Valley Eye care centre

01/06/2026

01/06/2026

Spot diagnosis: Pigmented paravenous retinochoroidal atrophy (PPRCA)

This is a rare, typically bilateral but often asymmetric retinal degenerative disorder characterized by pigment clumping and chorioretinal atrophy distributed along the retinal veins. It is usually discovered incidentally, as many patients are asymptomatic or present with mild visual complaints such as night blindness or peripheral field defects.

The condition is non-progressive or very slowly progressive in most cases. On fundus examination, there are bone-spicule–like pigmentations tracking along the venous arcade, associated with attenuation of retinal vessels, retinal pigment epithelium (RPE) atrophy, and chorioretinal thinning, often sparing the macula until late stages.

The etiology of PPRCA remains uncertain, though proposed mechanisms include prior inflammatory insults (such as healed viral retinitis), genetic susceptibility, or a developmental anomaly of the retinal pigment epithelium along venous drainage territories.

Differentiation from retinitis pigmentosa is important, as PPRCA tends to follow a perivenous distribution, progresses more slowly, and is less commonly associated with severe rod-cone dystrophy.

07/05/2026

“A diabetic patient came with sudden blurred vision.

On fundus examination:
👉 Neovascularization seen on disc
👉 Multiple retinal hemorrhages
👉 Fibrovascular proliferation present

What’s your diagnosis? 🤔
Comment below! ⬇️

24/04/2026

A rare retinal disorder with shimmering crystals—Bietti Crystalline Dystrophy slowly dims vision but highlights the importance of early detection and monitoring. 👁️✨

23/04/2026

Cataracts are not a single disease: multiple patterns, multiple stories 👁️🔬

Follow our IG account for more.

This image shows different types and morphologies of cataracts. Although they all share the loss of transparency of the lens, their location, cause, and clinical evolution can be very different.

📌 A cataract is the opacification of the lens that interferes with the passage of light and reduces visual quality. It remains one of the leading reversible causes of low vision worldwide.

🔬 Common Patterns

📍 Nuclear Cataract
• Sclerosis and yellowing of the nucleus
• Progressive myopia
• Frequent night glare

📍 Cortical Cataract
• Radial opacities in “rays” or wedges
• Visual fluctuation
• Greater discomfort with bright lights

📍 Posterior Subcapsular Cataract
• Posterior central lesion
• Significant glare and poor near vision
• Can appear more prominent than larger cataracts

📍 Anterior Polar Cataract / Posterior
• Localized capsular opacity
• Some are congenital
• Posterior cataracts are surgically important due to capsular fragility

📍 Rosette cataract 🌹
• Typically post-traumatic
• History of blunt trauma

📍 Cerulean cataract / congenital
• Punctate or lamellar
• May occur at an early age

📍 Hypermature cataract
• Cortical liquefaction, wrinkled capsule
• Risk of phacolytic or secondary inflammation

📍 Total white cataract
• Completely opaque lens
• No fundus visualization

📌 Common etiologies

• Age
• Diabetes mellitus
• Trauma
• Uveitis
• Corticosteroids
• Radiation
• Congenital / genetic

📌 Classic symptoms

• Progressive blurred vision
• Halos and glare
• Decreased contrast
• Frequent changes in Prescription
• Poor night vision

📌 Treatment

Surgery is the definitive treatment: removal of the opaque lens and implantation of an intraocular lens.

Today, this can be customized with monofocal, toric, EDOF, or multifocal lenses, depending on the case.

⚠️ Key concept
Not all cataracts mature in the same way, nor do they affect the same people. The location of the opacity is as important as

21/04/2026

Imposter on the Roster

Radiation retinopathy mimicking diabetic macular edema

Today’s case was submitted by Ayushi Gupta () and Vishal Agrawal (.agrawal.5), Agrawal Hospital Jaipur.

This 53YO female presented with gradual bilateral vision loss. Three years earlier she was treated elsewhere for metastatic breast carcinoma, which included mastectomy followed by radiotherapy to the supraclavicular region and brain. She denied having diabetes. Vision was 20/60 OD and 20/30 OS.

