A Great Conversation With Dr. James Corbett

Great Conversations Section Editors: Meagan D. Seay, DO Rachel Calix, MD A Great Conversation With Dr. James Corbett Kathleen B. Digre, Meagan D. Seay, Rachel A. Calix K athleen Digre (KD): Today we’re with Dr. James Corbett, Professor of Neurology and Ophthalmology and former Chair of Department of Neurology at the University of Mississippi. James, we’re so excited that you could be with us today. Can you give us a little bit of background about your life before you went to medical school? James Corbett (JC): Yes. My background is from a family of physicians. My father, grandfather, and uncle were all physicians. And none of them was an ophthalmologist, or a neurologist, but I had an opportunity to see patients when I was a little boy, starting when I was about 7 or 8. I would go down on Saturday mornings to the Corbett clinic in the city of Chicago (in an industrial region, west of the loop) with my father. And then I would wander around the clinic all day after making rounds with my father at the hospital, and I had an opportunity to see all sorts of pathology. None neuro-ophthalmologic, but nonetheless, I became familiar with the clinical setting. I also was influenced by my grandfather who came to Chicago from Ohio, where he grew up. He was newly married and worked as a Red Cap at the Union Station in Chicago and was just starting out; he had had a year of Denison College. He ran into a black physician who was having him carry his bags. And on the top of the bags were a couple of volumes of books on medicine, and he got to paging through it. He paged through these and thought he would go into medicine. And so he went to night medical school, Jenner Medical School, which was one of the medical schools that was put on probation with the Flexner Report. It’s still an ongoing entity now; it was the only one that survived the Flexner Report. He graduated from medical school and shortly after that took a job in Chicago with the Public Health Service, where he did coliform measurements in the Lake Michigan water—the water supply to Chicago. At that time, Chicago River flowed into Lake Michigan with sewage, and, as a result, the water was being extracted to be used in family and factory settings. JC: And he was part of the group that got the information down on coliform pollution of Lake Michigan. He quarantined and he did other things that Public Health Departments of Ophthalmology and Neurology (KBD, MDS), University of Utah Moran Eye Center, Salt Lake City, Utah; and Departments of Ophthalmology and Neurology (RC), Ochsner Medical Center, Jefferson, Louisiana. The authors report no conflicts of interest. Address correspondence to Meagan D. Seay, DO, 65 Mario Capecchi Drive, Salt Lake City, UT 84132; E-mail: [e-mail] Digre et al: J Neuro-Ophthalmol 2021; 41: e387-e393 officers did, but something drew him away from Chicago for about 4 years, and that was Hannibal, Missouri, Tom Sawyer’s hometown, where he did public health, and then came back to Chicago in 1915. He came back because the workman’s compensation had been initiated. He was able to be paid for taking care of people injured on the job, who would not be taken care of by regular physicians who had fancy offices in the downtown area, and were not suited to people walking in long boots and helmets on their head and filthy, dirty clothes from working in the mud. KD: Wow. Did he get you interested then in medicine? Do you think your grandfather was your inspiration? JC: No, but he explained the inspiration, and then he got both of his sons to go into medicine. And in doing that, I was immersed in medicine. Going down to the clinic and seeing cases, talking to patients, and doing all that sort of thing just made it almost a dead ringer that I was going to go into medicine. JC: I didn’t take up anything that my father or uncle or grandfather took up, but I got the bug about being a doctor. How I chose neurology is a combination of things. I got interested in neurology as a college student, having taken physical anthropology at Brown University. We were to write a paper in physical anthropology, looking at methods of comparing different kinds of primates. And I did a paper on the relationship between the olfactory cortex and the visual cortex in monkeys—New World monkeys, Old World monkeys, and apes and gibbon, orangutan, and chimp and gorilla. And I found illustrations of the brains of these animals, and I found an illustration that. Or a set of illustrations that showed what part of the brain was olfactory and what was visual and made the rather broad conclusion that there was an inverse relationship between the amount of visual cortex there was and the amount of olfactory cortex. I felt very accomplished having made that observation. Although I’m sure it was something that if I had known where to look, the