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TitleCreatorHistory
1 Looking for a Drop of Porcelain - VideoShannon J. Beres; Grant T. LiuA 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...
2 Heart of Darkness - VideoShira Simon; Shiraaz I. Rahman; John C. Heymann; Bahram Rahmani; Nicholas J. VolpeAn 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...
3 Many Small Lesions, One Big Problem - VideoHarsh V. Gupta; Tuhin Virmani; Rohan Samant; Murat Gokden; Joseph G. Chacko; Sarkis M. NazarianA 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...
4 Avengers Assemble! - VideoRadha Ram; Carrie A. Mohila; Jeremy Y. Jones; Veeral S. ShahA 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...
5 Leopard Can't Change Its Spots - VideoTerry S. Kang; Veeral S. ShahAn 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...
6 Growing Up Too Fast - VideoCourtney E. Francis; Thomas T. Chia; Gordana Juric-Sekhar; Manuel FerreiraA 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...
7 Diplopic Uveitis - VideoKinda Najem; Edward Margolin; Pradeep Krishnan33 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...
8 A Case of Progressive Orbital Cellulitis in an Immunocompetent Patient - VideoCinthi Pillai; Ivana Vodopivec; Daniel Lefebvre; Frederick Jakobiec; Joseph RizzoA 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...
9 Masquerade - VideoAmanda D. Henderson; Jacques J. Morcos; Oliver G. Fischer; Joshua PasolA 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...
10 Not a Meatball - VideoSteven Newman; James Mandell; Colleen Druzgal; John Jane Jr.; Spencer Payne; Sugoto Mukherjee; Beatriz LopesIn 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...
11 Not Right in the Head' - VideoMelinda Y. Chang; Janet Lee; Robert A. Goldberg; Stacy L. PinelesA 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, ...
12 Is It or Isn't It? - VideoPeter W. MacIntosh; Scott Jones; Milena Stocic; Amy Lin; Heather MossA 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...
13 It Is, Is It Not? - VideoIvana Vodopivec; Derek H. Oakley; Nagagopal Venna; John H. Stone; E. Tessa Hedley-Whyte; Sashank PrasadA 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...
14 A Night at the Met - VideoClotilde Hainline; Janet C. Rucker; David Zagzag; Yvonne W. Liu; Floyd A. Warren; Laura J. Balcer; Steven L. GalettaA 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...
15 The Good, The Bad, and The Ugly - VideoNathan H. Kung; Robert C. Bucelli; Gregory P. Van StavernA 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...
16 When a WEINO Goes Blind - VideoRustum Karanjia; Chiara La Morgia; Christina Liang; Carolyn Sue; Valerio Carelli; Peter A. Quiros; Alfredo A. SadunA 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...
17 Eyes and Bowels Bottled Up - VideoKristopher Kowal; Jonathan D. Trobe; Theodore T. BrownA 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. ...
18 In the Thick of ItKannan Narayana; Ritesh Ramdhani; Bradford Tannen; Laura Balcer; Steven Galetta; Janet RuckerA 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...
19 Star Spangled BannerDara M. Bier; Jeffrey P. Greenfield; Marc K. Rosenblum; Joseph Comunale; Cristiano Oliveira; Marc J. DinkinA 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...
20 Nobody's PerfectAlexander Ksendzovsky; Steven A. NewmanIn June of 2006 an 8 year old patient was referred for evaluation. Apparently at age 1 ½ she had developed headaches and was found to have a posterior fossa tumor. In El Salvador she was treated with shunting and chemotherapy plus radiation therapy for presumed medulloblastoma. She underwent a shun...
21 Some Like it HotAhmara G. Ross; Islam Zaydan; Gabrielle Bonhomme; Ellen Mitchell; Tarek Shazly; Deborah ParrishA 71 year old Caucasian man with a past medical history of hypertension, hyperlipidemia, Type 2 DM, ESRD status post renal transplant, facial melanoma, currently on ASA for a stable left sided putaminal hemorrhage presented with new right sided ptosis and lower extremity weakness. Brain MRI obtained...
22 Using MuscleNagham Al-Zubidi; John E. Carter; Bundhit Tantawongski; Patricia Chevez-Barrios; Lyndon Tyler; Constance L. FryA 30- year-old Saudi female student with no past medical history presented an eight month history of progressive blurred vision primarily at near, anisocoria OS, and periocular discomfort with eye movements. Neuro-Ophthalmologic examination revealed best corrected visual acuity of OD 20/20 and OS 20...
23 It's Not Just a FAD (EHR Fatigue Syndrome)Jacqueline A. Leavitt; John J. Chen; Diva R. SalomaoA 29 year-old female nurse, nine months postpartum, presented with an inability to see her computer well for the past two months. She denied eye pain, diplopia, numbness, tingling or weakness. There were no changes in vision in bright vs. dim lighting. She also had a headache at the back of her head...
24 Joe & Jerry Flew the CoopLulu L.C.D. Bursztyn; Dane A Breker; Andrew W. Stacey; Ashok Srinivasan; Mark W. Johnson; Jonathan D. TrobeA previously healthy 13-year-old girl presented to a local hospital with fever and myalgia, followed one day later by lethargy and vision loss. Past medical history was significant only for acne, for which she had been treated with doxycycline 40 mg/day intermittently starting 2 months prior to symp...
25 Hiding and Out of SightMichael L. Morgan; Sumayya J. Almarzouqi; Patricia Chevez-Barrios; Amina I. Malik; Andrew G. LeeA 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...
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