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Title | Creator | History |
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A Nod to the Nodule | Natalie Brossard, Kirill Zaslavski, Laila Al-Shafai, David Munoz, Edward Margolin | A 67-year-old man presented to emergency department in March'21 with 6hours h/o fever, headache, confusion, right- sided weakness and urinary incontinence. He had h/o hypertension, rheumatoid arthritis, spinal stenosis and was taking etanercept/leflunomide/sulfasalazine. Non-contrasted CT showed lef... |
2 |
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A 4-Year Wait | Dmitry Balian, Sachin Kedar, Michaelyn Everhart, Aleh Bobr, Liudmila Muinov | A 64 year old male with past history of hypertension, arthritis and chronic headache developed transient tingling and numbness of his left face in February 2016 and was diagnosed to have "trigeminal neuralgia". Two months later, he presented to the ED with sudden onset of binocular tilted diplopia. ... |
3 |
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Frizzle Frazzled | Eric D. Gaier, Farrah Rajabi, Anne Fulton, Gyula Acsadi, David Waitzman | An otherwise healthy 12-year-old boy originally from Palestine was referred for refractory papilledema secondary to familial IIH. He has a history of fully accommodative esotropia with onset age 2-3. At age 9, elevated optic nerves prompted a neuro-ophthalmic referral. Best corrected visual acuities... |
4 |
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Oh My GAD!! Something Else? | Olwen Murphy, Kemar Green, John Probasco, Daniel Gold | A 43 -year-old man presented with oscillopsia, dizziness, binocular vertical diplopia, and gait difficulties. He reported a six-month history of abdominal pain, anorexia and 50-pound weight loss, and a 3-month history of mood and cognitive changes. Torsional nystagmus, a left 4th nerve palsy (NP), u... |
5 |
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Never Too Young or Too Old | Bart Chwalisz, Laurel Tainsh, Mary Maher, Samantha Champion, Shuhei Nishiyima, Michael Levy | An 81-year-old woman with history of ocular myasthenia gravis presented with sequential bilateral vision loss. Six days before presentation, she discovered that vision of her left eye was reduced to light perception. She did not have any eye pain, pain with eye movement, headache, scalp tenderness, ... |
6 |
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Gone but Not Forgotten | Jonathan Micieli, Adriana Krizova, Walter Montanera | A 52 -year-old healthy woman presented with a 1-week history of blurred vision and "soreness" in her left eye. Neuro-ophthalmic examination revealed a visual acuity of 20/20 OD, 20/40 OS, left RAPD and left superior arcuate defect on Humphrey visual field testing. Dilated fundus examination demonstr... |
7 |
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A Small Leak Will Sink a Great Ship | Konstantinos Douglas, Vivian Paraskevi Douglas, Cameron Sadegh, David Chow, Sigurros Davidsdottir, Ganesh Shankar, Bradley Buchbinder, Bart Chwalisz | A 68 -year-old right -handed man presented for evaluation of progressive and fluctuating polyopia, gait instability and cognitive changes of about 14 months. Prior medical history was notable for Crohn's disease in remission, atrial fibrillation, a single episode of aseptic meningitis 12 years prior... |
8 |
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Orbiting a Diagnosis | Daniel Liebman, Daniel Lefebvre, Emily Tam, Marie Lithgow, Bart Chwalisz, Eric Gaier, Joseph Kane | A 75 -year-old male with a history of chronic/small lymphocytic leukemia (CLL/SLL) presented for one day of left retro-orbital headache, painful eye movements, eyelid swelling, and diplopia. One week prior, his WBC count was 39.9 K/uL with 86% lymphocytes. Three days prior to presentation, the patie... |
9 |
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'X' Marks the Spot | Luis Andre Leal Ferman, Leslie Bruch, John Buatti, Jeremy Greenlee | This 24 year-old man presented with several months of progressive visual loss in both eyes. His past medical, surgical and ocular history was unremarkable. There was no family history of phacomatosis. He complained of occasional binocular diplopia, but denied headaches or any other neurological symp... |
10 |
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Sometimes a Biopsy is Best | Kevin Chodnicki, Natalie Wolkow, Michael Yoon, Bart Chwalisz | A 30 -year-old pregnant woman without significant medical or ocular history presented with decreased right eye vision. In her 2nd trimester, she was diagnosed with Lyme disease with a bulls-eye rash and positive Lyme antibodies; she was treated with two weeks of amoxicillin. At 33 weeks pregnant she... |
