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TitleCreatorHistory
376 Using MuscleNagham Al-Zubidi; John E. Carter; Bundhit Tantawongski; Patricia Chevez-Barrios; Lyndon Tyler; Constance L. FryA 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...
377 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...
378 It's Not Just a FAD (EHR Fatigue Syndrome)Jacqueline A. Leavitt; John J. Chen; Diva R. SalomaoA 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...
379 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 ...
380 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...
381 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,...
382 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...
383 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...
384 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...
385 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...
386 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...
387 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...
388 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.
389 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...
390 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 ...
391 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,...
392 Its 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...
393 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.
394 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...
395 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...
396 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...
397 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...
398 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...
399 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.
400 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...
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