JAMA Ophthalmology

Periocular Swelling, Fever, and Organomegaly in a 4-Year-Old Child

A child aged 4 years presented with a 3-day history of worsening redness, pain, and swelling over the left lower eyelid and nose. Visual acuity was normal, and systemic examination revealed cervical lymphadenopathy and hepatosplenomegaly. The patient showed no improvement…

Subconjunctival Mass 30 Years After Melanoma Resection

A 70-year-old male is referred for evaluation of a conjunctival mass in the right eye, which has grown slowly over 27 years. Examination reveals a superonasal, multilobulated, pigmented lesion with episcleral feeder vessels and spontaneous vascular pulsations within the intraocular…

Branch Retinal Artery Occlusion in an Adolescent Male

A 17-year-old male with an unremarkable medical history presented with 2 days of painless blurred vision in the right eye. Three weeks prior, he was admitted with fever, myalgias, hepatosplenomegaly, lymphadenopathy, and truncal rash. What would you do next?

Bilateral Perifoveal Atrophy in a 46-Year-Old Woman

A 46-year-old woman is referred for a second opinion with recent onset of suspected seizures and imbalance. Fundus examination revealed bilateral discrete perifoveal circular areas of atrophy. What would you do next?

Viral Meningoencephalitis and Bilateral Blurry Vision

A 20-year-old Chinese woman was experiencing fever, malaise, headache, nausea, vomiting, and neck stiffness for 2 weeks. Further examination revealed inflammation, vitritis and cystoid macular edema, tortuous dilatation of retinal venous vessels with fluorescence leakage, and hyperfluorescence in the optic…