observation had been made before. But I felt very proud of myself and had enthusiasm about that subject. The other experience was getting to work on weekends on Dr. Yakovlev’s office and staining tissues of monkey brain and also experience of dissecting of whole brain. This was all pre-med, and I continued my interest in neuro-anatomy. KD: So that was your first introduction to neurology. Why did you choose neurology? JC: Well, I liked the oral history that was required, and I liked the examination. I also worked for a while in e387 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Great Conversations neurosurgery at Cook County during medical school at the University of Chicago. And the specialties of the examination that you had to do to know about neurology and ophthalmology. I didn’t have a particular thing that I could point to, except for the textbook by Steven Polyak, who was at my medical school University of Chicago and had written an enormous tome called, “The Vertebrate Visual System.” I’m sure that many of my ideas came from there. And then I read a lot of it and was very enthusiastic about it. I learned about the parcellation of the cortex into different areas and that they could be characterized by their histopathology. And there was nothing of CT, MRI, arteriography, or any electrical studies that had been done up to that time that gave us any hint of the relationship between structure and function. That was to come later, and that was one of the things that interested me was structure and function. KD: So really early on you got interested in the visual system, as well as the brain? JC: Yeah (Fig. 1). KD: And then why did you choose neurology and not ophthalmology? JC: I had a neurology course in medical school and had no ophthalmology training in medical school. KD: Yeah, like a lot of people. FIG. 1. Graduation from Medical School at the University of Chicago. Pictured my father Maxwell Corbett, me, and my son John Corbett. e388 JC: Yeah. I would like to have seen more ophthalmology, but I had one course, one afternoon [chuckle] for ophthalmology. KD: James, tell us about why you chose neuroophthalmology. How did that come about? Where did you go to medical school? JC: I went to medical school at Chicago Medical School, and it was not one of those medical schools that had a neuro-ophthalmologist in it or had an ophthalmology or neurology department. I just caught the bug of the anatomy. I won a prize in anatomy in college for doing the best cat brain dissection. And when I was in medical school, I got more textbooks than I needed to have and just gobbled up the material. I was very interested in the brain. And the visual aspects of it came next. KD: And then where did you do your residency? JC: Well, I took my two-year residency at Rhode Island Hospital for internal medicine. Then I took 3 years of neurology, at Case Western Reserve, where I read Big Red —Frank Walsh’s second edition, Neuro-ophthalmology. Then the event that changed everything and got me heading down the neuro-ophthalmologic trail was an encounter with my Chairman, Joe Foley. And my question of Joe was, “Could we have a set of lectures given to us on neuroophthalmology, I’m very interested in it?” And he said, “No.” And I said, “Why not?” And he said, “Because I arranged these courses for the residents. Everybody shows up for the first lecture, and the lecturer turns up for the last 5 lectures and is alone. And I’m not going to do that to my faculty. I’m not going to waste their time, having them be the only attendants at a course that’s set up specially for the neurology residents (Fig. 2).” JC: About a week later, he came to me and he said, “How would you like to take 3 months and go to St. Louis with Andrew Gay, Ron Burde’s mentor? They have a neuro-ophthalmology unit there. Very good one. Or San Francisco, Bill Hoyt.” And in my heart of hearts, I wanted to go to San Francisco. JC: When I met Dr. Hoyt the first time, he was visiting Cleveland for the Cushing Society meeting, and he recommended that I get his book on the fundus. And that anything else he was going to teach me, we would take care of out in San Francisco. KD: And which book was that? JC: That was the fundus book by Bill Hoyt (1). KD: Oh, the 3D pictures of the fundus. JC: And, of course that was the “ne plus ultra” on the fundus at the time. So, I felt fairly well-prepared to go out there. KD: So, you went with Hoyt as a resident? JC: Yeah, as a neuro-ophthalmologist, I’m a pretender. I didn’t take a full year of neuro-ophthalmology as a neurologist or as an ophthalmologist, what I did was take 3 months with Bill Hoyt, and I came back and enthused a bunch of guys at Case Western. Each one of whom, there Digre et al: J Neuro-Ophthalmol 2021; 41: e387-e393 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Great Conversations FIG. 2. Joe Foley