A 9-year-old boy presented twice in our practice with recurrent metallic foreign bodies (FB) in his left eye ([A] FB at the limbal 4 o’clock position; [B] FB at the 4 and 9 o’clock position 5 weeks later). His mother reported previous FB, which she had removed herself. Medical history and specific questioning revealed the metallic suspension of his indoor hanging swing as the source of metal wear (C, abraded karabiner and mounting). After removal of the swing, no further complaints occured. This case highlights the need for a careful review of the history in such situations.

A 63-year-old man with a family history of ocular colobomas was referred for review. His visual acuities were 20/60 in the right eye and 20/400 in the left eye. Fundus imaging of both eyes revealed inferonasal chorioretinal colobomas, which involved the macula and the optic disc (A, right eye). Widefield OCT shows retinal tissue bridging the colobomatous defect (yellow arrows) in the 3-dimensional rendering (B) and the B-scan (D). A vertical anterior-segment OCT B-scan illustrates the left iris coloboma extending from 4 to 8 o’clock (yellow arrow, C) and an intraocular lens with posterior capsular opacification.

A 5-year-old girl presented with bilateral cataracts. She had no nystagmus and could fixate briefly on a nearby object. (A) The left lens was diffusely opaque. (B) Ultrasound biomicroscopy of the left lens showed a thin lens with a pseudo-Soemmering ring–like configuration and adhesion between the collapsed anterior and posterior capsule. (C) The right lens had patchy opacity. (D) Ultrasound biomicroscopy of the right lens showed a membranous lens and opaque cortex. These lens configurations with preservation of the peripheral cortex near the lens equator suggested that lens volume loss in some congenital membranous cataracts may have started centrally and progressed peripherally.

A 16-year-old boy with T-cell acute lymphoblastic leukemia on chemotherapy presented with UL97 mutation ganciclovir-resistant cytomegalovirus (CMV) retinitis. His first ophthalmic examination and diagnosis of retinitis was made 2 months after he noticed peripheral vision loss nasally in the left eye, and 5 months after CMV viremia onset. The patient did not respond to ganciclovir or valganciclovir therapy, and underwent systemic treatment with maribavir, a direct UL97-inhibitor. Fundus photography (A) and autofluorescence (B) show temporal retinal atrophy with retinitis nasally and temporally (arrows) at presentation.

A 59-year-old man with a remote history of neck radiation presented with headaches and frequent episodes of transient, bilateral vision loss. Remarkably, symptoms resolved by placing his head between his knees. Fundoscopy revealed parafoveal cotton-wool spots and straightened, engorged retinal veins without retinal hemorrhages (A). Fluorescein angiography revealed arterial filling at 58 seconds and no retinal infarction (B), consistent with severe ocular ischemic syndrome (OIS). Bilateral carotid artery and left vertebral artery occlusions were observed on computed tomography angiography (CTA) (C) and presumed secondary to radiation-induced vasculopathy.

To investigate whether semaglutide increases the risk of non-arteritic anterior ischemic optic neuropathy (NAION) in the general population.

A 43-year-old man presented with a progressively enlarging cutaneous lesion of the left upper eyelid for 3 months (A). An incisional biopsy was performed, and oral itraconazole was initiated, leading to clinical improvement at 1 month (B). Histopathology revealed Periodic acid–Schiff and Gomori methenamine silver positive fungal yeasts with thick walls and broad-based budding, consistent with blastomycosis (C and D). The patient reported complete resolution of his cutaneous lesion and no systemic symptoms after 6 months.