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TitleCreatorHistory
26 Tissue Is the Issue (Video)Christine Greer; Jasmine Francis; Eli Diamond; Charles Eberhart; Marc DinkinThe 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...
27 A Par 3 Macular Hole? (Video)Archana Srinivasan; Jerald Gong; Mark MosterA 78-year old woman with 3-week history of sudden onset 'visual blur' OU and difficulty reading was evaluated by her ophthalmologist and suspected to have macular hole secondary to posterior vitreous detachment and vitreomacular traction (VMT). Her past medical history was significant for hypertensi...
28 A Trip Through the WormholeAnne KaoThe patient initially presented to me at age 19 years with a 'throbbing, aching pressure' behind her right eye and swelling of the right upper eyelid. Her pain was worse in lateral gaze, although she denied diplopia. She had been prescribed 60mg of prednisone by the referring provider, which reduced...
29 Three's a CrowdKanwal Matharu; Veeral ShahA 2 year-old male boy was referred for painless, progressive proptosis in the right eye over a one year. The patient had no history of trauma, personal or family history of malignancy, or orbital inflammation, and had an unremarkable past medical history. On exam, the patient had fix and follow visi...
30 Every Rose Has Its ThornWilliam Anderson; Aseem Sharma; Miguel Guzman; Sophia ChungA 26-year-old woman presented with a one-year history of horizontal binocular diplopia on far-right gaze. During a routine eye examination for contact lenses, she was found to have a gaze paretic nystagmus on far-right gaze. The patient also offered a one-year history of right-sided instability and ...
31 A Zebra Among ZebrasPeter Mortensen; Gabrielle Bonhomme61-year-old man with Type 2 diabetes and hypertension presented to outside hospital ED with fever, headache, and neck pain. Onset of neck pain was one week prior, with worsening of symptoms following chiropractic manipulation. Patient was evaluated at outpatient clinic one day prior and given Medrol...
32 The Great MasqueradeBart Chwalisz; Dean CestariA 56-year-old man with unremarkable prior history complained of visual and somatosensory disturbances. Five months prior, he had an episode of being unable to see oncoming traffic. He developed transient visual disturbances lasting minutes in the left hemifield, e.g., the right sides of people's fac...
33 Fire and IceMary Maher; Joah Aliancy; Gul Moonis; Angela Lignelli; Michael Kazim; Jeffrey OdelA 14 year-old boy, with ADHD on amphetamine and dextroamphetamine, presented with headache and bilateral decreased vision. Seven days prior, he began experiencing bilateral non-positional frontal headache unresponsive to NSAIDS that did not wake him from sleep. Five days prior, he felt fatigued and ...
34 Go With Your Gut FeelingPaul Freund; Ari Shemesh; Gabriella Mankovskii; Ana Pejovic-Milic; David Howarth; Edward Margolin71 year-old man noticed a "smudge" in his central vision when reading that was gradually progressing over a year. Medical history was significant for one episode of hemorrhagic colitis requiring colectomy 28 years ago diagnosed as Crohn's disease, atrial fibrillation, and congenital dyschromatopsia....
35 Chalky Pallid EdemaDaniel Kornberg; David Pisapia; Cynthia Magro; Cristiano Oliveira; Marc DinkinA 52 year-old woman with hypertension, insulin dependent type II diabetes, mild non-proliferative diabetic retinopathy in both eyes, obstructive sleep apnea, paroxysmal atrial fibrillation, obesity and multifactorial end-stage renal disease (ESRD) complained of four days of a dark scotoma in the inf...
36 A-deno What's Going On!Christine Greer; Salina Teja; Jennifer Danesch; Anna Mathew; Vivek Patel; Kimberly GokoffskiA 68 year-old Hispanic female with hypertension, type II diabetes mellitus, panhypopituitarism after pituitary adenoma resection 30 years prior and subsequent radiation therapy presented with decreased vision in the left eye and severe headache. The patient's vision in the left eye declined in the p...
37 Unexplained Becomes ExplainedJinu Han; Hye Young Kim; Sueng-Han Han7 years old male presented to the ophthalmology clinic for the evaluation of low vision. He was born with caesarean section after an uneventful pregnancy at 38 weeks, 4.05kg. The mother denied any perinatal hypoxia, ischemia or head injury during delivery. He first visited pediatric neurology clinic...
38 Don't Drink the WaterDevon Cohen; Muhammad Bhatti; John ChenA 19-year-old right-handed man presented with a 3 year history of episodic headaches, right hemiparesis, and progressive vision loss OU. Beginning in the fall of 2015, he developed stepwise deterioration in vision OU in association with severe headaches. Initial evaluation at an outside hospital sho...
