Pathologic Myopia with Albinism

These are images of a 65 year old African American male with a history of pathologic myopia and albinism. He noted a change in vision in the right eye unassociated with trauma or any other event. Pathologic myopia is caused by excessive elongation of the globe which can lead to thinning of the retina and severe vision loss. Albinism is associated with lack of development of the fovea and poor visual acuity, sometimes with nystagmus. At initial visit, his vision was 20/200 in both eyes. Optical coherence tomography shows peripapillary atrophy in both eyes with subretinal fluid in the right eye (yellow arrow). Optos fundus photos also show a hemorrhage in his right eye (white arrow). Such a hemorrhage could be associated with coughing, vomiting, or another type of straining, although he did not have a history of these. Albinism is apparent in both eyes as manifested by a clear view of the sclera underlying the thin choroid without pigment (blue arrows). At his recent exam his hemorrhage resolved and he tested at 20/125 and 20/100 in his right and left eye, respectively.