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1 Uncertainty with a Twist of Lyme (slideshow)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...
2 Uncertainty with a Twist of Lyme (abstract)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...
3 A Prolonged Path To The Final Diagnosis (abstract)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.
4 A Prolonged Path To The Final Diagnosis (slideshow)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.
5 Lions and Tigers and Bears, Oh My! (abstract)Larissa Ghadiali, Danlin Mao, Gul Moonis, Adam Sonabend, Catherine Shu, Terri Kreisl, Esther Coronel, Jeffrey OdelA 79 year-old female s/p resection of a right CPA meningioma in 1998 noted sudden painless visual loss OD on 6-12-2016. Two days later examination revealed 20/150 vision OD, a right RAPD, and an otherwise normal ophthalmic exam.
6 Lions and Tigers and Bears, Oh My! (slideshow)Larissa Ghadiali, Danlin Mao, Gul Moonis, Adam Sonabend, Catherine Shu, Terri Kreisl, Esther Coronel, Jeffrey OdelA 79 year-old female s/p resection of a right CPA meningioma in 1998 noted sudden painless visual loss OD on 6-12-2016. Two days later examination revealed 20/150 vision OD, a right RAPD, and an otherwise normal ophthalmic exam.
7 Not Surprised Surprise (abstract)Yu Zhao, Joshua Pasol, Sander Dubovy, Byron LamA 68-year-old Hispanic woman presented to our emergency department with significant vision loss OS for 1 week. A month ago, she was evaluated locally for mild blurry vision OS, and corrected acuity was 20/30 OD, 20/40 OS. She was diagnosed with cataracts and epiretinal membrane OD. Medical history i...
8 Not Surprised Surprise (slideshow)Yu Zhao, Joshua Pasol, Sander Dubovy, Byron LamA 68-year-old Hispanic woman presented to our emergency department with significant vision loss OS for 1 week. A month ago, she was evaluated locally for mild blurry vision OS, and corrected acuity was 20/30 OD, 20/40 OS. She was diagnosed with cataracts and epiretinal membrane OD. Medical history i...
9 Strike a Chord (abstract)Anastasia Neufeld, Kathleen B. Digre, MD, Professor of Neurology and Ophthalmology, Director of Neuro-Ophthalmology, John A. Moran Eye Center, University of Utah School of Medicine, Cheryl Palmer, H. Christian Davidson, Alison Crum, Bradley Katz, Judith E.A. Warner, MD, Moran Eye Center, University ...A 26 year old woman presented in August 2016 with migraine over the last 4 years, getting worse over the last 2 weeks. She reported occasional "glittering" in her vision in both eyes. She had no constitutional symptoms. Her past medical history included migraine, idiopathic leukocytosis, and nephrol...
10 A Wrong Turn at the Angle (abstract)Erica Archer, Jonathan Daniel Trobe MD, Michigan University, Hemant Parmar, Mohannad Ibrahim, Paul McKeever, Thomas GiordanoA 54-year-old woman developed numbness of the right jaw and right side of the tongue. She attributed her symptomatology to recent dental work, but when dental examination, including dental x-rays, failed to reveal an answer, she underwent brain MRI.
11 The Sound of Hoofbeats (abstract)Lilangi Ediriwickrema, Neil Miller, Thomas BosleyA 42-year-old woman with a recurrent cerebral malignant glioma in the left frontal lobe on clinical trial presented with blurry vision in her right eye 6 days after undergoing sinus surgery for paranasal inflammatory changes. She presented approximately 1 month after the sixth cycle of systemic ster...
12 Strike a Chord (slideshow)Anastasia Neufeld, Kathleen B. Digre, MD, Professor of Neurology and Ophthalmology, Director of Neuro-Ophthalmology, John A. Moran Eye Center, University of Utah School of Medicine, Cheryl Palmer, H. Christian Davidson, Alison Crum, Bradley Katz, Judith E.A. Warner, MD, Moran Eye Center, University ...A 26 year old woman presented in August 2016 with migraine over the last 4 years, getting worse over the last 2 weeks. She reported occasional "glittering" in her vision in both eyes. She had no constitutional symptoms. Her past medical history included migraine, idiopathic leukocytosis, and nephrol...
13 A Wrong Turn at the Angle (slideshow)Erica Archer, Jonathan Daniel Trobe MD, Michigan University, Hemant Parmar, Mohannad Ibrahim, Paul McKeever, Thomas GiordanoA 54-year-old woman developed numbness of the right jaw and right side of the tongue. She attributed her symptomatology to recent dental work, but when dental examination, including dental x-rays, failed to reveal an answer, she underwent brain MRI.
14 Nonchalant Midterm-taker Develops Altered Mental Status (abstract)Shira Simon, Bruno Policeni, Matthew ThurtellA 19 year-old female presented in April 2016 with two weeks of worsening headaches, malaise, left-hand weakness, and confusion. Symptoms started during a trip to Cancun and one week after visiting a friend with mumps. Although she was becoming increasingly lethargic, she refused to seek medical atte...
