SIGNIFICANCE Peripapillary retinoschisis is associated with primary and secondary glaucoma. It is important that clinicians are familiar with the presentation and management of peripapillary retinoschisis to understand its effects on the patient's glaucoma and to avoid unnecessary referral when the macula is not involved. PURPOSE We present a case of peripapillary retinoschisis found incidentally on routine optical coherence tomographic (OCT) surveillance of primary open-angle glaucoma. CASE REPORT A 70-year-old man presented for his annual diabetic eye examination. Surveillance with OCT revealed a splitting of the inner peripapillary retina corresponding to a previously noted notch in the right optic nerve. Further imaging of the right eye using enhanced depth imaging OCT revealed a defect in the lamina cribrosa that may have contributed to the formation and persistence of peripapillary retinoschisis. Retinal nerve fiber layer analysis showed a 5-year history of progressive temporal and inferotemporal thickening in the right eye. The patient was managed conservatively with instruction on regular Amsler grid testing. CONCLUSIONS As seen in this case, peripapillary retinoschisis typically alters retinal nerve fiber layer thickness on OCT and can be mistakenly attributed to glaucomatous change. Glaucoma-associated peripapillary retinoschisis is usually not vision threatening and can be managed conservatively; in rare cases of progression to macular involvement, patients should be referred to a retina specialist.

Due to the extensive differential diagnoses and overlapping clinical features, determining the aetiology of a crystalline retinopathy can be challenging. More effective ways are needed to help clinicians isolate the cause of a crystalline retinopathy and determine the appropriate management of concomitant ocular and/or systemic disease. This paper reviews literature on crystalline retinopathy focusing upon the key features of each aetiology, including medical history, laterality, and examination findings. Based on this review, an algorithm was formulated to clinically classify causes of crystalline retinopathy, which may help practising clinicians identify and manage key causes of crystalline retinopathy.

Trauma to the anterior segment can cause an iritis. A comprehensive eye examination is necessary to determine the extent of the injury to ocular structures. Ruling out differential diagnoses and prompt management with topical cycloplegic agents and steroids improves patient comfort and visual prognosis. CE Notification: This article is available as a COPE accredited CE course. You may take this course for 1-hour credit. Read the article and take the qualifying test to earn your credit. Click here to Enroll (https://www.crojournal.com/traumatic-iritis-a-case-study)

SIGNIFICANCE: Mantle cell lymphoma (MCL) is a rare lymphoma that can present even more rarely in the orbit. Diagnosis, differentiation, and systemic treatment with the help of an oncologist are necessary for improved prognosis. Eye care providers must be vigilant when addressing ocular findings to determine next steps. PURPOSE:We present a case of presumed orbital fat prolapse confirmed as MCL found on routine eye examination.CASE REPORT: A 72-year-old White man presented for an annual comprehensive eye examination and was found to have conjunctival elevation in the superior and inferior fornices bilaterally. The patient had stable lymphadenopathy on positron emission tomography/computed tomography imaging 1 week before presentation. Coupled with the patient's recent diagnosis of systemic MCL, there was high suspicion that the conjunctival lesions were malignant. Biopsy of the conjunctival lesion confirmed MCL. A reevaluation of the previous imaging with a neuroradiologist confirmed the presence of orbital lesions consistent with MCL. The patient responded to treatment with lowdose focal radiation therapy.CONCLUSIONS: Primary eye care providers should be aware of limitations of orbital imaging during routine positron emission tomography and computed tomography scans in those with MCL, and consultation with neuroradiology for image review may be useful if the clinical findings are suspicious.