was my early mentor. were 4, spent 3 months with Bill. It became part of the program, but I was the first one to go out there. JC: Jack Selhorst was the second, and Patrick Sweeney was the third; I can’t remember the name of the fourth. KD: Well, that’s the story I had never heard. So, when you were training then, your biggest mentors were, obviously, Bill Hoyt. JC: Joel Glaser was my biggest mentor. Joel was taking a fellowship at the same time I was out there, and so he had spent time with Bill, about 3 months as an ophthalmology resident about 4 years before. And he had been in the Public Health Service and gotten out of the Public Health Service and came right to the clinic to a resident fellowship. He knew Bill well, and they had a lot of stuff that was Bill and Joel and nobody else, private jokes, that sort of thing. But Joel spent time with me, showing me how to do examinations of various sorts. And then the 2 of us met Goldmann’s fellow who was spending time in ophthalmology at UCSF. He taught us how to do Goldmann perimetry the right way. We could field strip the machine if we had to! I would spend 2 or 3 hours a day doing perimetry. JC: And we didn’t know anything about the fact that there were standard perimeters, standardized factors. The first paper that we wrote where we did perimetry, the perimetry I did, and what we had were just a phantasmagoria of Digre et al: J Neuro-Ophthalmol 2021; 41: e387-e393 isopters that didn’t make much sense. They were the I-1, I-2, and I-4, and V-4 are the starting points of seeing whether the isopter is smaller or larger, and that’s the reason that you use those as starters. Going in and doing a II-4, III2, and a V-1 doesn’t make any sense because they’re all isopters, and it’s not a very good way to examine the visual field, but we found that out by learning from Goldmann’s fellow, and that was exciting. KD: That must have been exciting. What was your first job out of training? Well, obviously, you went to Bill Hoyt, but that was when you were a resident. And then what did you do after residency? JC: Well, I spent 3 years in residency, or 2 1/2 years in residency after I had taken my fellowship with Hoyt. I’ve always insisted that people know that I never took a whole fellowship with Hoyt. So, the first job out of training in neurology was 2 years in the Navy, and I almost stayed in the Navy, I enjoyed it. It was good work being a neurologist, and you did all sorts of things, and I hued out a little neuro-ophthalmologic time to present to residents and time to see neuro-ophthalmology patients. Those were the days when we did our own pneumoencephalograms, and I did 7 of those—I know what head pain is. I made it my purpose to become a neuro-ophthalmologist who would do that in addition to neurology. I applied for and was accepted to a year’s fellowship with Bob Daroff in Miami but Richard Nixon froze all NIH funding and I couldn’t go. I got a lot of training after I went into practice with Norm Schatz at Will’s Eye Hospital. In the next 3 years, we picked up Linda Orr and Peter Savino. Tulay Kansu from Ankara Turkey was our first neuro-ophthalmology fellow. She became editor of the Turkish Neurology, Chair of Neurology at Hacettepe University, and finally the Dean of the medical school. JC: Well, Norm was in practice with Dr. Nathan Schlezinger, and Nate was an old guy and trained by Morris Bender and Schlezinger was a psychiatrist, psychoanalyst, and neurologist. But he had a huge complement of people with myasthenia gravis, and he took care of the sickest of the sick. He was always sort of laughed at as being an old fart, but he was a very thoughtful physician. He wrote an editorial around 1952 (2) after a number of patients with myasthenia had died on higher doses of steroids, and his editorial was in contradistinction to the recommendations being made by the AMA, which was that you should not use steroids with generalized myasthenia gravis, that it would kill them. And he wrote a letter back and said, “A careful, slow progression of the use of prednisone can provide marked improvement in myasthenia gravis.” And it was. Oh, what was her name? She was out in California in San Diego. KD: Marge Sebyold JC Marjorie Seybold. Yeah, right. And she showed in mice (used their ear as a drooping ear); gave them myasthenia and then treated it with steroids and showed e389 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Great Conversations that it was an effective form of treatment. He (Nathan Schlezinger) was a guy who came from a period of time in medicine when private practitioners who had academic interests would do the work by themselves at home at night. It was never laboratory work, it was always clinical work, but a lot of good clinical observations were made that way. KD: So, was this all at Wills, then? That you were working with Norm? JC: Wills and