Fundus photography shows bilateral macular telangiectasia with flecks of radiating macular lipid (images 1 and 2). OCT scanning shows diffuse cystic retinal thickening with hyperreflective lipid centered around the outer plexiform layer. Anti-VEGF therapy was recommended.

Radiation retinopathy usually occurs 3 months to 3 years following external beam radiation or plaque radiotherapy. The ocular findings and pathogenesis closely resemble those seen with diabetic retinopathy. Radiation optic neuropathy can also develop (Carey et al, Br J Ophthalmol 2023;107:743-749).

Go to www.retinarocks.org/cases for more radiation retinopathy cases.

[This case can be found on www.retinarocks.org in the Image Gallery, Radiation retinopathy folder, Radiation retinopathy MTS-20260317]

Have an interesting case and want to help your peers learn something about the retina? Submit your images at www.retinarocks.org.

Retina Rocks and its charitable foundation, "Eye Reach" are supported in part by Optos () and Topcon Healthcare (). Retina Rocks is the image bank for the Retina World Congress ().

21/04/2026

🔷Differential Diagnosis:

💢Solar retinopathy:
👉 Small, round, red or yellow lesion at the center of the fovea, with surrounding fine gray pigment in a sun gazer or eclipse watcher. (Wills 8th)

https://t.me/gifts4Ophthalmologists/22877

11/04/2026

Familial exudative vitreoretinopathy (FEVR)
A comet's tail is the closest thing to nothing that anything can be

Today’s case was submitted by João Pedro Marques (, Coimbra University Hospital).
From
This healthy 6YO boy from Guinea-Bissau with long-standing low vision was referred due to a family history of familial exudative vitreoretinopathy (FEVR) in an older brother and maternal uncle. Vision was 20/400 OD and no light perception OS.

Fundus examination OD showed a falciform retinal fold, straightening of the temporal retinal vascular arcades and temporal macular dragging. There was a dense white cataract OS, with a total funnel-shaped retinal detachment noted on ultrasonography. Scatter laser and peripheral cryotherapy was applied throughout all ischemic retina. Postoperative Optos color RGB imaging shows the laser and cryotherapy scarring.

Familial variant testing confirmed the presence of the pathogenic c.362G>A p.(Arg121Gln) variant in hemizygosity in the NDP gene (NM_000266.4), establishing the diagnosis of X-linked FEVR.

Originally described by Criswick and Schepens (AJO 1969;58:578-594), familial exudative vitreoretinopathy (FEVR) can be inherited as an autosomal-dominant, recessive, or X-linked trait with high penetrance and variable expressivity. There are numerous genes associated with FEVR, including LRP5, FZD4, NDP, TSPAN12, ZNF408, CTNNB1 and KIF11 [Tao et al, Invest Ophthalmol Vis Sci 2021;62(15);4].

FEVR is characterized by peripheral temporal retinal avascularity, lipid exudation, peripheral neovascularization, tractional retinal detachment, and temporal dragging of the macula and retinal vessels. These findings are somewhat like those found with retinopathy of prematurity.

10/04/2026

4. Malignant hypertension
The fundus shows
optic-disk hyperemia and blurring, retinal hemorrhage,
a macular "star" with lipid deposits, and
venous congestion.
These findings are most consistent with malignant hypertension; this patient's blood pressure was 210/130 mm Hg at presentation. These ocular findings can also be caused by blood dyscrasias, systemic lupus erythematosus, neuroretinitis, sarcoidosis, and eclampsia.

24/03/2026

A scan you do not see every day.

First EVER reported case of a worm INSIDE the crystalline lens.

Swipe through these frames.

What investigation is this?

How would this change your surgical plan?

Upcoming reel shows the intraoperative steps and what we found.

Save this case. Share your answer. Follow for the full outcome.

Citation:

Aravind H, Shroff A, Rajendran A, Anthony E. Intralenticular gnathostomiasis: A rare parasitic invasion. Indian J Ophthalmol. 2025;73(8):1239. DOI: 10.4103/IJO.IJO_1759_24

Ophthalmology, Eye care, surgery, cataract, parasite