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1 Isolated Congenital Optic Disc AnomaliesAnthony C. Arnold, MDThis patient has known pseudoxanthoma elasticum (an uncommon elastic tissue disorder characterized by plaque-like skin folds [plucked chicken skin] and degeneration of collagen fibers involving multiple systems, including the GI tract and heart), angioid streaks, and optic disc drusen.
2 Isolated Optic Neuritis/NeuropathyAnthony C. Arnold, MDThis 48-year-old man presented with a 1-month history of headache. Both discs had the appearance seen in this image, with prominent peripapillary nerve fiber layer myelination; the disc itself is hyperemic, with dilated, telangiectatic surface vasculature, suggesting true disc edema as well.
3 Optic Disc Drusen, Fluorescein AngiogramAnthony C. Arnold, MDImages 92_64 and 92_67 demonstrate the characteristics of optic disc drusen on flourescein angiography. This image shows the early arteriovenous phase, with irregular dye uptake and focal hypoflourescence superotemporally. Pair with 92_63 and 92_67
4 Optic Nerve Drusen, Late Fluorescein AngiogramAnthony C. Arnold, MDImages 92_64 and 92_67 demonstrate the characteristics of optic disc drusen on flourescein angiography. This image displays the nodular staining of the drusen without leakage. Pair with 92_63 and 92_64.
5 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
6 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
7 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
8 Congenitally Tilted Optic DiscAnthony C. Arnold, MDColobomas or defects of the optic nerve may exhibit spontaneous pulsations. Disease/Diagnosis: Coloboma.
9 Isolated Optic Neuritis/NeuropathyAnthony C. Arnold, MDThis 42-year-old male with pseudotumor cerebri and chronic papilledema demonstrated refractile bodies, which can be seen with chronic optic disc edema. This image exhibits decreased disc edema and resolution of the refractile bodies OD after therapy. Pair with 96_01, 96_02, 96_03, 96_05, and 96_06.
10 Isolated Optic Neuritis/NeuropathyAnthony C. Arnold, MDThis 42-year-old male with pseudotumor cerebri and chronic papilledema demonstrated refractile bodies, which can been seen with chronic optic disc edema. This image demonstrates later recurrence of the refractile bodies with worsening papilledema OD. Pair with 96_01, 96_02, 96_03, 96_04, and 96_06.
11 Isolated Optic Neuritis/NeuropathyAnthony C. Arnold, MDThis 42-year-old male with pseudotumor cerebri and chronic papilledema demonstrated refractile bodies, which can be seen with chronic optic disc edema. This image demonstrates later recurrence of the refractile bodies with worsening papilledema OD. Pair with 96_01, 96_02, 96_03, 96_04, and 96_05.
12 Isolated Optic Neuritis/NeuropathyAnthony C. Arnold, MDThis 42-year-old male with pseudotumor cerebri and chronic papilledema demonstrated refractile bodies, which can be seen with chronic optic disc edema. This image shows the chronic papilledema at presentation, with associated refractile hyaline bodies at the disc periphery in both eyes. Pair with 96...
13 Isolated Optic Neuritis/NeuropathyAnthony C. Arnold, MDThis image demonstrates Paton's lines in a 34-year-old patient with pseudotumor cerebri and chronic papilledema.
14 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
15 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
16 Neuro-Ophthalmic Vascular DiseaseAnthony C. Arnold, MDThis coronal CT scan shows the enlarged superior ophthalmic vein in the left orbit. This 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a ri...
17 Isolated Optic Neuritis/NeuropathyAnthony C. Arnold, MDThis 42-year-old male with pseudotumor cerebri and chronic papilledema demonstrated refractile bodies, which can been seen with chronic optic disc edema. This image exhibits decreased disc edema and resolution of the refractile bodies OD after therapy. Pair with 96_01, 96_02, 96_04, 96_05, and 96_06...
18 Bridge ColobomaAnthony C. Arnold, MDThe patient is a 35-year-old asymptomatic woman with a bridge coloboma, also known as double optic disc. Disease/Diagnosis: Coloboma.
19 Isolated Congenital Optic Disc AnomaliesAnthony C. Arnold, MDThis image shows drusen that are especially prominent superotemporally. Pair with 92_64 and 92_67.
