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TitleCreatorHistory
101 I Can't See StraightSteven A. Newman; T. Ben AblemanIn May of 2014 this 30 year old right handed patient was referred for consultation regarding diplopia and dizziness. The patient relates that she had been told that she had 'tired eyes' as a child. Two and a half years ago she began to have intermittent exodeviation. She was seen locally and diagnos...
102 Three Weeks in FloridaAndrew R. Carey; J. Antonio Bermudez-Magner; Sander R. Dubovy; Norman J. Schatz; Linda L. Sternau; Byron L. LamA 36 year-old man presented with severe headaches, bilateral leg numbness, and bilateral decreased vision. He was born in Ecuador where he received BCG vaccination and immigrated to US at age 19. In 2005 he enrolled in nursing school and volunteered in homeless shelters. PPD was positive with a nega...
103 A Shot in the DarkJoshua Pasol; Ricardo Komotar; Feisal YamaniA 74 year-old man with a chief complaint of difficulty with night time driving for several years as well as difficulty going from a lighted room to a dark room. PMH of high cholesterol, BPH, hypothyroidism, GERD, glottic squamous cell cancer without recurrence, and a prior history of alcoholism. POH...
104 Requiem for a Cabinet MakerJennifer I. Doyle; Michael S. Vaphiades; James R. Hackney; Lanning B. Kline; Lina NagiaA 54-year-old white male presents with 3 weeks of painless horizontal nystagmus and 6 months of left sided forehead numbness. He reports a 20 lbs weight loss. Medical history includes a renal transplant 30 years prior. He takes prednisone 30 mg QOD and azathioprine. Visual acuity is 20/20 OU, color ...
105 Lights OutJohn J. Brinkley; John J. Chen; Patricia A. Kirby; Reid A. Longmuir; Matthew J. ThurtellA 78 year-old man presented with a one-month history of progressive painless binocular vision loss. He had sustained head trauma without loss of consciousness three days prior to the onset of vision loss. On the morning of his presentation to us, he had awoken with complete binocular vision loss and...
106 SpeakeasyJoseph G. Chacko; Marcus Moody; Harry H. Brown; Sarkis NazarianA 64 year-old Caucasian gentleman presented with an unusual complaint. He stated that if he touched the inside of his right cheek with his tongue, he felt a tingly sensation in his R eyebrow. This had started one month ago. He also complained of foreign body sensation and discomfort in the right eye...
107 Shady Double CrosserFrancine WeinHistory & Exam A 62-year-old woman presented with a one-month history of severe light sensitivity and headache, and a two week history of diplopia. Her photophobia was severe enough for her to wear sunglasses indoors. Her past medical history was significant for a cholecystectomy and Crohn's disease...
108 The Man with No Face (About Face)Michael Vaphiades; Jennifer Doyle; Lina Nagia; Kevin Bray; Kline Lanning; Glenn Roberson; Adam Quinn; Joel Cure; Katherine FeningA 61-year-old man presented with one week history of decreased vision OS. Past medical history includes asthma and amblyopia OD, but with complete visual loss OD 18 years prior. He takes no medications. He is retired but worked for 21 years in social science research. The remarkable thing upon meeti...
109 Growing SuspicionAngela M. Herro; Norman J. Schatz; Linda L. Sternau; John R. Guyloss in the right eye for 3 months. On presentation, vision was 4/200 in the right and 20/20 in the left with an afferent pupillary defect on the right. His visual field was full to confrontation but automated perimetry revealed a central scotoma. The remainder of the exam was normal with the except...
110 Under PressureNathan H. Kung; Collin M. McClelland; Gregory P. Van StavernA 29-year-old woman was referred to neuro-ophthalmology clinic for 1 year of headaches and papilledema discovered 2 months earlier. She complained of recently blurred vision but no positional headache, pulsatile tinnitus, transient visual obscurations, or other neurologic issues. She used no medicat...
111 Ataxia at the Masquerade BallKrista I. Kinard; Alison V. Crum; Judith E. Warner; Bradley J. Katz; Joshua A. Sonnen; Cheryl A. Palmer; Anne G. Osborn; L. Dana DeWitt; Kathleen B. DigreA 52-year-old right-handed salesman presented in July 2007 with a 5-year history of slowly progressive imbalance. In 2002 he developed difficulty using his eyes together and then imbalance resulting in frequent backward falls. He reported oscillopsia and episodic vertigo. He later developed fatigue,...
112 It's Not the TumorCourtney E. FrancisA 58 year old woman with a history of metastatic parotid adenocarcinoma presented with bilateral vision loss over 2 months. She had undergone surgical resection of the tumor followed by fractionated external beam radiation with a total of 66.6 Gy 18 months prior to presentation. She was recently fou...
113 Muscle Bound or Unbound?Dane A. Breker; Jonathan D. Trobe; Ann A. Little; Sandra I. Camelo-PiraguaA 52 year old former Olympic athlete developed myalgias, cramping, and stiffness in the upper arms, chest, thigh, and calves in 2009 after a blood transfusion for hematochezia attributed to antiplatelet treatment following coronary stenting. Symptoms were worst in the morning, when he could not walk...