Jeff (i.e., Thomas Jefferson Medical College). KD: Okay, Wills and Jeff. Wills Eye Hospital. JC: I practiced with those 3 people from 1973 to 1978. In 1978, I was asked by Bob Rodnitzky to come and take a look at the position, neuro-ophthalmology in neurology and ophthalmology at the University of Iowa. They would pay me half and half, and that was largely because of Dr. Maurice Van Allen (neurology) and Dr. Fred Blodi (ophthalmology) had worked together on EMG ocular muscles (3). JC: And I went to Iowa in 1978. You started medical school in what year? KD: I finished medical school in 1981. JC: So, I was there for all but 2 years of your medical school and fellowship and other stuff. At any rate, they were very important people in helping me to organize my thinking about neuro-ophthalmology. KD: And that’s when you joined Stan Thompson at Iowa. JC: Right. In 1978, I left Philly and went to Iowa. And I was at Iowa for 13 years. People who were influential in my development were not always teachers, they were residents or fellows who I had worked with and learned a lot from them. Another reason why I don’t put myself up as a fully trained neuro-ophthalmologist; I was all the time learning from residents and medical students. I benefited by traveling around to give lectures about what we were doing. Of course, I must mention Joyce, my wife, who learned as much neuro-ophthalmology as I did (Fig. 3). JC: Roger Hitchings was important to me and he familiarized me with glaucoma. JC: Hitchings was an ophthalmologist, with a specialty in glaucoma who had come from England. He ended up being the Chairman of the Department of Ophthalmology at a big glaucoma clinic in London at Moorfield’s Eye Hospital. JC: He and I wrote a paper on hemorrhagic drusen (4). So those were mentors who were very important to me. Of the fellows who I had subsequently, you [KDigre], Jacobson. I’m not going to name them all, but. (Fig. 4) KD: Well, you don’t have to name them all, but if there were people who were influential in your career you can bring that up. JC: Well, I think you were, and Jacobson was. Tim Martin. I think those plus the ones that I gave before, Joe Foley, (Bill) Hoyt, Bob Daroff, and Joel Glaser are people e390 FIG. 3. Joyce Corbett and I at our 25th wedding anniversary! who were mentors, whether I liked it or not; or were people who contributed to my way of thinking about medicine. I had no hell-bent to become an academic point of view at that time and I developed the academic approach to things when I got to Iowa. Oh! Stan Thompson, I forgot Stan Thompson. He should go right up at the top with Joe Foley and Bill Hoyt. “What would you go back and tell yourself FIG. 4. Fellows of James Corbett and Stan Thompson Snowbird, Utah NANOS meeting 2003. Digre et al: J Neuro-Ophthalmol 2021; 41: e387-e393 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Great Conversations during your early career?” Well I had a comment made to me by Stan Thompson, that was very helpful. I had just gotten to Iowa from Philly, and we were down at the lunch tables having a cigarette and drinking some sherry. And I had to talk about something that I felt very proprietary about, and it was my idea. And so I sort of casually looked around to see who was sitting near us and lowered my voice, and made this pronouncement. And Stan said, “Jim.” As we were walking out and he said, “Jim, that secret is poisonous.” And he said, “How do you know where you get your ideas? Can you be so sure that this thought of yours sprang fully-formed from your head?” And it was one of the most important pieces of advice given to me. In a way that it was not chiding but, “Hey, think about it this way (Fig. 5).” KD: And that’s why you’ve been a generous mentor all along, too. It’s that many people get involved in your projects, not just one person. JC: Yeah, right. Then I went on to become Chairman of Neurology at the University of Mississippi in 1991 and retired from there 2016. KD: James, what do you think is your biggest success? JC: My biggest success—training of the residents and fellows, I think is the biggest success. To see somebody light up when they make a new observation. I was out at Iowa for the last part of my sabbatical (this was a sabbatical after he was chair at Mississippi). I made an observation on a disc that was an “all ciliary disc,” and it went around the retina department and ended up showing to everybody, glaucoma, retina, and none of them recognized. They recognized that it was an unusual disc, but they didn’t know what it was all about. The “all ciliary disc” has no contribution to the blood supply from the central artery, and it is associated with a variety of not necessarily associated renal problems suggesting that both issues may have arisen at the same time that the retinal blood supply gets distributed. These are pure ciliary