20 Isolated Optic Neuritis/NeuropathyAnthony C. Arnold, MDThis 42-year-old male with pseudotumor cerebri and chronic papilledema demonstrated refractile bodies, which can be seen with chronic optic disc edema. This image shows the chronic papilledema at presentation, with associated refractile hyaline bodies at the disc periphery in both eyes. Pair with 96...
21 Isolated Congenital Optic Disc AnomaliesAnthony C. Arnold, MDA 10-year-old girl had central visual loss due to this optic pit. Disease/Diagnosis: Optic Pit.
22 Isolated Congenital Optic Disc AnomaliesAnthony C. Arnold, MDThis is a photograph of peripheral drusen. The paired image 92_69 demonstrates the typical autofluorescence.
23 Optic Disc Drusen AutofluorescenceAnthony C. Arnold, MDThis case of optic disc drusen demonstrates the typical autofluorescence. Pair with 92_68. Imaging: Autoflourescence?
24 Ocular Manifestations of Congenital/Inherited DiseasesAnthony C. Arnold, MDNote the retinal/optic nerve head astrocytoma in a 12-year-old boy with tuberous sclerosis. Disease/Diagnosis: Tuberous Sclerosis.
25 Optic NeuropathiesDaniel M. Jacobson MDThis 28-year-old otherwise-healthy woman was referred to for treatment of what was thought to be optic neuritis OD. Three weeks earlier she had noted a dark inferior scotoma OD that progressed to involve fixation over the next 10-12 days. She experienced photopsias OD at the onset. She had no viral ...
26 Optic NeuropathiesDaniel M. Jacobson MDThis 28-year-old otherwise-healthy woman was referred to for treatment of what was thought to be optic neuritis OD. Three weeks earlier she had noted a dark inferior scotoma OD that progressed to involve fixation over the next 10-12 days. She experienced photopsias OD at the onset. She had no viral ...
27 Optic NeuropathiesDaniel M. Jacobson MDThis 34-year-old otherwise-healthy woman was referred for a neuro-ophthalmologic consultation for unexplained loss of vision OD following head trauma. Two months earlier, she was involved in a motor vehicle accident that resulted in a closed head injury complicated by a spontaneously resolving small...
28 Optic NeuropathiesDaniel M. Jacobson MDThis 34-year-old otherwise-healthy woman was referred for a neuro-ophthalmologic consultation for unexplained loss of vision OD following head trauma. Two months earlier, she was involved in a motor vehicle accident that resulted in a closed head injury complicated by a spontaneously resolving small...
29 Optic NeuropathiesDaniel M. Jacobson MDThis 34-year-old otherwise-healthy woman was referred for a neuro-ophthalmologic consultation for unexplained loss of vision OD following head trauma. Two months earlier, she was involved in a motor vehicle accident that resulted in a closed head injury complicated by a spontaneously resolving small...
30 Optic NeuropathiesDaniel M. Jacobson MDThis 34-year-old otherwise-healthy woman was referred for a neuro-ophthalmologic consultation for unexplained loss of vision OD following head trauma. Two months earlier, she was involved in a motor vehicle accident that resulted in a closed head injury complicated by a spontaneously resolving small...
31 Ocular Manifestations of Systemic DisordersDaniel M. Jacobson MDThis 59-year-old man had a 4-week history of malaise, myalgias, night sweats, weight loss, fatigue, and generalized headaches, and a few days before admission he developed a red eye OS secondary to exposure keratitis associated with a left-sided seventh nerve palsy. Subsequent evaluation disclosed a...
32 Isolated Optic Neuritis/NeuropathyDaniel M. Jacobson MDThis 35-year-old otherwise-healthy woman developed typical optic neuritis OD with excellent recovery. She had no clinical evidence of multiple sclerosis at that time. She presented in August of 1991, at which time perivenous sheathing was seen in the retinal periphery OU. A limited workup was negati...
33 Isolated Optic Neuritis/NeuropathyDaniel M. Jacobson MDThis 35-year-old otherwise-healthy woman developed typical optic neuritis OD with excellent recovery. She had no clinical evidence of multiple sclerosis at that time. She presented in August of 1991, at which time perivenous sheathing was seen in the retinal periphery OU. A limited workup was negati...