114 Renal Red HerringJohn J. Chen; John J. Brinkley; Namrata Singh; Amanda C. Maltry; Bruno A. Policeni; Richard C. Allen; Reid A. Longmuir; Matthew J. ThurtellA 71 year-old Caucasian male with a history of Wegener's granulomatosis presented with vision loss OU and horizontal binocular diplopia. His past medical history was significant for Wegener's granulomatosis, which was diagnosed in 2000 on the basis of a renal biopsy. He was previously treated with v...
115 I Can't Stand the Double VisionIris Ben Bassat Mizrachi; Ruth Huna-Baron; Rivka Inzelberg; Yonathan SharabiA 37 year-old woman was referred to our clinic due to bilateral ptosis and vertical binocular diplopia. She denied diurnal variations, muscle weakness or bulbar symptoms. In the past year she had been suffering from bouts of abdominal pain, diarrhea, and severe weight loss (>40 pounds), and she pres...
116 A TAAD Bit UnusualNisreen K. Mesiwala; Susan T. StefkoA 12 year-old previously healthy boy presented to the emergency room with a five-day history of progressive frontal headaches and acute onset of horizontal, binocular diplopia on left gaze. He had no significant medical history and his only significant ocular history was mild myopia and X-linked col...
117 Innocent until Proven GuiltyHeather E. Moss; Tiffany Stroup; Amy Lin; Oliver Graf; Jeffrey Borgeson; Aaron Halfpenny; Howard Lipton; Tibor Valyi-NagyA 31 year-old male experienced right eye blurring and pain. He was diagnosed with optic neuritis and treated with IV steroids. Nine days later he developed headache, worsening vision, speech trouble and right-sided weakness. Two days later he developed low-grade fever and trouble walking. He had NLP...
118 Much-Ado About Acute Vision LossMahsa A. Sohrab; Andrea Birnbaum; Michael Sidiropoulos; Lois Polatnick; Nicholas J. VolpeProgressive fatigue and right face, arm, and leg pain.
119 Wear and Tear VisionKonrad P. Weber; Caterina Schweier; Veronika Kana; Thomas Guggi; Katarzyna Byber; Klara LandauA 66-year-old woman presented with a four-month history of insidious bilateral visual loss. Ophthalmologic examination revealed visual acuity reduced to finger counting in both eyes. On fundus examination, maculae and optic discs appeared normal. Visual fields showed bilateral central scotoma with m...
120 It's Deja Vu All Over AgainAileen A. Antonio-Santos; Yanny L. Phillips; Baha El Khatib; Howard T. Chang; David I. Kaufman; Eric R. EggenbergerA 51-year-old male with a history of amblyopia OD presented in February 1999 with hyperemia, swelling and periorbital pain of the left eye. Visual acuity (VA) was 20/80 OD and 20/25 OS; color vision was 10/11 Ishihara plates OU, and Goldmann perimetry showed an inferior quadrantanopia OS. There was ...
121 Blame it on the PillSachin Kedar; Padmaja Sudhakar; Stuart Tobin; William O. Connor; Fernando DecastroThree months earlier, he had been evaluated for malaise and weight loss and found to have lymphopenia, elevated TSH (20.3) and anti-thyroid peroxidase antibody (2874) with normal T3, ESR, B12 and folate.
122 Is it a Crime to be Blind? I plead the 4th!Jasmine Gopwani; Edward Margolin; Tran Le; Wayne Cornblath; Rasmus KiehlA 30 year old previously healthy man from Sudan presented to a community hospital with a seizure. MRI revealed a 'right frontal lobe tumor'. Brain biopsy was performed but the pathology findings were inconclusive. Initial interpretation was "brain tissue with increased cellularity consistent with gl...
123 A Candid Look at a Missed DiagnosisEdward Margolin; Jasmine Gopwani; Robert WillinskyShe was diagnosed with migraine, stress, and 'drug seeking' presumed from a history of past (intravenous?) heroin use.
124 Almost CatastrophicDanielle S. Rudich; Samuel Yun; Anne Liebling; Jonathan E. Silbert; Robert L. LesserA 36 year-old Caucasian male presented to his ophthalmologist with one month of headache, blurry vision, and intermittent diplopia. The patient denied transient visual obscurations, tinnitus, prior medical problems or use of steroids/Vitamin A/antibiotics. He was 235 pounds and 5'9". Because examina...
125 More Than a Cu-bit of Vision LossPhilip M. Skidd; Rebecca C. Stacy; Waqar Waheed; Mohamed-Ali BabiA 45 year-old, right-handed, man, presented after awakening with no vision in his left eye. Two days earlier he had experienced a brief episode of binocular horizontal, and then oblique, diplopia. One week prior, he developed left facial numbness and "sinus pain" on the same side; a five day course ...
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