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TitleCreatorDescriptionSubject
1 Cogan's Lid Twitch SignRaed Behbehani, MDCogan's lid twitch sign is a twitch sign of he upper lid upon looking straight from a sustained downgaze position. It is associated with Ocular Myasthenia Gavis.Myasthenia; Ptosis; Lid Twitch
2 Carotid Cavernous FistulaAdam Botwinick, MD; Rudrani Banik, MDPower point of case presentation of 66-year-old female with chronic red eye OU x 2 months, misdiagnosed as conjunctivitis. Exam showed dilated, tortuous episcleral vessels OU with proptosis OU and elevated intraocular pressure. MRI showed suspicion of carotid cavernous fistula (CCF), confirmed by ...Carotid Cavernous Fistula; Dural CCF; Chemosis; Corkscrew Vessels; Proptosis; Embolization; Neurointerventional Radiology
3 Bitemporal HemianopiaJulia Mathew Padiyedathu, MD; Rudrani Banik, MDPower point of case presentation of patient with painless progressive vision loss, optic nerve cupping with pallor and history of significant alcohol and tobacco use. Patient initially diagnosed at outside institution with normal tension glaucoma and toxic optic neuropathy. Exam suggests bitempora...Ditemporal Visual Field Defect; Toxic Optic Neuropathy; Pituitary Adenoma; Compressive Optic Neuropathy
4 Supranuclear and Infranuclear Motility DisorderBrittany Lin, MD; Rudrani Banik, MDPower point of case presentation of patient with supranuclear left gaze preference from frontotemporal CVA (overcome by Doll's head), as well as right sixth nerve palsy with incomitant esotropia from pontine CVA.Supranuclear Gaze Palsy; Sixth Nerve Palsy; Esotropia; Gaze Preference; Stroke
5 Thyroid Eye DiseaseHelen Jiang MD; Rudrani Banik MDPower point of case presentation of 50 year old male with newly diagnosed hyperthyroidism who presents with ocular hypertension, acute onset proptosis and visual loss. Diagnosed with thyroid eye disease and compressive optic neuropathy. Treatment options discussed for visual loss in thyroid eye dis...Thyroid Eye Disease; Compressive Optic Neuropathy; Proptosis; Ocular Hypertension
6 Optochiasmal TuberculomaJeanie Paik, MD; Rudrani Banik, MDPowerPoint of case of chiasmal tuberculoma causing bitemporal defect in patient with tuberculosis on RIPE treatment; case history, differential diagnosis and treatment discussed.Chiasmal Disorder; Chiasmal Tuberculoma; Bitemporal Visual Field Defect; Ethambutol Optic Neuropathy
7 Upbeat NystagmusRaed Behbehani, MD,A patient with a brain stem syndrome due to demyelination and upbeat nystagmus.Upbeat Nystagmus
8 Downbeat Nystagmus Anti-GAD Cerebellar SyndromeRaed Behbehani, MDA patient with Anti-GAD positive Cerebellar syndrome with ataxia and opsoclonus due to downbeat nystagmus , treated with Baclofen with some improvement.Downbeat Nystagmus
9 See-Saw NystagmusRaed Behbehani, MDThis nystagmus localizes to lesions supra/parasellar region (Large sellar and hypothalamic lesion) and is characterized by a see saw movement of elevation/intorsion of one eye and depression/extorsion of the other eye in a pendular fashion. This patient had a large pituitary macro-adenoma with supra...See-Saw Nystagmus
10 NeurosyphilisTimothy Sullivan, MD; Rudrani Banik, MDPower point of case of a 66 year old male with acute vision loss OD to no light perception. Underwent extensive work-up for cardiovascular and neurologic etiologies, all negative. Subsequent serologic work-up was positive for syphilis and the diagnosis of neurosyphilis was confirmed by lumbar punc...Neurosyphilis; Infectious/Vasculitic Optic Neuropathy
11 The Ice Pack Test For MyastheniaRyan D. Walsh, MD; Collin McClelland, MDThe ice pack test is a simple, low-tech, bedside test that can readily be applied in the outpatient clinic or hospital setting, with minimal risk or discomfort. The ice pack test is used in patients with ptosis to help support or refute a diagnosis of myasthenia. We describe how to perform and int...Ice Pack Test; Ice Test; Myasthenia Gravis; Ocular Myasthenia; Ptosis; Diagnostic Tests
12 Optic Nerve Sheath FenestrationRaed Behbehani, MDOptic nerve sheath fenestration is performed to manage papilledema causing progressive loss of vision , due to raised intracranial pressure from Idiopathic Intracranial Hypertension or Cerebral Venous Sinus Thrombosis. The procedure is usually performed in cases of severe visual field loss or when m...Optic Nerve Sheath Fenestration