34 Isolated Optic Neuritis/NeuropathyDaniel M. Jacobson MDThis 35-year-old otherwise-healthy woman developed typical optic neuritis OD with excellent recovery. She had no clinical evidence of multiple sclerosis at that time. She presented in August of 1991, at which time perivenous sheathing was seen in the retinal periphery OU. A limited workup was negati...
35 Optic NeuropathiesDaniel M. Jacobson MDThis 28-year-old otherwise-healthy woman was referred to for treatment of what was thought to be optic neuritis OD. Three weeks earlier she had noted a dark inferior scotoma OD that progressed to involve fixation over the next 10-12 days. She experienced photopsias OD at the onset. She had no viral ...
36 Optic NeuropathiesDaniel M. Jacobson MDThis 28-year-old otherwise-healthy woman was referred to for treatment of what was thought to be optic neuritis OD. Three weeks earlier she had noted a dark inferior scotoma OD that progressed to involve fixation over the next 10-12 days. She experienced photopsias OD at the onset. She had no viral ...
37 Optic NeuropathiesDaniel M. Jacobson MDThis 28-year-old otherwise-healthy woman was referred to for treatment of what was thought to be optic neuritis OD. Three weeks earlier she had noted a dark inferior scotoma OD that progressed to involve fixation over the next 10-12 days. She experienced photopsias OD at the onset. She had no viral ...
38 Optic NeuropathiesDaniel M. Jacobson MDThis 28-year-old otherwise-healthy woman was referred to for treatment of what was thought to be optic neuritis OD. Three weeks earlier she had noted a dark inferior scotoma OD that progressed to involve fixation over the next 10-12 days. She experienced photopsias OD at the onset. She had no viral ...
39 Optic NeuropathiesDaniel M. Jacobson MDA previously healthy 28-year-old woman (except for a history of optic neuritis OS 9 years previously with full recovery) was referred for management of optic neuritis OD. Three weeks earlier she had noted a dark inferior scotoma OD that progressed to involve fixation over the next 10-12 days. She ex...
40 Optic NeuropathiesDaniel M. Jacobson MDThis 28-year-old otherwise-healthy woman was referred to for treatment of what was thought to be optic neuritis OD. Three weeks earlier she had noted a dark inferior scotoma OD that progressed to involve fixation over the next 10-12 days. She experienced photopsias OD at the onset. She had no viral ...
41 Isolated Optic Neuritis/NeuropathyDaniel M. Jacobson MDThis 35-year-old otherwise-healthy woman developed typical optic neuritis OD with excellent recovery. She had no clinical evidence of multiple sclerosis at that time. She presented in August of 1991, at which time perivenous sheathing was seen in the retinal periphery OU. A limited workup was negati...
42 Ocular Manifestations of Congenital/Inherited DiseasesDaniel M. Jacobson MDThis 38-year-old man had unexplained poor vision in his left eye all his life and was told that he had some type of congenital vascular anomaly. He had no neurocutaneous problems. The photographs demonstrate a complex arteriovenous malformation with dilated loops of veins extending out from the nerv...
43 Motility DisturbancesDon Bienfang, MDThis patient displays a posttraumatic left fourth nerve palsy sustained after having struck her head on the dashboard.
44 Motility DisturbancesDon Bienfang, MDThis patient displays a posttraumatic left fourth nerve palsy sustained after having struck her head on the dashboard.
45 Motility DisturbancesDon Bienfang, MDThis patient displays a posttraumatic left fourth nerve palsy sustained after having struck her head on the dashboard.
46 Motility DisturbancesDon Bienfang, MDThis patient displays a posttraumatic left fourth nerve palsy sustained after having struck her head on the dashboard.
47 Neuro-Ophthalmic Consequences of TherapyDon Bienfang, MDAn elderly woman was first seen in 1991, after being on Plaquenil (Hydroxychloroquine Sulfate) for 5 to 6 years, with a new symptomatic disturbance in her reading. Because her blue/yellow color perception was disturbed, and because she had symptoms, the medication was stopped. However the fundi and ...