11 |
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A Definite Maybe | Raghu C. Mudumbai, Alex Solomon | 73 yo man French-Canadian presented to our institution for another opinion for a long standing diagnosis of Oculopharyngeal Dystrophy given at an outside institution. 17 years ago, the patient developed unfluctuating double vision that progressed to include severe, unfluctuating ptosis and mild dysp... |
12 |
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Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (Video) | David DeLeon, Mariel Rojas, Francisco Sanchez, Rosa Tang, Julie Patel, Jade Schiffman | A 16 y/o Caucasian female with a BMI of 24, went for an eye exam for blurry vision which corrected with refraction, however bilateral disc edema was found. There was a 4-year history of headaches that were intermittent and escalating in nature around 5 days a week, about 1 hour after awakening, and ... |
13 |
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From Brainstem to Stern (Video) | Neena Cherayil, Angela Viane, Grant Liu, Ali Hamedani | A previously healthy 32-year-old man complained of diplopia and one month of worsening positional headaches. He then acutely developed confusion and chills, prompting ER referral. Further history was limited by altered mental status. On presentation, he was afebrile and encephalopathic. Serum WBC wa... |
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A Myel-In, a Long Way to Go (Video) | Aishwarya Pareek, Timothy Lotze, Gail Demmler, Brandon Tran, William Whitehead, Carrie Mohila, Veeral Shah | A 9-year-old previously healthy female with two recent admissions for presumed diagnosis of ADEM re-presented with persistent headache and ataxic gait. During her initial admissions, she presented with fever, acute onset of ataxia, facial asymmetry and abnormal eye movements. Inpatient ocular exam s... |
15 |
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Are We "Tilting At Windmills"? (Video) | Michael Vaphiades, DO | A 52-year-old African American woman presented to her primary care physician with a 4 week history of headaches, nausea, vomiting, fever and ataxia. Her medical history includes rheumatoid arthritis, hypertension and a recent diagnosis of pulmonary; sarcoidosis for which she was taking 20 mg of pred... |
16 |
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Smoke Gets in Your Eyes (Video) | Tatiana Bakaeva, John Gittinger, Jr. | A 61-year-old woman, active smoker with history of COPD, presented with bilateral progressive vision loss and ataxia. Four months prior to her presentation she developed "black spot" in her right eye (OD) and was found to have "OD disc edema and right hypertropia" by an outside ophthalmologist. She ... |
17 |
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Oh Oh Oh It's Magic, You Know…Never Believe It's Not So! (Video) | Zeeshan Haq, Jeremy Tanner, Christine Glastonbury, Cathryn Cadwell, Brooks Crawford, Elan Guterman, Maulik Shah, Megan Richie, Nailyn Rasool | A 72-year-old man with chronic sinusitis, obstructive sleep apnea, and recent extensive travel presented with right-sided headaches, vision changes, and allergy symptoms. A head CT demonstrated a sinus infection and he was treated with amoxicillin-clavulanate; and prednisone. His headache persisted ... |
18 |
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Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (Video) | Jorge Kattah, Scott Eggers, Sarah Bach | A 45 y/o man developed insidious unsteadiness and bilateral hearing impairment. A neurosurgeon diagnosed possible myelopathy, and despite an anterior cervical discectomy, he noted progressive gait difficulty, poor handwriting, and inability to play the guitar. Additionally, dysarthria, oscillopsia a... |
19 |
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Undiscovered Islands - So Close, Yet So Far (Video) | Magdalena Wirth, Farahna Sabiq, Mehdi Agoumi | A 30-year old female, visiting Canada from India, presented to ophthalmology with a 2-day history of right periorbital swelling, painful proptosis, fevers and chills. Initial examination suggested a clinical diagnosis of post-septal cellulitis with mild motility restriction, without optic nerve comp... |
20 |
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Tumefictive MS (Video) | Anthony Brune III, Hemant Parmar, Sandra Camelo-Piragua, Lindsey De Lott | A 26-year-old woman with history of diabetes insipidus and hypothyroidism presented for evaluation of painless vision loss in her right eye. She was evaluated by a local neurologist and multiple sclerosis (MS) specialist who diagnosed acute optic neuritis. MRI brain showed an enhancing T2 hyperinten... |
21 |