13 Temporal Artery BiopsyRaed Behbehani, MDThis is a video of Superficial Temporal Artery Biopsy done under local anaesthesia for a patient who was suspected to have Giant Cell Arteritis (GCA. GCA is vasculitis of the medium sized vessels than can lead to permanent visual loss by causing Arteritis Ischemic Optic Neuropathy. The diagnosis of ...Temporal Artery Biopsy; Giant Cell Arteritis
14 Pulsating ExophthalmosRaed Behbehani, MDThis patient had brain surgery with bone removal resulted in transmission of CSF pulsation into the orbit and pulsating exophthalmos. This sign can also be seen in patient with neurofibromatosis with hypoplasia of the sphenoid wing bone.Pulsating Exophthalmos; Neurofibromatosis
15 Congenital Oculomotor ApraxiaRaed Behbehani, MDCongenital Ocular Motor Apraxia is an uncommon condition that causes children to have difficulty moving their eyes horizontally or from side to side. They are usually unable to quickly move their eyes from side to side and often have to turn their head (head jerking) and not just their eyes to track...Oculomotor Apraxia
16 Ocular NeuromyotoniaRaed Behbehani, MDOcular Neuromytonia is a characterised by by paroxysmal tonic contraction of the extraocular muscles supplied by the oculomotor nerve. It is has been reported after cranial radiation therapy, especially to the sellar-parasellar region and from compressive lesions such tumours or aneurysms. The patho...Ocular Neuromyotania
17 Periodic Alternating NystagmusRaed Behbehani, MDPAN is a nystagamus characterized by a cycle of uniderectional jerk nystagamus for 60-90 sec , a pause for 10-20 sec and a a cycle of a jerk nystagmus in the opposite direction for 60-90 sec. It is found in brain stem and cerebellar conditions as well as ocular albinism ( as in this patient).Periodic Alternating Nystagmus
18 See-Saw NystagmusRaed Behbehani, MDSee-saw nystagmus is a localizing nystagmus to lesions of the sellar and parasellar region. "It's characterized by synchronous elevation and intorsion of one eye and depression and extorsion of the contra lateral eye . This patent has a craniopharyngioma, which was operated twice, optic atrophy and ...See-Saw Nystagmus
19 Marcus Gunn Jaw WinkingRaed Behbehani, MDMarcus Gunn Jaw Wink causes congenital ptosis and eyelid retraction associated with jaw movement or sucking. It's due to "miswiring" between 3rd and 5th cranial nerves. The treatment of ptosis in children is surgery to prevent amblyopia .Jaw Winking; Marcus Gunn
20 Apraxia of Eyelid OpeningRaed Behbehani, MDPatient has Parkinson disease and has developed this condition following deep brain stimulation.Apraxia; Eyelid Opening
21 Pertinent Pupillary ProblemsKarl C. Golnik, MDPupil Exam is a narrated PowerPoint that covers the basic of examining pupils.Pupil Exam; Pupil
22 AnisocoriaKarl C. Golnik, MDThis is a narrated PowerPoint presentation that covers the common causes of anisocoria.Pupil; Anisocoria
23 Parinaud SyndromeRaed Behbehani, MDParinaud syndrome, as called dorsal midbrain syndrome, is due to dorsal midbrain lesions from compression (e.g., a tumor), demyelination, or ischemia. The syndrome is characterized by limitation of upward gaze, convergence retraction nystagmus, light near dissociation, and lid retraction (Collier's ...Dorsal Mibrain Syndrome; Parinaud's Syndrome
24 Square Wave Jerks with ContrapulsionRaed Behbehani, MDA patient with history of brain stem stroke 2 months ago (right hemifacial anesthesia , left sided weakness and bulbar symptoms dysphagia) comes complaining of oscillipsia , binocular vertical diplopia). On exam he had a vertical tropia of 3-4 PD (Skew deviation), dissociated nystagmus , and saccadi...Square Wave Jerks; Contrapulsion
25 Oculopalatal TremorRaed Behbehani, MDThis is a usually vertical, pendular nystagmus associated with synchronous rhythmic movement of the palate, developing months after a severe brain stem stroke. The stroke involves the dentato-rubro-olivary tract (Mollaret's triangle). MRI can show hypertrophy of the inferior olivary nucleus in the m...Oculopalatal Tremor
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