48 Neuro-Ophthalmic Consequences of TherapyDon Bienfang, MDAn elderly woman was first seen in 1991, after being on Plaquenil (Hydroxychloroquine Sulfate) for 5 to 6 years, with a new symptomatic disturbance in her reading. Because her blue/yellow color perception was disturbed, and because she had symptoms, the medication was stopped. However the fundi and ...
49 Neuro-Ophthalmic Consequences of TherapyDon Bienfang, MDAn elderly woman was first seen in 1991, after being on Plaquenil (Hydroxychloroquine Sulfate) for 5 to 6 years, with a new symptomatic disturbance in her reading. Because her blue/yellow color perception was disturbed, and because she had symptoms, the medication was stopped. However the fundi and ...
50 Neuro-Ophthalmic Consequences of TherapyDon Bienfang, MDAn elderly woman was first seen in 1991, after being on Plaquenil (Hydroxychloroquine Sulfate) for 5 to 6 years, with a new symptomatic disturbance in her reading. Because her blue/yellow color perception was disturbed, and because she had symptoms, the medication was stopped. However the fundi and ...
51 Neuro-Ophthalmic Consequences of TherapyDon Bienfang, MDAn elderly woman was first seen in 1991, after being on Plaquenil (Hydroxychloroquine Sulfate) for 5 to 6 years, with a new symptomatic disturbance in her reading. Because her blue/yellow color perception was disturbed, and because she had symptoms, the medication was stopped. However the fundi and ...
52 Neuro-Ophthalmic Consequences of TherapyDon Bienfang, MDAn elderly woman was first seen in 1991, after being on Plaquenil (Hydroxychloroquine Sulfate) for 5 to 6 years, with a new symptomatic disturbance in her reading. Because her blue/yellow color perception was disturbed, and because she had symptoms, the medication was stopped. However the fundi and ...
53 Neuro-Ophthalmic Consequences of TherapyDon Bienfang, MDAn elderly woman was first seen in 1991, after being on Plaquenil (Hydroxychloroquine Sulfate) for 5 to 6 years, with a new symptomatic disturbance in her reading. Because her blue/yellow color perception was disturbed, and because she had symptoms, the medication was stopped. However the fundi and ...
54 Neuro-Ophthalmic Imaging-MRIDon Bienfang, MDA 59-year-old untreated hypertensive man had a sudden onset of vomiting, gait ataxia, dysarthria, and left-sided weakness. The eyes were deviated downward and to the left. (Note position of gaze in 94_11). Extraocular motility was full. There was rotary nystagmus with the fast phase to the left; the...
55 Motility DisturbancesEric L. Berman, MDThis is a 60-year-old albino woman with chronic progressive external ophthalmoplegia and strabismus fixus. Her extreme bilateral esotropia caused her acuity to be 20/400 OU, no view of fundus could be obtained except for the far periphery. CPEO is the most common manifestation of mitochondrial myopa...
56 Isolated Hereditary Optic Neuritis/NeuropathyGregory S. Kosmorsky, MDLeber's hereditary optic neuropathy is a mitochondrial hereditary optic neuropathy that usually affects young males but may occur at any age and in males or females. The clinical features are usually acute bilateral simultaneous or sequential visual loss with a central acuity and central visual fiel...
57 Isolated Hereditary Optic Neuritis/NeuropathyGregory S. Kosmorsky, MDLeber's hereditary optic neuropathy is a mitochondrial hereditary optic neuropathy that usually affects young males but may occur at any age and in males or females. The clinical features are usually acute bilateral simultaneous or sequential visual loss with a central acuity and central visual fiel...
58 Isolated Hereditary Optic Neuritis/NeuropathyGregory S. Kosmorsky, MDLeber's hereditary optic neuropathy is a mitochondrial hereditary optic neuropathy that usually affects young males but may occur at any age and in males or females. The clinical features are usually acute bilateral simultaneous or sequential visual loss with a central acuity and central visual fiel...
59 Ocular Manifestations of Congenital/Inherited DiseasesJacqueline A. Leavitt, MDThis 22-year-old woman has neurofibromatosis, type 2. Acuity, color plates, pupillary responses, slit-lamp examination, IOP, fields, and funduscopy are all normal. There is a 3 mm proptosis OS. The patient has recently undergone gamma knife for the acoustic tumor, and she has residual facial nerve p...