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Bones of the Past (Video) | Bart Chwalisz, Konstantinos Douglas, Vivian Douglas, Otto Rapalino | A 44-year-old woman presented with two episodes of binocular horizontal diplopia within one year. She had a history of Cushing's syndrome status post transsphenoidal resection and bilateral adrenalectomy 4 years prior, hypertension, and secondary diabetes mellitus. Nine months prior she developed se... |
22 |
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You're Too Young for That! (Video) | Sravanthi Vegunta, Kathleen Digre, Bradley Katz, Meagan Seay, Alison Crum, Edward Quigley, Sean Kennedy, Nick Mamalis, Judith Warner | An 11-year old boy presented with right orbital pain for two months with recent double vision. He had no recent viral illnesses or sick contacts. He had no past medical history. His brother had Kawasaki disease; his paternal grandmother had rheumatoid arthritis; and his father died of a myocardial i... |
23 |
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Not All Men With Thick Skulls Have High Testosterone (Video) | Yosbelkys Martin Paez, MD | A 54-year-old retired USAF fighter pilot was referred in Aug 2016 for evaluation of possible bilateral optic disc swelling noted on routine optometric examination. His past medical history included low testosterone discovered 2 years prior in the context of fatigue and exercise intolerance. MRI brai... |
24 |
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Close Encounters of the Third Kind (Video) | Trishal Jeeval-Patel, Danny Mandell | A 65-year old woman started experiencing headaches which increased in severity over two weeks. She eventually sought care in the emergency department. Neurological examination was reported as normal. Unenhanced CT of the brain was performed and reported as normal. Headaches continued and she was pre... |
25 |
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Look in the Back (Video) | Tatiana Deveney, Aristides Capizzano, Jonathan Trobe | A 59-year old man with Graves disease developed increasing proptosis and diplopia. Attributing these abnormalities to worsening of the Graves disease, an ophthalmologist treated him with high-dose oral and intravenous corticosteroids. When improvement did not occur, he underwent orbital x-irradiatio... |
26 |
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Tissue Is the Issue (Video) | Christine Greer, Jasmine Francis, Eli Diamond, Charles Eberhart, Marc Dinkin | A 34-year-old man with a past medical history of bilateral corneoscleral lesions and brainstem, thalamic, and temporal lobe lesions presented with progressive vision loss over seven months. He described graying out of vision with light sensitivity. Bilateral, retrobulbar, deep ocular pain started 2 ... |
27 |
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A Par 3 Macular Hole? (Video) | Archana Srinivasan, Jerald Gong, Mark Moster | A 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 |
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A Trip Through the Wormhole | Anne R. Kao, MD | |
29 |
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Three's a Crowd | Kanwal S. Matharu, MD | |
30 |
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Every Rose Has Its Thorn | William J. Anderson, BS | |
31 |
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A Zebra Among Zebras | Peter Mortensen, Gabrielle Bonhomme | |
32 |
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The Great Masquerade | Bart Chwalisz, Dean Cestari | |
33 |
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Fire and Ice | Mary Maher, Joah Aliancy, Gul Moonis, Angela Lignelli, Michael Kazim, Jeffrey Odel | |
34 |
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Go With Your Gut Feeling | Paul R. Freund, MD, MSc, FRCSC | |
35 |
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Chalky Pallid Edema | Daniel Kornberg, David Pisapia, Cynthia Magro, Cristiano Oliveira, Marc Dinkin | |
36 |
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A-deno What's Going On! | Christine Greer, Salina Teja, Jennifer Danesch, Anna Mathew, Vivek Patel, Kimberly Gokoffski | |
37 |
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Unexplained Becomes Explained | Jinu Han, Hye Young Kim, Sueng-Han Han | |
38 |
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Don't Drink the Water | Devon A. Cohen, MD | |
39 |
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Turbulence, Fluid Waves, and the Black Hole | Stella Y. Chung, MD, MS | |
40 |
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At the Crossroads | Konstantinos Douglas, MD, DVM, MBA | |
41 |
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Fooled Thrice | Jonathan A. Micieli, MD, CM | |
