NOVEL - Frank B. Walsh Collection
 
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TitleCreatorHistory
26 Sometimes a Biopsy is BestKevin Chodnicki; Natalie Wolkow; Michael Yoon; Bart ChwaliszA 30 -year-old pregnant woman without significant medical or ocular history presented with decreased right eye vision. In her 2nd trimester, she was diagnosed with Lyme disease with a bulls-eye rash and positive Lyme antibodies; she was treated with two weeks of amoxicillin. At 33 weeks pregnant she...
27 A Small Leak Will Sink a Great ShipKonstantinos Douglas; Vivian Paraskevi Douglas; Cameron Sadegh; David Chow; Sigurros Davidsdottir; Ganesh Shankar; Bradley Buchbinder; Bart ChwaliszA 68 -year-old right -handed man presented for evaluation of progressive and fluctuating polyopia, gait instability and cognitive changes of about 14 months. Prior medical history was notable for Crohn's disease in remission, atrial fibrillation, a single episode of aseptic meningitis 12 years prior...
28 A 4-Year WaitDmitry Balian; Sachin Kedar; Michaelyn Everhart; Aleh Bobr; Liudmila MuinovA 64 year old male with past history of hypertension, arthritis and chronic headache developed transient tingling and numbness of his left face in February 2016 and was diagnosed to have 'trigeminal neuralgia'. Two months later, he presented to the ED with sudden onset of binocular tilted diplopia. ...
29 Orbiting a DiagnosisDaniel Liebman; Daniel Lefebvre; Emily Tam; Marie Lithgow; Bart Chwalisz; Eric Gaier; Joseph KaneA 75 -year-old male with a history of chronic/small lymphocytic leukemia (CLL/SLL) presented for one day of left retro-orbital headache, painful eye movements, eyelid swelling, and diplopia. One week prior, his WBC count was 39.9 K/uL with 86% lymphocytes. Three days prior to presentation, the patie...
30 Gone but Not ForgottenJonathan Micieli; Adriana Krizova; Walter MontaneraA 52 -year-old healthy woman presented with a 1-week history of blurred vision and 'soreness' in her left eye. Neuro-ophthalmic examination revealed a visual acuity of 20/20 OD, 20/40 OS, left RAPD and left superior arcuate defect on Humphrey visual field testing. Dilated fundus examination demonstr...
31 X' Marks the SpotLuis Andre Leal Ferman; Leslie Bruch; John Buatti; Jeremy GreenleeThis 24 year-old man presented with several months of progressive visual loss in both eyes. His past medical, surgical and ocular history was unremarkable. There was no family history of phacomatosis. He complained of occasional binocular diplopia, but denied headaches or any other neurological symp...
32 Frizzle FrazzledEric Gaier; Farrah Rajabi; Anne Fulton; Gyula Acsadi; David WaitzmanAn otherwise healthy 12-year-old boy originally from Palestine was referred for refractory papilledema secondary to familial IIH. He has a history of fully accommodative esotropia with onset age 2-3. At age 9, elevated optic nerves prompted a neuro-ophthalmic referral. Best corrected visual acuities...
33 Frizzle FrazzledEric Gaier; Farrah Rajabi; Anne Fulton; Gyula Acsadi; David WaitzmanAn otherwise healthy 12-year-old boy originally from Palestine was referred for refractory papilledema secondary to familial IIH. He has a history of fully accommodative esotropia with onset age 2-3. At age 9, elevated optic nerves prompted a neuro-ophthalmic referral. Best corrected visual acuities...
34 A Small Leak Will Sink a Great ShipKonstantinos Douglas; Vivian Paraskevi Douglas; Cameron Sadegh; David Chow; Sigurros Davidsdottir; Ganesh Shankar; Bradley Buchbinder; Bart ChwaliszA 68 -year-old right -handed man presented for evaluation of progressive and fluctuating polyopia, gait instability and cognitive changes of about 14 months. Prior medical history was notable for Crohn's disease in remission, atrial fibrillation, a single episode of aseptic meningitis 12 years prior...
35 A Definite MaybeRaghu Mudumbai; Alex Solomon73 yo man French-Canadian presented to our institution for another opinion for a long standing diagnosis of Oculopharyngeal Dystrophy given at an outside institution. 17 years ago, the patient developed unfluctuating double vision that progressed to include severe, unfluctuating ptosis and mild dysp...
36 Never Too Young or Too OldBart Chwalisz; Laurel Tainsh; Mary Maher; Samantha Champion; Shuhei Nishiyima; Michael LevyAn 81-year-old woman with history of ocular myasthenia gravis presented with sequential bilateral vision loss. Six days before presentation, she discovered that vision of her left eye was reduced to light perception. She did not have any eye pain, pain with eye movement, headache, scalp tenderness, ...
37 A Definite MaybeRaghu Mudumbai; Alex Solomon73 yo man French-Canadian presented to our institution for another opinion for a long standing diagnosis of Oculopharyngeal Dystrophy given at an outside institution. 17 years ago, the patient developed unfluctuating double vision that progressed to include severe, unfluctuating ptosis and mild dysp...
