Pupil Pod

Maura Di Nicola, MD, joins Ogul Uner, MD, to talk about white dot syndromes, a group of inflammatory chorioretinopathies. They begin with a case of a 32-year-old woman who presents with blurry vision in the right eye for 2 weeks, with new onset floaters with mild pain and photophobia. Examination showed 2+ vitreous cells and multiple yellow-white chorioretinal lesions in both eyes. Dr. Di Nicola shares what questions to ask about the patient’s history and what factors to consider when forming a differential diagnosis. Drs. Uner and Di Nicola further discuss the signs of multifocal choroiditis, distinguishing between different presentations of white dot syndrome, and what can be learned from multimodal imaging.

Erick Rivera Grana, MD, meets with host Ogul Uner, MD, to review a case of a 34-year-old woman who experienced blurred vision and mild discomfort in her right eye with an IOP of 38 mm Hg. The patient also presented with conjunctival injection and posterior synechiae. Dr. Rivera Grana describes his diagnostic approach to this case and explains the management of uveitic ocular hypertension and uveitic glaucoma.

Ogul Uner, MD, is joined by vitreoretinal surgeon and uveitis specialist Akshay Thomas, MD, for a comprehensive, case-based discussion on intermediate uveitis and pars planitis. In this case of a young patient presenting with floaters and blurred vision, Dr. Thomas breaks down how to distinguish intermediate uveitis from pars planitis and recognize key exam findings. The conversation highlights the critical role of widefield imaging, OCT, and fluorescein angiography, as well as a thoughtful approach to systemic workup.

Kareem Moussa, MD, speaks with Ogul Uner, MD, about a case in which a 30-year-old man presented with pain, redness, and photophobia in his right eye for 3 days. The patient reports that the pain was sudden, worsening, and similar to a previous instance 1 year prior in his left eye that had been treated with drops. Dr. Moussa explains the information he would need to determine a diagnosis and recommend treatment for this patient. He emphasizes the importance of considering potential systemic conditions that can cause eye inflammation and shares the clinical findings of anterior uveitis, its treatments, and potential risks.

In this episode, John Chen, MD, PhD, joins Ogul Uner, MD, to share his experience in neuro-ophthalmology. In the case discussed, a 32-year-old woman presented with decreased vision and pain in her right eye for 1 week, and examination revealed a rapid afferent pupillary defect. The patient also mentioned she had experienced numbness in her right arm 1 year ago. Dr. Chen explains why he would suspect retrobulbar optic neuritis in this case, and what his next steps would be to confirm that diagnosis and treat the patient.

Jordan Deaner, MD, vitreoretinal surgeon and uveitis specialist at Wills Eye Hospital, talks to Ogul Uner, MD, about white dot syndromes, a group of inflammatory chorioretinopathies. In the discussed case, a 35-year-old woman presented with photopsias in both eyes, and dilated examination showed 1+ vitreous cells and gray-white lesions in both eyes. Dr. Deaner explains what additional questions he would ask about this patient’s history and how he would start to build a differential diagnosis. Drs. Uner and Deaner further discuss the typical presentations of white dot syndromes, including acute posterior multifocal placoid pigment epitheliopathy (APMPPE), multiple evanescent white dot syndrome (MEWDS), and others.

Jeff Pettey, MD, MBA, joins the podcast to review a case of a 75-year-old woman who presented with blurred vision. She had nuclear sclerosis with uniform brunescence in her right eye, an intumescent white cataract in her left eye, and poor red reflex in both eyes. Dr. Pettey reviews this patient’s options for cataract removal and explains the indications and key steps of small-incision cataract surgery (SICS).

In this episode, Kingsley Okafor, MD, joins Ogul Uner, MD, to review a case of a 40-year-old man who presented with intermittent visual changes, pain, and halos in his left eye. On examination, the patient had an IOP of 19 mm Hg, mild myopia, pigment on the corneal endothelium, and midperipheral transillumination iris defects in both eyes. Dr. Okafor reviews findings for pigment dispersion syndrome (PDS) and risk factors for developing pigmentary glaucoma.

In this case, a 55-year-old man presented with an uncontrollable spasm on the right side of his face. Sila Bal, MD, invites oculofacial surgeon Julie Woodward, MD, to explain how she would approach the examination of this patient, describing the questions she would ask to obtain a detailed family and medical history and determine if the condition is a hemifacial spasm, blepharospasm, or myokymia. She shares insights into distinguishing each condition and outlines diagnostic and treatment approaches.

Sila Bal, MD, MPH, invites I. Paul Singh, MD, to discuss a recent case in which a 72-year-old pseudophakic patient with open-angle glaucoma inquired about alternatives to topical treatments due to compliance issues. Dr. Singh reviews the benefits of more interventional treatment options such as selective laser trabeculoplasty and drug delivery platforms and explains how he counsels patients about these options.

Sila Bal, MD, MPH, invites Rachel Simpson, MD, to review a case of a 56-year-old woman who presented with elevated intraocular pressure with inferior and superior disc thinning. The patient had not undergone an eye examination in 10 years and experienced no other visual symptoms. Dr. Simpson reviews how she would proceed after these findings, describing the questions she would ask regarding family history of glaucoma and potential next steps towards treatment.

William Trattler, MD, joins Sila Bal, MD, MPH, to discuss a case of a 31-year-old woman who presented with pain and decreased vision in her right eye. Slit lamp examination revealed conjunctival injection and a unifocal area of stromal haze with no epithelial defects. Dr. Trattler explains further diagnostic strategies for this case to help determine the best treatment. He also reviews approaches to suppress inflammation in different forms of keratitis.

Caroline Baumal, MD, joins Sila Bal, MD, MPH, to discuss a case in which a 53-year-old man with a history of hypertension and type 2 diabetes presented with sudden painless loss of vision in his left eye. Dr. Baumal explains that a dilated exam revealed the retina had an opaque appearance with a cherry red spot, causing her to suspect central retinal artery occlusion (CRAO). Listen to gain insights into additional risk factors, pathophysiology, and how to approach patients with presumed CRAO.