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Title | Creator | History |
51 |
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Who Deserves a Second Chance? | Lina Nagia; Jennifer Doyle; Lanning Kline | An 81-year-old woman presents with a one-month history of blurred vision OS, acutely worse in the past 5 days. She reports pain with left gaze, left sided forehead tenderness and some weight loss. Medical history includes hypertension, borderline diabetes, cerebral vascular accident and basal cell c... |
52 |
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A Weak Presentation | Reuben M. Valenzuela; Bradley Katz; Alison Crum; Kathleen B. Digre; Nick Mamalis; Hans C. Davidson; Judith Warner | An 82-year-old right-handed man with myasthenia gravis presented in May 2014 with double vision and right facial numbness and weakness. He was first seen in 1998 with horizontal diplopia. He had an abduction deficit of the right eye, and right nasolabial fold flattening. He was diagnosed with myasth... |
53 |
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I Can't See Straight | Steven A. Newman; T. Ben Ableman | In 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... |
54 |
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Star Spangled Banner | Dara M. Bier; Jeffrey P. Greenfield; Marc K. Rosenblum; Joseph Comunale; Cristiano Oliveira; Marc J. Dinkin | A 12-year-old girl with a history of bilateral optic nerve enlargement, enterovirus meningitis, seizures, and bilateral hygromas, presented with acute onset chronic vision loss in her left eye. Two years prior, she presented to an outside hospital with headaches, intermittent speech arrest and right... |
55 |
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Three Weeks in Florida | Andrew R. Carey; J. Antonio Bermudez-Magner; Sander R. Dubovy; Norman J. Schatz; Linda L. Sternau; Byron L. Lam | A 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... |
56 |
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Nobody's Perfect | Alexander Ksendzovsky; Steven A. Newman | In June of 2006 an 8 year old patient was referred for evaluation. Apparently at age 1 ½ she had developed headaches and was found to have a posterior fossa tumor. In El Salvador she was treated with shunting and chemotherapy plus radiation therapy for presumed medulloblastoma. She underwent a shun... |
57 |
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A Shot in the Dark | Joshua Pasol; Ricardo Komotar; Feisal Yamani | A 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... |
58 |
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Some Like it Hot | Ahmara G. Ross; Islam Zaydan; Gabrielle Bonhomme; Ellen Mitchell; Tarek Shazly; Deborah Parrish | A 71 year old Caucasian man with a past medical history of hypertension, hyperlipidemia, Type 2 DM, ESRD status post renal transplant, facial melanoma, currently on ASA for a stable left sided putaminal hemorrhage presented with new right sided ptosis and lower extremity weakness. Brain MRI obtained... |
59 |
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Requiem for a Cabinet Maker | Jennifer I. Doyle; Michael S. Vaphiades; James R. Hackney; Lanning B. Kline; Lina Nagia | A 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 ... |
60 |
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Using Muscle | Nagham Al-Zubidi; John E. Carter; Bundhit Tantawongski; Patricia Chevez-Barrios; Lyndon Tyler; Constance L. Fry | A 30- year-old Saudi female student with no past medical history presented an eight month history of progressive blurred vision primarily at near, anisocoria OS, and periocular discomfort with eye movements. Neuro-Ophthalmologic examination revealed best corrected visual acuity of OD 20/20 and OS 20... |
61 |
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Lights Out | John J. Brinkley; John J. Chen; Patricia A. Kirby; Reid A. Longmuir; Matthew J. Thurtell | A 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... |
62 |
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It's Not Just a FAD (EHR Fatigue Syndrome) | Jacqueline A. Leavitt; John J. Chen; Diva R. Salomao | A 29 year-old female nurse, nine months postpartum, presented with an inability to see her computer well for the past two months. She denied eye pain, diplopia, numbness, tingling or weakness. There were no changes in vision in bright vs. dim lighting. She also had a headache at the back of her head... |
63 |
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Speakeasy | Joseph G. Chacko; Marcus Moody; Harry H. Brown; Sarkis Nazarian | A 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... |
64 |
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Shady Double Crosser | Francine Wein | History & 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... |
65 |
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Joe & Jerry Flew the Coop | Lulu L.C.D. Bursztyn; Dane A Breker; Andrew W. Stacey; Ashok Srinivasan; Mark W. Johnson; Jonathan D. Trobe | A previously healthy 13-year-old girl presented to a local hospital with fever and myalgia, followed one day later by lethargy and vision loss. Past medical history was significant only for acne, for which she had been treated with doxycycline 40 mg/day intermittently starting 2 months prior to symp... |
66 |
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The Man with No Face (About Face) | Michael Vaphiades; Jennifer Doyle; Lina Nagia; Kevin Bray; Kline Lanning; Glenn Roberson; Adam Quinn; Joel Cure; Katherine Fening | A 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... |
67 |
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Ataxia at the Masquerade Ball | Krista 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. Digre | A 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,... |
68 |
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It's Not the Tumor | Courtney E. Francis | A 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... |
69 |
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Blame it on the Pill | Sachin Kedar; Padmaja Sudhakar; Stuart Tobin; William O. Connor; Fernando Decastro | Three 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. |
70 |
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Muscle Bound or Unbound? | Dane A. Breker; Jonathan D. Trobe; Ann A. Little; Sandra I. Camelo-Piragua | A 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... |
71 |
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Renal Red Herring | John J. Chen; John J. Brinkley; Namrata Singh; Amanda C. Maltry; Bruno A. Policeni; Richard C. Allen; Reid A. Longmuir; Matthew J. Thurtell | A 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... |
72 |
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Is it a Crime to be Blind? I plead the 4th! | Jasmine Gopwani; Edward Margolin; Tran Le; Wayne Cornblath; Rasmus Kiehl | A 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... |
73 |
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I Can't Stand the Double Vision | Iris Ben Bassat Mizrachi; Ruth Huna-Baron; Rivka Inzelberg; Yonathan Sharabi | A 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... |
74 |
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A Candid Look at a Missed Diagnosis | Edward Margolin; Jasmine Gopwani; Robert Willinsky | She was diagnosed with migraine, stress, and 'drug seeking' presumed from a history of past (intravenous?) heroin use. |
75 |
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Almost Catastrophic | Danielle S. Rudich; Samuel Yun; Anne Liebling; Jonathan E. Silbert; Robert L. Lesser | A 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... |