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TitleCreatorHistory
251 Three Weeks in FloridaAndrew R. Carey; J. Antonio Bermudez-Magner; Sander R. Dubovy; Norman J. Schatz; Linda L. Sternau; Byron L. LamA 36 year-old man presented with severe headaches, bilateral leg numbness, and bilateral decreased vision. He was born in Ecuador where he received BCG vaccination and immigrated to US at age 19. In 2005 he enrolled in nursing school and volunteered in homeless shelters. PPD was positive with a nega...
252 Who Deserves a Second Chance?Lina Nagia; Jennifer Doyle; Lanning KlineAn 81-year-old woman presents with a one-month history of blurred vision OS, acutely worse in the past 5 days. She reports pain with left gaze, left sided forehead tenderness and some weight loss. Medical history includes hypertension, borderline diabetes, cerebral vascular accident and basal cell c...
253 Hiding and Out of SightMichael L. Morgan; Sumayya J. Almarzouqi; Patricia Chevez-Barrios; Amina I. Malik; Andrew G. LeeA 75-year-old white woman presented with a history of biopsy-proven giant cell arteritis (GCA) presented with recurrence of severe left sided headaches and left global ophthalmoparesis for 4 days. GCA had been diagnosed 4 months prior by biopsy. Left eye vision loss occurred when an outside physicia...
254 Star Spangled BannerDara M. Bier; Jeffrey P. Greenfield; Marc K. Rosenblum; Joseph Comunale; Cristiano Oliveira; Marc J. DinkinA 12-year-old girl with a history of bilateral optic nerve enlargement, enterovirus meningitis, seizures, and bilateral hygromas, presented with acute onset chronic vision loss in her left eye. Two years prior, she presented to an outside hospital with headaches, intermittent speech arrest and right...
255 Joe & Jerry Flew the CoopLulu L.C.D. Bursztyn; Dane A Breker; Andrew W. Stacey; Ashok Srinivasan; Mark W. Johnson; Jonathan D. TrobeA previously healthy 13-year-old girl presented to a local hospital with fever and myalgia, followed one day later by lethargy and vision loss. Past medical history was significant only for acne, for which she had been treated with doxycycline 40 mg/day intermittently starting 2 months prior to symp...
256 Under PressureNathan H. Kung; Collin M. McClelland; Gregory P. Van StavernA 29-year-old woman was referred to neuro-ophthalmology clinic for 1 year of headaches and papilledema discovered 2 months earlier. She complained of recently blurred vision but no positional headache, pulsatile tinnitus, transient visual obscurations, or other neurologic issues. She used no medicat...
257 The Man with No Face (About Face)Michael Vaphiades; Jennifer Doyle; Lina Nagia; Kevin Bray; Kline Lanning; Glenn Roberson; Adam Quinn; Joel Cure; Katherine FeningA 61-year-old man presented with one week history of decreased vision OS. Past medical history includes asthma and amblyopia OD, but with complete visual loss OD 18 years prior. He takes no medications. He is retired but worked for 21 years in social science research. The remarkable thing upon meeti...
258 I Can't See StraightSteven A. Newman; T. Ben AblemanIn May of 2014 this 30 year old right handed patient was referred for consultation regarding diplopia and dizziness. The patient relates that she had been told that she had 'tired eyes' as a child. Two and a half years ago she began to have intermittent exodeviation. She was seen locally and diagnos...
259 A Shot in the DarkJoshua Pasol; Ricardo Komotar; Feisal YamaniA 74 year-old man with a chief complaint of difficulty with night time driving for several years as well as difficulty going from a lighted room to a dark room. PMH of high cholesterol, BPH, hypothyroidism, GERD, glottic squamous cell cancer without recurrence, and a prior history of alcoholism. POH...
260 A Weak PresentationReuben M. Valenzuela; Bradley Katz; Alison Crum; Kathleen B. Digre; Nick Mamalis; Hans C. Davidson; Judith WarnerAn 82-year-old right-handed man with myasthenia gravis presented in May 2014 with double vision and right facial numbness and weakness. He was first seen in 1998 with horizontal diplopia. He had an abduction deficit of the right eye, and right nasolabial fold flattening. He was diagnosed with myasth...
261 Growing SuspicionAngela M. Herro; Norman J. Schatz; Linda L. Sternau; John R. Guyloss in the right eye for 3 months. On presentation, vision was 4/200 in the right and 20/20 in the left with an afferent pupillary defect on the right. His visual field was full to confrontation but automated perimetry revealed a central scotoma. The remainder of the exam was normal with the except...
262 Nobody's PerfectAlexander Ksendzovsky; Steven A. NewmanIn June of 2006 an 8 year old patient was referred for evaluation. Apparently at age 1 ½ she had developed headaches and was found to have a posterior fossa tumor. In El Salvador she was treated with shunting and chemotherapy plus radiation therapy for presumed medulloblastoma. She underwent a shun...
263 Shady Double CrosserFrancine WeinHistory & Exam A 62-year-old woman presented with a one-month history of severe light sensitivity and headache, and a two week history of diplopia. Her photophobia was severe enough for her to wear sunglasses indoors. Her past medical history was significant for a cholecystectomy and Crohn's disease...
264 Now you see it. Now you don't.Prem S. SubramanianA 70 yo RH African American female presented to our institution with sequential, severe vision loss in the preceding 4 months. Her past medical history included well-controlled hypertension and hyperlipidemia, CAD s/p coronary stent placement x 2 after MI, and stroke. She had no prior history of vis...
265 Bariatric Surgery and the Neuro-OphthalmologistHeather E. MossBariatric surgery, in which the gastrointestinal tract is surgically manipulated with the goal of decreasing caloric absorption and ultimately causing weight loss, is relevant to neuro-ophthalmologists for two main reasons. First, it is a treatment option we can discuss with our patients who have we...
266 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...
267 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...
268 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...
269 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 ...
270 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...
271 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,...
272 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...
273 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.
274 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...
275 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...
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