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1 Neuro-Ophthalmic Manifestations of Brain TumorsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyChordomas 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.
2 Optic NeuropathiesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 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...
3 Optic NeuropathiesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyOptic atrophy might be a false-localizing sign of optic nerve disease, as retinal disease may secondarily produce optic atrophy. In retinitis pigmentosa, for example, patients may exhibit a waxy disc palor
4 Neuro-Ophthalmic manifestations of brain tumorsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyChordomas 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.
5 Neuro-Ophthalmic Consequences of TherapyAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyAn 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 ...
6 Neuro-Ophthalmic Consequences of TherapyAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyAn 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 ...
7 Neuro-Ophthalmic Consequences of TherapyAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyAn 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 ...
8 Neuro-Ophthalmic Consequences of TherapyAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyAn 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 ...
9 Neuro-Ophthalmic Consequences of TherapyAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyAn 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 ...
10 Ocular Manifestations of Congenital/Inherited DiseasesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 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...
11 Ocular Manifestations of Congenital/Inherited DiseasesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 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...
12 Neuro-Ophthalmic Imaging-Cerebral AngiographyAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyEhlers-Danlos syndrome is a connective tissue disorder that may affect blood vessels and predispose some affected patients to development of carotid cavernous fistula. Most patients with high-flow direct carotid cavernous sinus fistulas have suffered acute traumatic tears in the internal carotid art...
13 Chiasmal SyndromesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 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....
14 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyA 42-year old woman presented with a history of severe brow pain and 4 days of progressive visual loss OD. There was no increased pain on ocular rotation. Aside from heavy menses, she denied any significant past medical history. Her examination revealed a
15 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyA 42-year old woman presented with a history of severe brow pain and 4 days of progressive visual loss OD. There was no increased pain on ocular rotation. Aside from heavy menses, she denied any significant past medical history. Her examination revealed acuity NLP OD, 20/25 OS; color vision 9/10 OS;...
16 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyA 42-year old woman presented with a history of severe brow pain and 4 days of progressive visual loss OD. There was no increased pain on ocular rotation. Aside from heavy menses, she denied any significant past medical history. Her examination revealed acuity NLP OD, 20/25 OS; color vision 9/10 OS;...
17 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyAneurysms of the intracranial circulation may act as mass lesions and compress the afferent of efferent visual pathway. Ophthalmic artery aneurysms may compress the optic nerve and result in an optic neuropathy (ie, visual loss, afferent pupillary defect, optic atrophy). Treatment includes endovascu...
18 Ocular Manifestations of Congenital/Inherited DiseasesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 14-year-old boy presented with sudden visual loss of the right eye that occurred 3 weeks before and due to a central retinal vein occlusion. His ocular history was quite complicated. He had had a resection of a lymphangioma of the left upper lid at age 7 months and underwent left orbitotomy for...
19 Bridge ColobomaAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe patient is a 35-year-old asymptomatic woman with a bridge coloboma, also known as double optic disc
20 Isolated congenital optic disc anomaliesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyPatients with hypoplasia of the optic nerve may have normal or subnormal visual acuity or visual field. The condition may be unilateral or bilateral. Optic nerve hypoplasia is usually idiopathic, but maternal diabetes, or maternal use of anti-epileptic drugs or alcohol are predisposing factors. Opti...
21 Ocular Manifestations of Systemic DisordersRobert F. Saul, MD, Neurologist, Salem VA Medical CenterWilson's disease (hepatolenticular degeneration) is a progressive autosomal recessive multisystem disease that may result in cirrhosis of the liver, renal dysfunction, and motor neurologic disease. A Kayser-Fleischer ring may occur as a green-brown band at the level of Descemet's membrane in the cor...
22 Neuro-Ophthalmic Imaging-CT ScanAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis is a patient with trauma leading to enucleation, with swelling years later over the implant. This is a presumed chronic abscess between orbit and dura.
23 Neuro-Ophthalmic Imaging-CT ScanAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyIdiopathic orbital pseudotumor is an inflammatory disorder that may effect any part of the ocular anatomy. The site of inflammation determines the nomenclature. For example, involvement of the sclera is referred to as scleritis. And involvement of one or more of the extraocular muscles is referred t...
24 Neuro-Ophthalmic Imaging-CT ScanAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyIdiopathic orbital pseudotumor is an inflammatory disorder that may effect any part of the ocular anatomy. The site of inflammation determines the nomenclature. For example, involvement of the sclera is referred to as scleritis. And involvement of one or more of the extraocular muscles is referred t...
25 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyA 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, ...
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