NOVEL - Frank B. Walsh Collection
 
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176 When the Problem Becomes the Solution - VideoAri Shemesh; Timo Krings; Dalia Rotstein; David Munoz; Waleed Brinjikji; Laila Al Shafai; Edward Margolin25 year-old man noticed slow progressive decrease in vision in left eye. Vision was 20/20 OD and 20/40 OS, there was swelling of left optic nerve head. MRI demonstrated white matter lesions in left frontal lobe; cerebrospinal fluid composition was normal. Patient was seen in MS clinic and treatment ...
177 A Giant (Cell) Mistake - VideoBehzad Mansouri; Paul Wawryko; Frank Bovell71-year-old, left-handed woman, who was referred with ptosis, loss of vision in the right eye and headache. In July 2015 she presented to ER with severe right temporal headache and watery right eye. Her exam and head CT was normal. Her ESR/CRP were elevated. She was allegedly diagnosed with GCA and ...
178 One Peak is Worth Twenty Finesses - VideoSteven Newman; James MandellAn 8 year old was referred with a one week history of swelling around her left eye. She was not aware of any change in her vision or double vision. Visual acuity was 20/20 OD and 20/25 OS. Visual fields demonstrated minimal scattered desaturation with < ½ dB asymmetry between the two sides. Externa...
179 When the Problem Becomes the Solution - AbstractAri Shemesh; Timo Krings; Dalia Rotstein; David Munoz; Waleed Brinjikji; Laila Al Shafai; Edward Margolin25 year-old man noticed slow progressive decrease in vision in left eye. Vision was 20/20 OD and 20/40 OS, there was swelling of left optic nerve head. MRI demonstrated white matter lesions in left frontal lobe; cerebrospinal fluid composition was normal. Patient was seen in MS clinic and treatment ...
180 A Sad Story - VideoJason PeragalloA healthy 6-year-old boy had a two-week history of progressive headaches associated with nausea and vomiting. An ER diagnosed allergic rhinitis, treated with augmentin and steroids, however his symptoms worsened. At a second ER he was febrile to 103F. A classmate was recently diagnosed with Erlichio...
181 Testing the Hypophysis - AbstractAlberto Distefano; Julie Cho; Adeniyi Fisayo; Mahsa SohrabA 60 year-old female with history of hypertension, hyperlipidemia, and Lyme disease 12 years ago treated with doxycycline, developed extreme thirst and polyuria four years ago and was diagnosed with central diabetes insipidus. Magnetic resonance imaging (MRI) at that time showed enhancement of the p...
182 One Peak is Worth Twenty Finesses - AbstractSteven Newman; James MandellAn 8 year old was referred with a one week history of swelling around her left eye. She was not aware of any change in her vision or double vision. Visual acuity was 20/20 OD and 20/25 OS. Visual fields demonstrated minimal scattered desaturation with < ½ dB asymmetry between the two sides. Externa...
183 A Sad Story - AbstractJason PeragalloA healthy 6-year-old boy had a two-week history of progressive headaches associated with nausea and vomiting. An ER diagnosed allergic rhinitis, treated with augmentin and steroids, however his symptoms worsened. At a second ER he was febrile to 103F. A classmate was recently diagnosed with Erlichio...
184 Triple Take - AbstractJohanna Beebe; Liang Cheng; Shira Simon; Michael Wall; Randy Kardon; Alkapalan Deema; Ian Han; Matthew ThurtellA 42 year-old male noticed difficulty reading labels while stocking shelves at work. Over the next three weeks, he developed a dark 'cloud' in his central vision in the left eye, and then the right eye. He did not have associated pain. When evaluated by the retina service, his visual acuities were 2...
185 A Giant (Cell) Mistake - AbstractBehzad Mansouri; Paul Wawryko; Frank Bovell71-year-old, left-handed woman, who was referred with ptosis, loss of vision in the right eye and headache. In July 2015 she presented to ER with severe right temporal headache and watery right eye. Her exam and head CT was normal. Her ESR/CRP were elevated. She was allegedly diagnosed with GCA and ...
186 Coming to a Rapid Conclusion - AbstractLeanne Stunkel; Namita Sinha; Nathan Kung; Robi Maamari; Cole Ferguson; Sonika Dahiya; George Harocopos; Gregory Van StavernA 21-year-old man presented to a retina specialist for 2.5 weeks of painless central vision loss OD. His initial examination was notable for visual acuity 20/200 OD and 20/20 OS. Fundus examination was significant for several macular areas of retinal pigment epithelial (RPE) atrophy with associated ...
187 A Can of Worms - AbstractAli Hamedani; Madhura TamhankarA 67 year-old man presented to the ophthalmology clinic with one day of binocular horizontal diplopia. He also complained of one week of bilateral periorbital pain which was worse on the right than the left. Four days prior, he had undergone partial right nephrectomy for grade II papillary renal cel...
188 It's Always Been Like That - AbstractEric Gaier; William Butler; Joseph RizzoAn 18 year-old Caucasian boy presented with left upper eyelid ptosis, headaches, and iris heterochromia. The patient and his family reported the left iris being darker than the right since early childhood. Over the 5 years preceding his presentation, the patient's mother noted progressive ptosis of ...
189 Cold Fever - AbstractShannon BeresA 34-year old rock-climbing-mountain man woke with bilateral painless blurry vision along with alternating conjunctival erythema and eyelid edema. A headache began without associated migrainous features. Prior history revealed an untreated mysterious ‘new form of TB' followed by the CDC at age 2 d...
190 Light at the End of the Tunnel - VideoNoel Chan; Tak Lap Poon; Joyce Chow; Wai Lun Poon; Sherman Lo; Wing Hung Lau; Ka Hong Au; Carmen ChanA 24-year-old Chinese man presented with 1-year history of progressive blurring of vision of the right eye. He had no significant past ocular nor medical history except moderate myopia and migraine. On ophthalmologic examination, his corrected visual acuity at distance was 20/100 OD and 20/30 OS. Is...
191 Light at the End of the Tunnel - AbstractNoel Chan; Tak Lap Poon; Joyce Chow; Wai Lun Poon; Sherman Lo; Wing Hung Lau; Ka Hong Au; Carmen ChanA 24-year-old Chinese man presented with 1-year history of progressive blurring of vision of the right eye. He had no significant past ocular nor medical history except moderate myopia and migraine. On ophthalmologic examination, his corrected visual acuity at distance was 20/100 OD and 20/30 OS. Is...
192 A Tough Nut to Crack! - AbstractLauren Maloley; Sachin Kedar; Deepta Ghate; Dominick DiMaio; Jason Helvey; Sachin KedarA 47-year-old previously healthy female was transferred to our facility when she developed left abducens nerve palsy during treatment of intractable sinusitis. Two weeks prior to presentation, she developed headache and sinus congestion. She was treated with amoxicillin-clavulanic acid and prednison...
193 Whipping Up a New Flavor - AbstractMeagan Seay; Tory Johnson; Benjamin Larman; Avindra Nath; Myoung-Hwa Lee; Janet Rucker; Jonathan Howard; Ilya Kister; Matija Snuderl; Laura Balcer; Steven GalettaA 43-year old Indian man presented with two years of progressive gait imbalance, dysarthria, and cognitive decline. Neurological exam revealed supranuclear gaze palsy with impaired downgaze and loss of OKN quick phases, impaired horizontal pursuit, ideomotor apraxia, facial and arm dystonia, foot an...
194 Lumps and Bumps - AbstractWayne Tie; Martha SchatzA 37 year-old man with no PMH presented with bilateral painful red eyes and progressive proptosis for several months. He noted the increasing protrusion of both eyes, but only complained of recent onset of pain in both eyes over the last four days. He also developed worsening blurry vision in both e...
195 Gee...What's Causing that Pap? - AbstractSusan Mollan; Daniel White; Santhosh Nagaraju; Swarupsinh Chavda; Tom Hayton; Saiju JacobA 36 year old woman presented with history of Myasthenia Gravis (MG) since the age of 18. She was known to have dry eyes and hypothyroidism. Past surgical history included a thymectomy (age 23 years). The MG had been difficult to control with past medications including corticosteroids, azathioprine,...
196 What Don't You See? - AbstractJames O'Brien; R. Michael SiatkowskiA four-year old male presented for evaluation of abnormal eye movements and strabismus which had been present since approximately 6 weeks of age. He was previously diagnosed with nystagmus, ocular torticollis, and esotropia by another provider. An MRI of the brain was performed at approximately 4 we...
197 Uncertainty with a Twist of Lyme (video)Amrita-Amanda Lakraj; Sang Hong; Jennifer Connelly; Elizabeth CochranThe patient is a 59-year-old woman who presented with vision loss. Her ophthalmologic history is significant for; myopic astigmatism and presbyopia. Her past medical history is notable for left breast cancer (T2N0 invasive lobular carcinoma, ER/PR positive, HER2/neu negative) s/p left mastectomy, ch...
198 Papilledema Gone Wrong (video)Ahmara Ross; Payal Patel; Jessica Panzer; Grant LiuA 12 year old obese female with a history of enterovirus meningitis presented with throbbing, constant, 10/10, occipital and positional headaches, associated with diplopia, photophobia, nausea, and vomiting for one week in; the setting of a recent 20 lb. weight gain. Her vision, pupils, fields, and ...
199 A Prolonged Path To The Final Diagnosis (video)Cindy Lam; Edward MarglinPreviously healthy 25-year-old male presented with a 3-week history of frontal headache, right 3rd nerve palsy with ptosis, and areflexia of the left leg. MRI brain was normal. Two days later new symptoms developed: lower back pain, paresthesias, left leg weakness, right facial weakness.
200 Pseudo-Pseudotumor Cerebri (video)Valerie Biousse; Jose Velázquez Vega; Amit Saindane; Nancy NewmanA 54-yo man presented with a 10-month history of daily headaches and bilateral disc edema. PMHx was remarkable for uncomplicated type-2 diabetes mellitus, and hypothyroidism. He developed headaches in 07/2014 after being stung by wasps.
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