60 Neuro-Ophthalmic Manifestations of Brain TumorsJacqueline A. Leavitt, MDChordomas of the clivus may result in diplopia due to a sixth nerve palsy. The sixth nerve runs up the clivus and may be the presenting manifestation of the lesion. Pair with Images 97_33, 97_34, and 97_35.
61 Ocular Manifestations of Congenital/Inherited DiseasesJacqueline A. Leavitt, MDThis 22-year-old woman has neurofibromatosis, type 2. Acuity, color plates, pupillary responses, slit-lamp examination, IOP, fields, and funduscopy are all normal. There is a 3 mm proptosis OS. The patient has recently undergone gamma knife for the acoustic tumor, and she has residual facial nerve p...
62 Neuro-Ophthalmic Vascular DiseaseJacqueline A. Leavitt, MDArteriovenous malformations are dysplastic vascular channels. They may result in neuro-ophthalmologic findings from direct compressive effects, secondary hemorrhage, or secondary seizure disorder. CT and/or MRI may demonstrate the lesion, but cerebral arteriography is usually required to better defi...
63 Ocular Manifestations of Congenital/Inherited DiseasesJacqueline A. Leavitt, MDThis 22-year-old woman has neurofibromatosis, type 2. Acuity, color plates, pupillary responses, slit-lamp examination, IOP, fields, and funduscopy are all normal. There is a 3 mm proptosis OS. The patient has recently undergone gamma knife for the acoustic tumor, and she has residual facial nerve p...
64 Ocular Manifestations of Congenital/Inherited DiseasesJacqueline A. Leavitt, MDThis 22-year-old woman has neurofibromatosis, type 2. Acuity, color plates, pupillary responses, slit-lamp examination, IOP, fields, and funduscopy are all normal. There is a 3 mm proptosis OS. The patient has recently undergone gamma knife for the acoustic tumor, and she has residual facial nerve p...
65 Ocular Manifestations of Congenital/Inherited DiseasesJacqueline A. Leavitt, MDThis 22-year-old woman has neurofibromatosis, type 2. Acuity, color plates, pupillary responses, slit-lamp examination, IOP, fields, and funduscopy are all normal. There is a 3 mm proptosis OS. The patient has recently undergone gamma knife for the acoustic tumor, and she has residual facial nerve p...
66 Neuro-Ophthalmic Manifestations of Brain TumorsJacqueline A. Leavitt, MDChordomas of the clivus may result in diplopia due to a sixth nerve palsy. The sixth nerve runs up the clivus and may be the presenting manifestation of the lesion. Pair with Images 97_34, 97_35, and 97_36.
67 Neuro-Ophthalmic Manifestations of Brain TumorsJacqueline A. Leavitt, MDChordomas of the clivus may result in diplopia due to a sixth nerve palsy. The sixth nerve runs up the clivus and may be the presenting manifestation of the lesion. Pair with Images 97_33, 97_34, and 97_36.
68 Neuro-Ophthalmic Manifestations of Brain TumorsJacqueline A. Leavitt, MDChordomas of the clivus may result in diplopia due to a sixth nerve palsy. The sixth nerve runs up the clivus and may be the presenting manifestation of the lesion. Imaging: MRI, T-1 axial with contrast. Pair with Images 97_33, 97_34, and 97_36. Anatomy: Clivus, Sixth nerve. Pathology: Sixth nerve p...
69 Pupillary SyndromeJeffrey G. Odel, MDIntermittent dilation of the pupils may occur as a benign phenomenon in healthy young adults. In the absence of other third nerve signs, (eg, ptosis, diplopia, ophthalmoplegia), an isolated transient dilation of the pupil in an otherwise healthy adult is unlikely to represent a third nerve palsy. Tr...
70 Pupillary SyndromeJeffrey G. Odel, MDIntermittent dilation of the pupils may occur as a benign phenomenon in healthy young adults. In the absence of other third nerve signs, (eg, ptosis, diplopia, ophthalmoplegia), an isolated transient dilation of the pupil in an otherwise healthy adult is unlikely to represent a third nerve palsy. Tr...
