In this vignette-based companion to the highly popular Ophthalmology Secrets, the authors, largely from Wills Eye Hospital, present a wealth of real-patient cases with which to challenge the reader. For each case, a patient case scenario is presented, accompanied by physical findings, pertinent lab data and an illustration, and the reader is asked to make a diagnosis and formulate a management plan. The authors answer the questions they have proposed, provide a focused discussion, and conclude with three or four key "Secrets" distilled from the case.