42 |
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Just the Two of Us | Dan Milea, MD, PhD | |
43 |
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When the Problem Becomes the Solution - Video | Ari Shemesh, Timo Krings, Dalia Rotstein, David Munoz, Waleed Brinjikji, Laila Al Shafai, Edward Margolin | |
44 |
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A Tough Nut to Crack! - Video | Lauren Maloley, Sachin Kedar, Deepta Ghate, Dominick DiMaio, Jason Helvey, Sachin Kedar | |
45 |
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Lumps and Bumps - Video | Wayne Tie, Martha P. Schatz, MD | |
46 |
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Testing the Hypophysis - Video | Alberto Distefano, Julie Cho, Adeniyi Fisayo, Mahsa Sohrab | |
47 |
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A Giant (Cell) Mistake - Video | Behzad Mansouri, Paul Wawryko, Frank Bovell | |
48 |
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A Sad Story - Video | Jason Peragallo, MD | |
49 |
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One Peak is Worth Twenty Finesses - Video | Steven Newman, James Mandell | |
50 |
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Coming to a Rapid Conclusion - Video | Leanne Stunkel, Namita Sinha, Nathan Kung, Robi Maamari, Cole Ferguson, Sonika Dahiya, George Harocopos, Gregory Van Stavern | |
51 |
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A Can of Worms - Video | Ali Hamedani, Madhura Tamhankar | |
52 |
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It's Always Been Like That - Video | Eric Gaier, William Butler, Joseph Rizzo | |
53 |
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Gee...What's Causing that Pap? - Video | Susan Mollan, Daniel White, Santhosh Nagaraju, Swarupsinh Chavda, Tom Hayton, Saiju Jacob | |
54 |
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Cold Fever - Video | Shannon Beres | |
55 |
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Triple Take - Video | Johanna Beebe, Liang Cheng, Shira Simon, Michael Wall, Randy Kardon, Alkapalan Deema, Ian Han, Matthew Thurtell | |
56 |
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Light at the End of the Tunnel - Video | Noel Chan, Tak Lap Poon, Joyce Chow, Wai Lun Poon, Sherman Lo, Wing Hung Lau, Ka Hong Au, Carmen Chan | |
57 |
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What Don't You See? - Video | James O'Brien, MD, R. Michael Siatkowski, MD, Bradley K. Farris, MD | |
58 |
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Whipping Up a New Flavor - Video | Meagan Seay, Tory Johnson, Benjamin Larman, Avindra Nath, Myoung-Hwa Lee, Janet Rucker, Jonathan Howard, Ilya Kister, Matija Snuderl, Laura Balcer, Steven Galetta | |
59 |
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Uncertainty with a Twist of Lyme (video) | Amrita-Amanda Lakraj, Sang Hong, Jennifer Connelly, Elizabeth Cochran | The 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... |
60 |
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Alcohol is Never the Answer, but it Does Make You Forget the Question (video) | Ali Saber Tehrani, Diana Londono, Thomas Rashid, Manuel Doria, Julia Biernot, Jorge Kattah | A 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 ... |
61 |
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A Prolonged Path To The Final Diagnosis (video) | Cindy Lam, Edward Marglin | Previously 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. |
62 |
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Not Surprised Surprise (video) | Yu Zhao, Joshua Pasol, Sander Dubovy, Byron Lam | A 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... |
63 |
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Strike a Chord (video) | Anastasia Neufeld, Kathleen B. Digre, MD, Professor of Neurology and 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 of Utah | 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... |
64 |
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A Wrong Turn at the Angle (video) | Erica Archer, Jonathan Daniel Trobe MD, Michigan University, Hemant Parmar, Mohannad Ibrahim, Paul McKeever, Thomas Giordano | A 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. |
65 |
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Nonchalant Midterm-taker Develops Altered Mental Status (video) | Shira Simon, Bruno Policeni, Matthew Thurtell | A 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... |
66 |
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Pseudo-Pseudotumor Cerebri (video) | Valérie Biousse, MD, Departments of Ophthalmology and Neurology, Emory University School of Medicine, Jose Velázquez Vega, Amit Saindane, Nancy J. Newman, MD, Emory Eye Center | A 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. |
