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1 Close Encounters of the Third Kind (Video)Trishal Jeeval-Patel, Danny MandellA 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...
2 Look in the Back (Video)Tatiana Deveney, Aristides Capizzano, Jonathan TrobeA 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...
3 Tissue Is the Issue (Video)Christine Greer, Jasmine Francis, Eli Diamond, Charles Eberhart, Marc DinkinA 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 ...
4 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...
5 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 RasoolA 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 ...
6 Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (Video)Jorge Kattah, Scott Eggers, Sarah BachA 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...
7 Undiscovered Islands - So Close, Yet So Far (Video)Magdalena Wirth, Farahna Sabiq, Mehdi AgoumiA 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...
8 Tumefictive MS (Video)Anthony Brune III, Hemant Parmar, Sandra Camelo-Piragua, Lindsey De LottA 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...
9 Bones of the Past (Video)Bart Chwalisz, Konstantinos Douglas, Vivian Douglas, Otto RapalinoA 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...
10 You're Too Young for That! (Video)Sravanthi Vegunta, Kathleen Digre, Bradley Katz, Meagan Seay, Alison Crum, Edward Quigley, Sean Kennedy, Nick Mamalis, Judith WarnerAn 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...
11 Smoke Gets in Your Eyes (Video)Tatiana Bakaeva, John Gittinger, JrA 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 ...
12 Not All Men With Thick Skulls Have High Testosterone (Video)Yosbelkys Martin Paez, MDA 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...
13 A Myel-In, a Long Way to Go (Video)Aishwarya Pareek, Timothy Lotze, Gail Demmler, Brandon Tran, William Whitehead, Carrie Mohila, Veeral ShahA 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...
14 Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (Video)David DeLeon, Mariel Rojas, Francisco Sanchez, Rosa Tang, Julie Patel, Jade SchiffmanA 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 ...
15 From Brainstem to Stern (Video)Neena Cherayil, Angela Viane, Grant Liu, Ali HamedaniA 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...
16 Are We "Tilting At Windmills"? (Video)Michael Vaphiades, DOA 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...
17 Every Rose Has Its ThornWilliam J. Anderson, BS
18 A Zebra Among ZebrasPeter Mortensen, Gabrielle Bonhomme
19 The Great MasqueradeBart Chwalisz, Dean Cestari
20 Fire and IceMary Maher, Joah Aliancy, Gul Moonis, Angela Lignelli, Michael Kazim, Jeffrey Odel
21 Go With Your Gut FeelingPaul R. Freund, MD, MSc, FRCSC
22 Chalky Pallid EdemaDaniel Kornberg, David Pisapia, Cynthia Magro, Cristiano Oliveira, Marc Dinkin
23 A-deno What's Going On!Christine Greer, Salina Teja, Jennifer Danesch, Anna Mathew, Vivek Patel, Kimberly Gokoffski
24 Unexplained Becomes ExplainedJinu Han, Hye Young Kim, Sueng-Han Han
25 Three's a CrowdKanwal S. Matharu, MD
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