arteries. We did angiograms on them and it showed a ciliary supply had lit up, but no central or branch FIG. 5. The dynamic duo: Stan Thompson and James Corbett University of Iowa 1977–1990. Digre et al: J Neuro-Ophthalmol 2021; 41: e387-e393 retinal arteries lit up. So, I showed it around, and there was all this enthusiasm about it, and they were particularly impressed that it was a neurologist who knew it. [chuckle] And I consider the little trips that you take outside of your specialty, where you demonstrate something that is germane to their specialty is particularly satisfying. It’s a little polishing your fingernails on your chest. It helps to keep your validity as a clinician going. I think the things that I did that were important were the description of the mechanism of the enlarged blind spot. And I’m particularly satisfied with that because it was subsequently confirmed by OCT. And we made the observation using perimetry, and the explanation that the peripapillary retina gets hoisted up into the air, and that disturbs the refraction of the peripapillary retina. JC: And so what you get is the reverse of what you get with a disc that is depressed and has a coloboma or coloboma-like defect where the posterior portion of the sclera is pushed back and you get a big blind spot when you examine it with regular isopters. But you shrink the isopters of the blind spot by putting plus lenses in. In papilledema, you put minus lenses in and that brings the retina up towards the middle of the vitreous. JC: So that was an observation that I made that was a result of riding back and forth to work and thinking about it. And then we did some patients and normals and published it in the AJO (5). It particularly tickled me because someone spent one of his whole tapes trying to debunk my explanation for enlarged blind spot and he [Dr. Lawton Smith] said “I went to Don Gass and asked him, the reason that the blind spot is enlarged in papilledema is because the retina’s pushed aside.” And he replied “Well, if it’s pushed aside then there’s no reception and you should not be able to improve it with lenses.” But my observation held. And that was very satisfying. It was making an observation that was not entirely agreed on, and that you got a lot of criticism that showed that the person who was doing or criticizing had not completely thought it out. So that was satisfying. The paper that I did with all of the neuro-ophthalmology people (6), having to do with the loss of vision with pseudotumor I think is my best piece of work I did. And I would say that and the Canadian Journal article (7) both took from a data standpoint (that was my article) and from a summary of work that had been done before and my work, to create a reasonable, thoughtful way of taking care of these patients. And I don’t think it’s been made better since. KD: James, that article you’re referring to, that you did with all the neuro-ophthalmologists, is that the one of the up to 57-year follow-up of the pseudotumor patients? JC: That’s right. KD: That one still gets quoted all the time. It’s a very important article (6). JC: Yeah. A doctor who just died recently, a year ago. He was at Harvard. Very good friend of mine, Simmons Lessell, asked an open-ended question to a group of his residents and some neuro-ophthalmologists that were in his office e391 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Great Conversations when I was invited up there to speak, and he said, “One of the 10 best articles, the 10 most important articles that have been written in the 20th century.” And he included mine as one of them. KD: Oh wow. That’s great. JC: Which I’m very proud of. [chuckle]. KD: James, if you were trying to influence somebody to go into neuro-ophthalmology, what would you tell them? What would you say about neuro-ophthalmology? JC: Well, neuro-ophthalmology is a super specialty. What it requires of you is to know more about uncommon visual presentations of disease than anybody else. You’ve got to know the name of the weird diseases, you’ve got to know how to take care of the uncommon problems, you should be able to do chapter and verse on methanol poisoning and ocular-renal syndrome, and you name it. You should be able to at least bring together a couple of ideas and know where to look to flush it out. You need a very solid background of all the common things and some of the uncommon things and then you need to continually tweak yourself about the uncommon things. I remember the Walsh session in 1991 when Sophia Chung8 presented a case. When she started to present it, I went to the bathroom, came back, and she was just about ready to let loose with what do you think it is? And I looked at it, and it was an MRI of a cerebellar tumor that’s familial and is characterized by hyperplasia of all of the layers in an unconfined form. That is to say it doesn’t