71 Isolated Congenital Optic Disc AnomaliesJoel M. Weinstein, MDThis 8-year-old boy presented with a 2-week history of decreased vision in the right eye. He had undergone a normal MRI and CSF examination, including intracranial pressure, before neuro-ophthalmologic assessment. The fundus photographs and fluorescein angiograms show subretinal neovascularization a...
72 Neuro-Ophthalmic Consequences of TherapyJoel M. Weinstein, MDThe patient is a 38-year-old woman with oligodendroglioma of the left cerebral hemisphere. The patient received intracarotid BCNU and developed BCNU retinopathy, optic neuropathy, and partial ophthalmoplegia. Image 92_21is from 1 month later and demonstrates hemorrhagic swelling of the disc, retinal...
73 Neuro-Ophthalmic Consequences of TherapyJoel M. Weinstein, MDThe patient is a 38-year-old woman with oligodendroglioma of the left cerebral hemisphere. The patient received intracarotid BCNU and developed BCNU retinopathy, optic neuropathy, and partial ophthalmoplegia. Image 92_22 Shows late changes, with more severe retinal ischemia, vascular attenuation, an...
74 Pseudopapilledema With Subretinal Neovascularization on Fluorescein AngiogramJoel M. Weinstein, MDThis 8-year-old boy presented with a 2-week history of decreased vision in the right eye. He had undergone a normal MRI and CSF examination, including intracranial pressure, before neuro-ophthalmologic assessment. The fundus photographs and fluorescein angiograms show subretinal neovascularization a...
75 Pseudopapilledema With Retinal Neovascularization, Fluorescein AngiogramJoel M. Weinstein, MDThis 8-year-old boy presented with a 2-week history of decreased vision in the right eye. He had undergone a normal MRI and CSF examination, including intracranial pressure, before neuro-ophthalmologic assessment. The fundus photographs and fluorescein angiograms show subretinal neovascularization a...
76 Isolated Congenital Optic Disc AnomaliesJoel M. Weinstein, MDThis 8-year-old boy presented with a 2-week history of decreased vision in the right eye. He had undergone a normal MRI and CSF examination, including intracranial pressure, before neuro-ophthalmologic assessment. The fundus photographs and fluorescein angiograms show subretinal neovascularization a...
77 Systemic Disorders With Optic Nerve and Retinal FindingsJoel M. Weinstein, MDThis 46-year-old woman noted progressive bilateral visual loss over a 10-month period. She had a malignant melanoma removed from her right thigh 2 years ago and excisional biopsy of an inguinal node metastasis 8 months ago. She also complained of poor night vision and rare intermittent ""sparkles"" ...
78 Systemic Disorders With Optic Nerve and Retinal FindingsJoel M. Weinstein, MDThis 46-year-old woman noted progressive bilateral visual loss over a 10-month period. She had a malignant melanoma removed from her right thigh 2 years ago and excisional biopsy of an inguinal node metastasis 8 months ago. She also complained of poor night vision and rare intermittent ""sparkles"" ...
79 Systemic Disorders With Optic Nerve and Retinal FindingsJoel M. Weinstein, MDThis 46-year-old woman noted progressive bilateral visual loss over a 10-month period. She had a malignant melanoma removed from her right thigh 2 years ago and excisional biopsy of an inguinal node metastasis 8 months ago. She also complained of poor night vision and rare intermittent ""sparkles"" ...
80 Systemic Disorders With Optic Nerve and Retinal FindingsJoel M. Weinstein, MDThis 46-year-old woman noted progressive bilateral visual loss over a 10-month period. She had a malignant melanoma removed from her right thigh 2 years ago and excisional biopsy of an inguinal node metastasis 8 months ago. She also complained of poor night vision and rare intermittent ""sparkles"" ...
81 Systemic Disorders With Optic Nerve and Retinal FindingsJohn A. Charley, MDA hypercoagulable state may result from deficiency of various factors involved in the clotting pathway, such as factor V. This may result in venous thrombosis and a branch or central retinal vein occlusion. Consideration for testing for an underlying coagulopathy, including the factor V deficiency, ...