67 |
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A Diagnostic Potpourri (video) | Padmaja Sudhakar, Robert Lightfoot, Douglas Lukins, Dianne Wilson | A 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... |
68 |
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Keep Your Eye On the Ball (video) | 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. |
69 |
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Island Fever (video) | 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 Medicine | A 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. |
70 |
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Papilledema Gone Wrong (video) | Ahmara Ross, Payal Patel, Jessica Panzer, Grant T. Liu, MD, Professor of Neurology, University of Pennsylvania | A 12 year old obese female with a history of enterovirus meningitis presented with throbbing, constant, 10/10, occipital and positional headaches, associated with diplopia, photophobia, nausea, and vomiting for one week in; the setting of a recent 20 lb. weight gain. Her vision, pupils, fields, and ... |
71 |
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Occam Rings True (video) | Reid Longmuir, Michael Bradshaw, Taylor Davis, Woon Chow, Laura Craig-Owens, Kim Ely, Katherine McDonell | A 57-year-old, previously healthy man was referred for vision loss in both eyes. Six weeks before our evaluation, he presented to an outside ophthalmologist with "greying" of the central vision in his right eye that progressed to blindness over a week. |
72 |
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M.I.A. (video) | Julie DeBacker, Janet Rucker, Josef Gutman, Heather Lau, Laura J. Balcer, MD, Professor, Department of Neurology, NYU Langone; Steven L. Galetta, MD, NYU Langone | A 69-year-old man presented with a several year history of vertical double vision. At age 46, he presented with a two year history of imbalance, four year history of urinary urgency/frequency, and a six-month history of leg numbness and tingling. |
73 |
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A "Frosty" Altered Level of Consciousness (video) | Alaa Bou Ghannam, Emily McCourt, Victoria Pelak, Jeffrey Bennett, Prem S Subramanian, MD, PhD, Professor of Ophthalmology, Neurology, and Neurosurgery, University of Colorado, David Smits | 15-year-old previously healthy male, transferred because of 9-day history of headache, difficulty walking, diplopia, blurry vision and new onset altered level of consciousness. Neurologic examination was remarkable for delirium; with semi-coherent speech, VA of CF 2ft and 20/400, no APD, and bilater... |
74 |
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Looking for a Drop of Porcelain - Video | Shannon J. Beres, MD, Grant T. Liu, MD | A 4 year old healthy boy presented with severe headache. A right subdural hygroma was seen on brain MRI and CSF evaluation showed a leukocytosis with elevated protein. A week later he developed left leg weakness and a repeat brain MRI showed progressive leptomeningeal enhancement and new punctate in... |
75 |
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Heart of Darkness - Video | Shira Simon, Shiraaz I. Rahman, John C. Heymann, Bahram Rahmani, Nicholas J. Volpe, MD, Northwestern University | An 18 year-old woman presented to the emergency department in October 2014 with three days of blurred vision in her left eye. Past medical history included a hypoplastic right heart status-post orthotopic heart transplant at 2 months of age, chronic kidney disease with BK viremia since 12 years of a... |
76 |
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Is It or Isn't It? - Video | Peter W. MacIntosh, Scott Jones, Milena Stocic, Amy Lin, Heather Moss | A 58-year-old woman with recurrent left idiopathic orbital inflammation (IOI) presented with one day of rapidly progressive bilateral proptosis, edema, right eye redness, photophobia, and blurry vision. Her right eye had previously been asymptomatic. Her left eye had macular scarring with reduced vi... |
77 |
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Many Small Lesions, One Big Problem - Video | Harsh V. Gupta, Tuhin Virmani, Rohan Samant, Murat Gokden, Sarkis M. Nazarian, Joseph G. Chacko, MD, University of Arkansas | A 73-year old hypertensive and hyperlipidemic man presented with 18 months of horizontal diplopia, worse at distance and gaze right, oscillopsia on left head turn, and unsteady gait. Six months prior to consult, he developed dysphagia, worse with liquids, and recurrent falls forced him to use a walk... |
78 |