come in a para-median or globular or flocculonodular, it worms its way all through the cerebellum and I said I think this is Lhermitte Duclos Disease, and it was a piece of information I had been carrying around since I was an intern and saw the case at Rhode Island Hospital. Everybody was flabbergasted. Nobody had ever heard of the disease. There is a value to that. But it can’t be used on a computer without having a background of where to start from. KD: Great, so to a young person thinking about neuroophthalmology what would you say? JC: I think if you’re a person who likes detail and likes the elements of the examination. Neuro-ophthalmologists are the only doctors I know today that are doing complete examinations. What do you think? KD: I agree that we like detail and we like examinations. Any last words of wisdom, James? JC: Well, advice for the early years. The advice for the early years is collect a handsome way of collecting your materials. And that can be open-ended. Just a notebook. You can have a three-by-five card system. You can put it in a computer. However you want to do it, but have some way of being able to approach the work that you’ve done in order to be able to write papers. Remember, that when I started out, there were no computers. And at 57 patients, I had to take my shoes and socks off a lot counting how many of this and how many of that there were. JC: There was no computer setup that wasn’t enormous and done by punch cards. So, I think you want to be able to e392 FIG. 6. Colleagues: Joel Glaser, James Corbett, Roy Beck, Mitchell Brigell, James Goodwin, Stan Thompson, and James Sharpe at Illinois Eye and Ear meeting in 1981. organize your material. Have a systematic way to collect interesting patients or questions—Stan Thompson had a manila folder with napkins he had written on—on questions we had discussed. This provided ideas for future investigations and papers. At the beginning, I would say to look at problems that pique your fancy. Do Jim King kinds of things. You know Jim King wrote individual problems and then examined hundreds of patients with the problem on the hoof. Did his own photographs, did his own appeals, that sort of thing. You can collect material if you’re thoughtful about how you do it from the start. If it’s a problem that is, a therapeutic problem or a diagnostic question, it can be answered by looking at lots of people. Organization, don’t have just one thing going. Keep a couple, 3, 4 projects going. Look for questions that have no plausible answer has been given to you. JC: And you should be very attentive to the scientific statistical analysis of multiple patient work. No sloppy stuff. Individual case reports are important if you’ve never seen it before and you can’t find it or it’s one of a very few that you have found, and there’s no good summary of what’s going on with the patients that have this particular problem. Well, “I stuck in my thumb and pulled out a plum” is not a reason to write a paper. Joe Foley used to say, “I shot an arrow into the air and where it landed, I knew not, but the next day I found it, so I wrote a paper about it.” KD: That’s a good one. Very good. Well, James, this has been wonderful. JC: All right. Thank you. KD: Thank you so much for your time. Alright. Bye (Fig. 6). JC: Bye now. ACKNOWLEDGMENTS M. D. Seay and K. B. Digre are supported in part by an Unrestricted Grant from Research to Prevent Blindness, Digre et al: J Neuro-Ophthalmol 2021; 41: e387-e393 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Great Conversations New York, NY, to the Department of Ophthalmology & Visual Sciences, University of Utah. REFERENCES 1. Hoyt WF, Beeston D. The Ocular Fundus in Neurologic Disease: A Diagnostic Manual and Stereo Atlas. St Louis, MO: CV Mosby, 1966. 2. Schlezinger NS. Present status of therapy in myasthenia gravis. J Am Med Assoc. 1952;148:508–513. 3. van Allen MW, Blodi FC. Neurologic aspects of the Mobius syndrome. A case study with electromyography of the extraocular and facial muscles. Neurology. 1960;10:249–259. Digre et al: J Neuro-Ophthalmol 2021; 41: e387-e393 4. Hitchings RA, Corbett JJ, Winkleman J, Schatz NJ. Hemorrhages with optic nerve drusen. A differentiation from early papilledema. Arch Neurol. 1976;33:675–677. 5. Corbett JJ, Jacobson DM, Mauer RC, Thompson HS. Enlargement of the blind spot caused by papilledema. Am J Ophthalmol. 1988;105:261–265. 6. Corbett JJ, Savino PJ, Thompson HS, Kansu T, Schatz NJ, Orr LS, Hopson D. Visual loss in pseudotumor cerebri. Follow-up of 57 patients from five to 41 years and a profile of 14 patients with permanent severe visual loss. Arch Neurol. 1982;39:461–74. 7. Corbett JJ. The 1982 Silversides lecture. Problems in the diagnosis and treatment of pseudotumor cerebri. Can J Neurol Sci. 1983;10:221–9. e393 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited.