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Title | Creator | History |
26 |
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Never Too Young or Too Old | Bart Chwalisz; Laurel Tainsh; Mary Maher; Samantha Champion; Shuhei Nishiyima; Michael Levy | An 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, ... |
27 |
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Sometimes a Biopsy is Best | Kevin Chodnicki; Natalie Wolkow; Michael Yoon; Bart Chwalisz | A 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... |
28 |
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Sometimes a Biopsy is Best | Kevin Chodnicki; Natalie Wolkow; Michael Yoon; Bart Chwalisz | A 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... |
29 |
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Never Too Young or Too Old | Bart Chwalisz; Laurel Tainsh; Mary Maher; Samantha Champion; Shuhei Nishiyima; Michael Levy | An 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, ... |
30 |
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Frizzle Frazzled | Eric Gaier; Farrah Rajabi; Anne Fulton; Gyula Acsadi; David Waitzman | An 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... |
31 |
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X' Marks the Spot | Luis Andre Leal Ferman; Leslie Bruch; John Buatti; Jeremy Greenlee | This 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 |
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A 4-Year Wait | Dmitry Balian; Sachin Kedar; Michaelyn Everhart; Aleh Bobr; Liudmila Muinov | A 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. ... |
33 |
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Orbiting a Diagnosis | Daniel Liebman; Daniel Lefebvre; Emily Tam; Marie Lithgow; Bart Chwalisz; Eric Gaier; Joseph Kane | A 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... |
34 |
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Gone but Not Forgotten | Jonathan Micieli; Adriana Krizova; Walter Montanera | A 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... |
35 |
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A Small Leak Will Sink a Great Ship | Konstantinos Douglas; Vivian Paraskevi Douglas; Cameron Sadegh; David Chow; Sigurros Davidsdottir; Ganesh Shankar; Bradley Buchbinder; Bart Chwalisz | A 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... |
36 |
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A Definite Maybe | Raghu Mudumbai; Alex Solomon | 73 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... |
37 |
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Oh My GAD!! Something Else? | Olwen Murphy; Kemar Green; John Probasco; Daniel Gold | A 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... |
38 |
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A Small Leak Will Sink a Great Ship | Konstantinos Douglas; Vivian Paraskevi Douglas; Cameron Sadegh; David Chow; Sigurros Davidsdottir; Ganesh Shankar; Bradley Buchbinder; Bart Chwalisz | A 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... |
39 |
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A Definite Maybe | Raghu Mudumbai; Alex Solomon | 73 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... |
40 |
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Orbiting a Diagnosis | Daniel Liebman; Daniel Lefebvre; Emily Tam; Marie Lithgow; Bart Chwalisz; Eric Gaier; Joseph Kane | A 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... |
41 |
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Oh My GAD!! Something Else? | Olwen Murphy; Kemar Green; John Probasco; Daniel Gold | A 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... |
42 |
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Not All Men with Thick Skulls Have High Testosterone (PDF) | Prem Subramanian | A 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... |
43 |
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Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (PDF) | David DeLeon; Mariel Rojas; Francisco Sanchez; Rosa Tang; Julie Patel; Jade Schiffman | A 16 y/o Caucasian female with a BMI of 24, went for an eye exam for blurry vision which corrected with refraction, however bilateral disc edema was found. There was a 4-year history of headaches that were intermittent and escalating in nature around 5 days a week, about 1 hour after awakening, and ... |
44 |
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Tissue Is the Issue (PDF) | Christine Greer; Jasmine Francis; Eli Diamond; Charles Eberhart; Marc Dinkin | The pathologic specimen demonstrated atypical histiocytic proliferation and infiltration with abundant cytoplasm, CD68+, S100+, consistent with Rosai Dorfman (RDD). The patient had been treated with steroids with a partial response and disease stabilization with radiation therapy with subsequent pro... |
45 |
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You're Too Young for That! (PDF) | Sravanthi Vegunta; Kathleen Digre; Bradley Katz; Meagan Seay; Alison Crum; Edward Quigley; Sean Kennedy; Nick Mamalis; Judith Warner | An 11-year old boy presented with right orbital pain for two months with recent double vision. He had no recent viral illnesses or sick contacts. He had no past medical history. His brother had Kawasaki disease; his paternal grandmother had rheumatoid arthritis; and his father died of a myocardial i... |
46 |
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Tissue Is the Issue (Slides) | Christine Greer; Jasmine Francis; Eli Diamond; Charles Eberhart; Marc Dinkin | The pathologic specimen demonstrated atypical histiocytic proliferation and infiltration with abundant cytoplasm, CD68+, S100+, consistent with Rosai Dorfman (RDD). The patient had been treated with steroids with a partial response and disease stabilization with radiation therapy with subsequent pro... |
47 |
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You're Too Young for That! (Slides) | Sravanthi Vegunta; Kathleen Digre; Bradley Katz; Meagan Seay; Alison Crum; Edward Quigley; Sean Kennedy; Nick Mamalis; Judith Warner | An 11-year old boy presented with right orbital pain for two months with recent double vision. He had no recent viral illnesses or sick contacts. He had no past medical history. His brother had Kawasaki disease; his paternal grandmother had rheumatoid arthritis; and his father died of a myocardial i... |
48 |
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Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (Slides) | David DeLeon; Mariel Rojas; Francisco Sanchez; Rosa Tang; Julie Patel; Jade Schiffman | A 16 y/o Caucasian female with a BMI of 24, went for an eye exam for blurry vision which corrected with refraction, however bilateral disc edema was found. There was a 4-year history of headaches that were intermittent and escalating in nature around 5 days a week, about 1 hour after awakening, and ... |
49 |
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Not All Men with Thick Skulls Have High Testosterone (Slides) | Prem Subramanian | A 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 |
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Bones of the Past (PDF) | Bart Chwalisz; Konstantinos Douglas; Vivian Douglas; Otto Rapalino | A 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... |