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It Is, Is It Not? - Video | Ivana Vodopivec, Derek H. Oakley, Nagagopal Venna, John H. Stone, E. Tessa Hedley-Whyte, Sashank Prasad, MD, Brigham and Women's Hospital | A 44-year-old man presented with visual loss, confusion, apraxia, and left-sided weakness. His medical history included retinal vasculopathy, chronic kidney disease, hypertension, and hypertensive cardiomyopathy that had presented over the preceding six years. The retinal vasculopathy had been terme... |
79 |
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Avengers Assemble! - Video | Radha Ram, Carrie A. Mohila, Jeremy Y. Jones, Veeral S. Shah | A five-year-old otherwise healthy boy presented with a two-week history of behavioral changes, nausea, vomiting, headache, and subacute vision loss bilaterally. Six weeks prior to presentation to our hospital, he had presented to an outside hospital with esotropia and blurred vision in both eyes. At... |
80 |
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Leopard Can't Change Its Spots - Video | Terry S. Kang, Veeral S. Shah | An 8 year-old Caucasian female presented with bilateral conjunctivitis, photophobia, and blurred vision. Visual acuity was 20/50 OD and 20/60 OS. She had 2-3+ anterior chamber cell and flare OU, 1+ vitreous cells OU, 2+ optic disc edema OU, and macular edema OU. She was diagnosed with anterior uveit... |
81 |
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A Night at the Met - Video | Clotilde Hainline, Janet C. Rucker, David Zagzag, Yvonne W. Liu, Floyd A. Warren, Laura J. Balcer, MD, Professor, Department of Neurology, NYU Langone; Steven L. Galetta, MD, NYU Langone | A 73-year old woman with no headache history presented to the emergency department with several days of right-sided, retro-ocular, and vertex headaches and inability to see the left side of the TV screen-- all beginning 1 week after cataract surgery. Evaluation by her ophthalmologist was unrevealing... |
82 |
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Growing Up Too Fast - Video | Courtney E. Francis, Thomas T. Chia, Gordana Juric-Sekhar, Manuel Ferreira | A 7 ½ year old boy presented in 2000 with precocious puberty (development of pubic hair, acne and rapid linear growth). Work-up included a brain MRI revealing a suprasellar mass, consistent with a visual pathway glioma. On ophthalmologic evaluation, he was noted to be 20/25 OU with a normal fundusc... |
83 |
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Diplopic Uveitis - Video | Kinda Najem, Edward Margolin, Pradeep Krishnan | 33 year-old man presented with 3 days of binocular diplopia. Visual acuity was 20/30 OU and pupillary exam was normal. Motility testing demonstrated right partial 3rd nerve palsy (no adduction and limited supraduction with complete ptosis). There were +1/2 anterior chamber cells and few vitreous cel... |
84 |
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A Case of Progressive Orbital Cellulitis in an Immunocompetent Patient - Video | Cinthi Pillai, MD, NYU Langone; Ivana Vodopivec, MD, Brigham and Women's Hospital; Daniel Lefebvre, MD, Massachusetts Eye and Ear; Frederick A. Jakobiec, MD, DSc, Massachusetts Eye and Ear; Joseph F. Rizzo III, MD, Massachusetts Eye and Ear | A 74 year-old woman presented 2/7/2015 with left orbital swelling/discomfort. Imaging revealed paranasal sinus and orbital soft tissue abnormalities suggestive of inflammatory/infectious disease. She received intravenous vancomycin/meropenam but worsened. Medical history was notable for paroxysmal a... |
85 |
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The Good, The Bad, and The Ugly - Video | Nathan H. Kung, Robert C. Bucelli, Gregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of Medicine | A 37-year-old man with a history of hearing loss presented to the Neuro-Ophthalmology clinic in 2014 with 1 month of decreased vision in the left visual field. He also reported a period of binocular horizontal diplopia, similar in all directions of gaze, which had since resolved. Past medical histor... |
86 |
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Masquerade - Video | Amanda D. Henderson; Jacques J. Morcos; Oliver G. Fischer; Joshua Pasol | A 68 year-old man from Nicaragua, with a past medical history of diabetes and hypertension, presented with a one-year history of right-sided headaches, diplopia, and a four-month history of sudden vision loss in his right eye. In Nicaragua, a head CT and an angiogram had revealed a sphenoid wing and... |
87 |