39 Turbulence, Fluid Waves, and the Black HoleStella Chung; Daniel Rubinstein; Leon Rafailov; Nilo Toledo; Paul Langer; James Liu; Roger TurbinA 61-year old male developed an acute exacerbation superimposed on a 3-month relapsing and remitting course of painless eyelid swelling beginning in the right upper lid progressing to involve both upper and lower eyelids, malar area, and temporalis. He provided photographic documentation of dramatic...
40 At the CrossroadsKonstantinos Douglas; Michael Yoon; Frederick Jakobiec; Joseph Rizzo III; Bart ChwaliszA 54-year-old female former smoker presented with vertical diplopia, left facial pain and left forehead weakness. She previously had thyroidectomy for a noncancerous nodule and abdominal hysterectomy for fibroids. She reported a two-year history of worsening facial pain and numbness that started as ...
41 Fooled ThriceJonathan Micieli; Hui-Kuo Shu; Alessandra Schmitt; Nancy NewmanA 40-year-old healthy man presented with a one-month history of left ptosis and binocular horizontal diplopia. Examination revealed normal afferent visual function. He had left ptosis and there was limitation of elevation, depression, adduction and a dilated, sluggishly reactive pupil in the left ey...
42 Just the Two of UsDan Milea; Pratik Chougule; Ming LeeA 63-year-old female patient of Chinese ethnicity was referred for unexplained visual loss in her right eye, discovered incidentally 1 month before presentation. Her past medical history revealed quiescent asthma and a benign cyst in the left lung, excised 27 years earlier. The patient had no vascul...
43 When the Problem Becomes the Solution - VideoAri Shemesh; Timo Krings; Dalia Rotstein; David Munoz; Waleed Brinjikji; Laila Al Shafai; Edward Margolin25 year-old man noticed slow progressive decrease in vision in left eye. Vision was 20/20 OD and 20/40 OS, there was swelling of left optic nerve head. MRI demonstrated white matter lesions in left frontal lobe; cerebrospinal fluid composition was normal. Patient was seen in MS clinic and treatment ...
44 A Tough Nut to Crack! - VideoLauren Maloley; Sachin Kedar; Deepta Ghate; Dominick DiMaio; Jason Helvey; Sachin KedarA 47-year-old previously healthy female was transferred to our facility when she developed left abducens nerve palsy during treatment of intractable sinusitis. Two weeks prior to presentation, she developed headache and sinus congestion. She was treated with amoxicillin-clavulanic acid and prednison...
45 Lumps and Bumps - VideoWayne Tie; Martha SchatzA 37 year-old man with no PMH presented with bilateral painful red eyes and progressive proptosis for several months. He noted the increasing protrusion of both eyes, but only complained of recent onset of pain in both eyes over the last four days. He also developed worsening blurry vision in both e...
46 Testing the Hypophysis - VideoAlberto Distefano; Julie Cho; Adeniyi Fisayo; Mahsa SohrabA 60 year-old female with history of hypertension, hyperlipidemia, and Lyme disease 12 years ago treated with doxycycline, developed extreme thirst and polyuria four years ago and was diagnosed with central diabetes insipidus. Magnetic resonance imaging (MRI) at that time showed enhancement of the p...
47 A Giant (Cell) Mistake - VideoBehzad Mansouri; Paul Wawryko; Frank Bovell71-year-old, left-handed woman, who was referred with ptosis, loss of vision in the right eye and headache. In July 2015 she presented to ER with severe right temporal headache and watery right eye. Her exam and head CT was normal. Her ESR/CRP were elevated. She was allegedly diagnosed with GCA and ...
48 A Sad Story - VideoJason PeragalloA healthy 6-year-old boy had a two-week history of progressive headaches associated with nausea and vomiting. An ER diagnosed allergic rhinitis, treated with augmentin and steroids, however his symptoms worsened. At a second ER he was febrile to 103F. A classmate was recently diagnosed with Erlichio...
49 One Peak is Worth Twenty Finesses - VideoSteven Newman; James MandellAn 8 year old was referred with a one week history of swelling around her left eye. She was not aware of any change in her vision or double vision. Visual acuity was 20/20 OD and 20/25 OS. Visual fields demonstrated minimal scattered desaturation with < ½ dB asymmetry between the two sides. Externa...
50 Coming to a Rapid Conclusion - VideoLeanne Stunkel; Namita Sinha; Nathan Kung; Robi Maamari; Cole Ferguson; Sonika Dahiya; George Harocopos; Gregory Van StavernA 21-year-old man presented to a retina specialist for 2.5 weeks of painless central vision loss OD. His initial examination was notable for visual acuity 20/200 OD and 20/20 OS. Fundus examination was significant for several macular areas of retinal pigment epithelial (RPE) atrophy with associated ...
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