15 Alcohol is Never the Answer, but it Does Make You Forget the Question (abstract)Ali Saber Tehrani, Diana Londono, Thomas Rashid, Manuel Doria, Julia Biernot, Jorge KattahA 63-year old male with a history of alcohol abuse presented with two weeks of confusion and imbalance. On exam, he had left beating nystagmus on left gaze, and right beating and torsional nystagmus on right gaze. Head impulse test was abnormal in all canals bilaterally with video head impulse test ...
16 Alcohol is Never the Answer, but it Does Make You Forget the Question (slideshow)Ali Saber Tehrani, Diana Londono, Thomas Rashid, Manuel Doria, Julia Biernot, Jorge KattahA 63-year old male with a history of alcohol abuse presented with two weeks of confusion and imbalance. On exam, he had left beating nystagmus on left gaze, and right beating and torsional nystagmus on right gaze. Head impulse test was abnormal in all canals bilaterally with video head impulse test ...
17 Nonchalant Midterm-taker Develops Altered Mental Status (slideshow)Shira Simon, Bruno Policeni, Matthew ThurtellA 19 year-old female presented in April 2016 with two weeks of worsening headaches, malaise, left-hand weakness, and confusion. Symptoms started during a trip to Cancun and one week after visiting a friend with mumps. Although she was becoming increasingly lethargic, she refused to seek medical atte...
18 The Sound of Hoofbeats (slideshow)Lilangi Ediriwickrema, Neil Miller, Thomas BosleyA 42-year-old woman with a recurrent cerebral malignant glioma in the left frontal lobe on clinical trial presented with blurry vision in her right eye 6 days after undergoing sinus surgery for paranasal inflammatory changes. She presented approximately 1 month after the sixth cycle of systemic ster...
19 Pseudo-Pseudotumor Cerebri (radiology)Valérie Biousse, MD, Departments of Ophthalmology and Neurology, Emory University School of Medicine, Jose Velázquez Vega, Amit Saindane, Nancy J. Newman, MD, Emory Eye CenterA 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.
20 A Diagnostic Potpourri (abstract)Padmaja Sudhakar, Robert Lightfoot, Douglas Lukins, Dianne WilsonA 63 yr. old incarcerated man with history of diabetes, hypertension, rheumatoid arthritis (RA) (on hydroxychloroquine, sulfasalazine and prednisone 7 mg), cutaneous lupus and Hepatitis C presented with sudden painless vision loss of the left eye without headache or symptoms of temporal arteritis. V...
21 A Diagnostic Potpourri (slideshow)Padmaja Sudhakar, Robert Lightfoot, Douglas Lukins, Dianne WilsonA 63 yr. old incarcerated man with history of diabetes, hypertension, rheumatoid arthritis (RA) (on hydroxychloroquine, sulfasalazine and prednisone 7 mg), cutaneous lupus and Hepatitis C presented with sudden painless vision loss of the left eye without headache or symptoms of temporal arteritis. V...
22 Keep Your Eye On the Ball (abstract)Danielle Rudich, Eugenia Vining, Kenneth Allen, Joel Geffin, Mena Mansour, Robert L. Lesser, MD, The Eye Care Group, Clinical Professor of Ophthalmology and Visual Science and Neurology at Yale, Clinical Professor of Neurology and Surgery (Neurosurgery) at the University of Connecticut School of Med...In March 2014, an 82-year-old male developed left sided facial pain and numbness over his left temple and periorbital region. He was treated for a presumed dental infection with no response. MRI brain in July 2014; showed only microvascular white matter changes.
23 Island Fever (abstract)Laura Hanson, Judith E. A. Warner, MD, Moran Eye Center, University of Utah, Alison Crum, Bradley Katz, Kathleen B. Digre, MD, Professor of Neurology and Ophthalmology, Director of Neuro-Ophthalmology, John A. Moran Eye Center, University of Utah School of MedicineA 22 year-old male paralegal in the military presented with double and blurred vision. One month ago, he had traveled to Hawai'i for a wedding. Two weeks ago, he had been evaluated for an acute onset of fever, headache, emesis, light sensitivity and neck stiffness.
24 Island Fever (slideshow)Laura Hanson, Judith E. A. Warner, MD, Moran Eye Center, University of Utah, Alison Crum, Bradley Katz, Kathleen B. Digre, MD, Professor of Neurology and Ophthalmology, Director of Neuro-Ophthalmology, John A. Moran Eye Center, University of Utah School of MedicineA 22 year-old male paralegal in the military presented with double and blurred vision. One month ago, he had traveled to Hawai'i for a wedding. Two weeks ago, he had been evaluated for an acute onset of fever, headache, emesis, light sensitivity and neck stiffness.
25 It Must Be Voodoo... and he was Far from Spineless (slideshow)Norah S. Lincoff, MD, University at Buffalo, Charles Chung, Lucia BalosA 35 yo legally blind gentleman was referred for evaluation because of neck and new lower back pain. His visual; loss began 4 years prior, following a trip to "N'Orleans". He had been on a "Boys Trip" for 10 days, and had been cursed with Voodoo for not paying a cemetery tour guide as promised.
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