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When a WEINO Goes Blind - Video | Rustum Karanjia, Chiara La Morgia, Christina Liang, Carolyn Sue, Valerio Carelli, Peter A Quiros, Alfredo A. Sadun, MD, PhD, Flora L. Thornton Chair, Professor of Ophthalmology and Neurological Surgery, Keck School of Medicine at USC | A 16 year old male presented to an outside center with binocular horizontal diplopia. His symptoms began approximately six months prior when he noticed difficulty reading. He was seen by an optometrist and prescribed reading glasses. His vision was 20/66 in the right eye and 20/25 in the left eye. H... |
88 |
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Not a Meatball - Video | Steven A. Newman, MD, University of Virginia School of Medicine, James Mandell, Colleen Druzgal, John Jane Jr., Spencer Payne, Sugoto Mukherjee, Beatriz Lopes | In April 2015, a 10 year old girl was referred for a four day history of ptosis and double vision. On examination, visual acuity was 20/20-OU; near vision was 3pt OU. Visual fields showed subtle arcuate visual field changes. External examination revealed palpebral fissures of 6.5 and 9 with an upper... |
89 |
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Eyes and Bowels Bottled Up - Video | Kristopher Kowal, Jonathan Daniel Trobe, MD, Michigan University, Theodore T. Brown | A 56 year-old man presented with diplopia and ptosis. Actually he was more concerned about severe constipation that had started about the same time. Abdominal x-rays had shown stool loading; laxatives had been ineffective. Our exam showed bilateral ptosis with complete ophthalmoplegia in both eyes. ... |
90 |
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"Not Right in the Head" - Video | Melinda Y. Chang, MD, Janet Lee, MD, Robert A. Goldberg, MD, Stacy L. Pineles, MD | A 55 year old man presented with eight months of progressive left orbital swelling. His past ocular history was significant for LASIK of the right eye with monovision. His past medical history was significant for melanoma of the left arm, treated by surgical excision, with two negative lymph nodes, ... |
91 |
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In the Thick of It | Kannan M. Narayana, Ritesh A. Ramdhani, Bradford Tannen, Laura J. Balcer, Steven L. Galetta, Janet C. Rucker | A 38 year-old woman with a history of premature birth with significant developmental delay was sent for neuroophthalmic evaluation for excessive head movements with gaze shifting. As an adult, she was verbal and able to take the bus alone to a day program. Over the past two years, language and cogni... |
92 |
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Growing Suspicion | Angela M. Herro, Norman J. Schatz, MD, Bascom Palmer Eye Institute, Linda L. Sternau, John R. Guy | loss 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... |
93 |
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Under Pressure | Nathan H. Kung, Collin M. McClelland, Gregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of Medicine | A 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... |
94 |
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The Relationship Between PDE-5 Inhibitors and NAION | Howard D. Pomeranz, MD | Sildenafil was first synthesized by pharmaceutical chemists working at Pfizer. It was initially studied for use in hypertension and angina. Phase I clinical trials suggested that the drug had little effect on angina but could induce penile erection. Sildenafil (Viagra®) was patented in 1996 and app... |
95 |
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Hiding and Out of Sight | Michael M. Morgan, Sumayya J. Almarzouqi, Patricia Chevez-Barrios, Amina I. Malik, Andrew G. Lee | A 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... |
96 |
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Who Deserves a Second Chance? | Lina Nagia, Jennifer I. Doyle, Lanning B. Kline | An 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... |
97 |
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A Weak Presentation | Reuben M. Valenzuela, Bradley J. Katz, Alison V. Crum, Kathleen B. Digre, Nick Mamalis, Hans C. Davidson, Judith E. A. Warner, MD, Moran Eye Center, University of Utah | An 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... |
98 |
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I Can't See Straight | Steven A. Newman, T. Ben Ableman | In 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... |
99 |
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Star Spangled Banner | Dara M. Bier, Jeffrey P. Greenfield, Marc K. Rosenblum, Joseph P. Comunale Jr., Cristiano Oliveira, Marc J. Dinkin | A 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... |
100 |
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Three Weeks in Florida | Andrew R. Carey, J. Antonio Bermudez-Magner, Sander R. Dubovy, Norman J. Schatz, MD, Bascom Palmer Eye Institute; Linda L. Sternau, Byron L. Lam | A 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... |