38 X' Marks the SpotLuis Andre Leal Ferman; Leslie Bruch; John Buatti; Jeremy GreenleeThis 24 year-old man presented with several months of progressive visual loss in both eyes. His past medical, surgical and ocular history was unremarkable. There was no family history of phacomatosis. He complained of occasional binocular diplopia, but denied headaches or any other neurological symp...
39 Oh My GAD!! Something Else?Olwen Murphy; Kemar Green; John Probasco; Daniel GoldA 43 -year-old man presented with oscillopsia, dizziness, binocular vertical diplopia, and gait difficulties. He reported a six-month history of abdominal pain, anorexia and 50-pound weight loss, and a 3-month history of mood and cognitive changes. Torsional nystagmus, a left 4th nerve palsy (NP), u...
40 Never Too Young or Too OldBart Chwalisz; Laurel Tainsh; Mary Maher; Samantha Champion; Shuhei Nishiyima; Michael LevyAn 81-year-old woman with history of ocular myasthenia gravis presented with sequential bilateral vision loss. Six days before presentation, she discovered that vision of her left eye was reduced to light perception. She did not have any eye pain, pain with eye movement, headache, scalp tenderness, ...
41 Sometimes a Biopsy is BestKevin Chodnicki; Natalie Wolkow; Michael Yoon; Bart ChwaliszA 30 -year-old pregnant woman without significant medical or ocular history presented with decreased right eye vision. In her 2nd trimester, she was diagnosed with Lyme disease with a bulls-eye rash and positive Lyme antibodies; she was treated with two weeks of amoxicillin. At 33 weeks pregnant she...
42 Smoke Gets in Your Eyes (PDF)Tatiana Bakaeva; John Gittinger, JrA 61-year-old woman, active smoker with history of COPD, presented with bilateral progressive vision loss and ataxia. Four months prior to her presentation she developed 'black spot' in her right eye (OD) and was found to have 'OD disc edema and right hypertropia' by an outside ophthalmologist. She ...
43 From Brainstem to Stern (Slides)Neena Cherayil; Angela Viane; Grant Liu; Ali HamedaniA previously healthy 32-year-old man complained of diplopia and one month of worsening positional headaches. He then acutely developed confusion and chills, prompting ER referral. Further history was limited by altered mental status. On presentation, he was afebrile and encephalopathic. Serum WBC wa...
44 Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (Slides)Jorge Kattah; Scott Eggers; Sarah BachA 45 y/o man developed insidious unsteadiness and bilateral hearing impairment. A neurosurgeon diagnosed possible myelopathy, and despite an anterior cervical discectomy, he noted progressive gait difficulty, poor handwriting, and inability to play the guitar. Additionally, dysarthria, oscillopsia a...
45 Look in the Back (Slides)Tatiana Deveney; Aristides Capizzano; Jonathan TrobeA 59-year old man with Graves disease developed increasing proptosis and diplopia. Attributing these abnormalities to worsening of the Graves disease, an ophthalmologist treated him with high-dose oral and intravenous corticosteroids. When improvement did not occur, he underwent orbital x-irradiatio...
46 Tumefictive MS (Slides)Anthony Brune III; Hemant Parmar; Sandra Camelo-Piragua; Lindsey De LottA 26-year-old woman with history of diabetes insipidus and hypothyroidism presented for evaluation of painless vision loss in her right eye. She was evaluated by a local neurologist and multiple sclerosis (MS) specialist who diagnosed acute optic neuritis. MRI brain showed an enhancing T2 hyperinten...
47 Bones of the Past (Slides)Bart Chwalisz; Konstantinos Douglas; Vivian Douglas; Otto RapalinoA 44-year-old woman presented with two episodes of binocular horizontal diplopia within one year. She had a history of Cushing's syndrome status post transsphenoidal resection and bilateral adrenalectomy 4 years prior, hypertension, and secondary diabetes mellitus. Nine months prior she developed se...
48 Not All Men with Thick Skulls Have High Testosterone (Slides)Prem SubramanianA 54-year-old retired USAF fighter pilot was referred in Aug 2016 for evaluation of possible bilateral optic disc swelling noted on routine optometric examination. His past medical history included low testosterone discovered 2 years prior in the context of fatigue and exercise intolerance. MRI brai...
49 Not All Men with Thick Skulls Have High Testosterone (PDF)Prem SubramanianA 54-year-old retired USAF fighter pilot was referred in Aug 2016 for evaluation of possible bilateral optic disc swelling noted on routine optometric examination. His past medical history included low testosterone discovered 2 years prior in the context of fatigue and exercise intolerance. MRI brai...
50 A Myel-In, a Long Way to Go (PDF)Aishwarya Pareek; Timothy Lotze; Gail Demmler; Brandon Tran; William Whitehead; Carrie Mohila; Veeral ShahA 9-year-old previously healthy female with two recent admissions for presumed diagnosis of ADEM re-presented with persistent headache and ataxic gait. During her initial admissions, she presented with fever, acute onset of ataxia, facial asymmetry and abnormal eye movements. Inpatient ocular exam s...
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