT orbit/sinuses indicated

β€’ Management
Preseptal: oral antibiotics, close follow-up
Orbital: admission to hospital with IV antibiotics + urgent imaging

β€’ Key clinical pearl
Any pain with EOMs, ↓ vision, or proptosis β†’ treat as orbital cellulitis until proven otherwise

By 🩺
With πŸ‘©πŸΌβ€πŸŽ“
At πŸ₯

05/04/2026

β€’ Etiology
Chalazion: sterile granulomatous inflammation from blocked meibomian gland
Hordeolum: acute bacterial infection (usually staph)

β€’ Onset
Chalazion: gradual, chronic
Hordeolum: rapid, acute

β€’ Pain
Chalazion: typically painless
Hordeolum: painful, tender

β€’ Location
Chalazion: deeper, within tarsal plate/ Meibomian gland
Hordeolum:
β€’ External: lash follicle / Zeis or Moll gland
β€’ Internal: meibomian gland

β€’ Appearance
Chalazion: firm, non-erythematous nodule (may have mild redness)
Hordeolum: erythematous, swollen, may point with pustule

β€’ Course
Chalazion: persists, may enlarge slowly
Hordeolum: often drains spontaneously within days- release of pus

β€’ Management
Chalazion: warm compress, lid hygiene, consider steroid injection or surgical removal if persistent

Hordeolum:
External: warm compress, topical antibiotics
Internal: warm compress, oral antibiotics may be needed

Clinical pearl:
Beware of preseptal spread in internal hordeolum

Clinical pearl:
Recurrent/persistent β€œchalazion” β†’ rule out sebaceous gland carcinoma

By 🩺
With πŸ‘©πŸΌβ€πŸŽ“
At πŸ₯

05/02/2026

Thyroid Eye Disease patient - Part 2

By 🩺
With πŸ‘©πŸΌβ€πŸŽ“
At πŸ₯

04/17/2026

Glaucoma Yes or Glaucoma No? Let’s find out.

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With
At ✨

04/13/2026

Full OCT analysis of Drusen, CNVM and management.

By π·π‘Ÿ. π‘†π‘‘π‘’Μπ‘β„Žπ‘Žπ‘›π‘’ πΉπ‘–π‘‘π‘œπ‘’π‘ π‘ π‘– πŸ‡«πŸ‡·, π‘€π‘–π‘Žπ‘šπ‘–, πΉπ‘™π‘œπ‘Ÿπ‘–π‘‘π‘Ž
With Marthelena Valdes
At Blinking Owl Eyecare ℒ️ ✨

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