82 Systemic Disorders With Optic Nerve and Retinal FindingsJohn A. Charley, MDA hypercoagulable state may result from deficiency of various factors involved in the clotting pathway, such as factor V. This may result in venous thrombosis and a branch or central retinal vein occlusion. Consideration for testing for an underlying coagulopathy, including the factor V deficiency, ...
83 Isolated Optic Neuritis/NeuropathyJohn A. Charley, MDSeveral Primary Mutations result in Leber's hereditary optic neuropathy, including mitochondrial deletions at positions 11778, 3460, and 14484. Although the 11778 is the most common mutation, the 11484 has the best prognosis for spontaneous recovery. This case exhibits the 3460 mutation.
84 Isolated Optic Neuritis/NeuropathyJohn A. Charley, MDSeveral Primary Mutations result in Leber's hereditary optic neuropathy, including mitochondrial deletions at positions 11778, 3460, and 14484. Although the 11778 is the most common mutation, the 11484 has the best prognosis for spontaneous recovery. This case exhibits the 3460 mutation.
85 Isolated Optic Neuritis/NeuropathyJohn A. Charley, MDSeveral Primary Mutations result in Leber's hereditary optic neuropathy, including mitochondrial deletions at positions 11778, 3460, and 14484. Although the 11778 is the most common mutation, the 11484 has the best prognosis for spontaneous recovery. This case exhibits the 3460 mutation.
86 Isolated Optic Neuritis/NeuropathyJohn A. Charley, MDSeveral Primary Mutations result in Leber's hereditary optic neuropathy, including mitochondrial deletions at positions 11778, 3460, and 14484. Although the 11778 is the most common mutation, the 11484 has the best prognosis for spontaneous recovery. This case exhibits the 3460 mutation.
87 Isolated Optic Neuritis/NeuropathyJohn A. Charley, MDSeveral Primary Mutations result in Leber's hereditary optic neuropathy, including mitochondrial deletions at positions 11778, 3460, and 14484. Although the 11778 is the most common mutation, the 11484 has the best prognosis for spontaneous recovery. This case exhibits the 3460 mutation.
88 Chiasmal SyndromesLarry P. Frohman, MDThis woman was 61 years old when she underwent initial neuro-ophthalmologic evaluation. Twenty-three years earlier, she had undergone removal of a pituitary adenoma followed by radiation therapy. At that time, she had noted a preoperative visual field defect that improved somewhat after the surgery....
89 Chiasmal SyndromesLarry P. Frohman, MDThis woman was 61 years old when she underwent initial neuro-ophthalmologic evaluation. Twenty-three years earlier, she had undergone removal of a pituitary adenoma followed by radiation therapy. At that time, she had noted a preoperative visual field defect that improved somewhat after the surgery....
90 Chiasmal SyndromesLarry P. Frohman, MDThis woman was 61 years old when she underwent initial neuro-ophthalmologic evaluation. Twenty-three years earlier, she had undergone removal of a pituitary adenoma followed by radiation therapy. At that time, she had noted a preoperative visual field defect that improved somewhat after the surgery....
91 Neuro-Ophthalmic Imaging-CT ScanLarry P. Frohman, MDThis patient was assaulted with a blunt object and suffered acute blindness due to traumatic optic neuropathy. Note how the lateral orbital wall has been fractured and displaced posteromedially into the region of the anterior optic canal.
92 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
93 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
94 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
95 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
96 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDCogan's syndrome is a vasculitic-autoimmune process with critical ocular features. In its original classical form it consists of nonluetic interstitial keratitis, with audiovestibular dysfunction, often with pain. More recently, it has been pointed out that there are nonclassical forms as well, part...
97 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
98 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
99 Motility DisturbancesLarry P. Frohman, MDThis 5-year-old child presented with a 70 PD exotropia OS and a right face turn. She had a CT scan of the head at age 4 months that was normal , and she was felt to have an isolated left medial rectus paresis. Her acuity was 20/20 OU. She could fuse with a large face turn, and was orthomorphic is ex...
100 Motility DisturbancesLarry P. Frohman, MDThis 5-year-old child presented with a 70 PD exotropia OS and a right face turn. She had a CT scan of the head at age 4 months that was normal , and she was felt to have an isolated left medial rectus paresis. Her acuity was 20/20 OU. She could fuse with a large face turn, and was orthomorphic is ex...
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