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1 Chiasmal SyndromesShlomo A. Dotan, MDA 52-year-old, morbidly obese man with a past medical history that included ischemic cardiac disease with a history of angioplasty, COPD, hypertension, and NIDDM, presented with a severe headache. The next day he had a frozen OD, complete right ptosis, and an unreactive middilated right pupil with V...
2 Chiasmal SyndromesShlomo A. Dotan, MDA 52-year-old, morbidly obese man with a past medical history that included ischemic cardiac disease with a history of angioplasty, COPD, hypertension, and NIDDM, presented with a severe headache. The next day he had a frozen OD, complete right ptosis, and an unreactive middilated right pupil with V...
3 Chiasmal SyndromesShlomo A. Dotan, MDA 52-year-old, morbidly obese man with a past medical history that included ischemic cardiac disease with a history of angioplasty, COPD, hypertension, and NIDDM, presented with a severe headache. The next day he had a frozen OD, complete right ptosis, and an unreactive middilated right pupil with V...
4 Chiasmal SyndromesShlomo A. Dotan, MDA 52-year-old, morbidly obese man with a past medical history that included ischemic cardiac disease with a history of angioplasty, COPD, hypertension, and NIDDM, presented with a severe headache. The next day he had a frozen OD, complete right ptosis, and an unreactive middilated right pupil with V...
5 Chiasmal SyndromesShlomo A. Dotan, MDA 52-year-old, morbidly obese man with a past medical history that included ischemic cardiac disease with a history of angioplasty, COPD, hypertension, and NIDDM, presented with a severe headache. The next day he had a frozen OD, complete right ptosis, and an unreactive middilated right pupil with V...
6 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
7 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
8 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
9 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
10 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
11 Motility DisturbancesLarry P. Frohman, MDA 27-year-old healthy man presented for neuro-ophthalmologic evaluation for recurrent vertical binocular diplopia. In 1982, he had a minor blow to the head, and 12 days later he sustained vertical binocular diplopia, worse on downgaze, without ever having diurnal variation. His sense of taste was al...
12 Motility DisturbancesEric L. Berman, MDThis is a 60-year-old albino woman with chronic progressive external ophthalmoplegia and strabismus fixus. Her extreme bilateral esotropia caused her acuity to be 20/400 OU, no view of fundus could be obtained except for the far periphery. CPEO is the most common manifestation of mitochondrial myopa...
13 Pupillary SyndromeJeffrey G. Odel, MDIntermittent dilation of the pupils may occur as a benign phenomenon in healthy young adults. In the absence of other third nerve signs, (eg, ptosis, diplopia, ophthalmoplegia), an isolated transient dilation of the pupil in an otherwise healthy adult is unlikely to represent a third nerve palsy. Tr...
14 Pupillary SyndromeJeffrey G. Odel, MDIntermittent dilation of the pupils may occur as a benign phenomenon in healthy young adults. In the absence of other third nerve signs, (eg, ptosis, diplopia, ophthalmoplegia), an isolated transient dilation of the pupil in an otherwise healthy adult is unlikely to represent a third nerve palsy. Tr...
15 Optic NeuropathiesLarry P. Frohman, MDThe patient is a 66-year-old man with a history of ethanol abuse. He presented with 3 months of right-sided headache and a few days of progressive visual loss OD to hand motions only. When seen by the orbital service, he had nearly complete ophthalmoplegia and ptosis. Sinus biopsy showed fungus, whi...
16 Optic NeuropathiesLarry P. Frohman, MDThe patient is a 66-year-old man with a history of ethanol abuse. He presented with 3 months of right-sided headache and a few days of progressive visual loss OD to hand motions only. When seen by the orbital service, he had nearly complete ophthalmoplegia and ptosis. Sinus biopsy showed fungus, whi...
17 Optic NeuropathiesLarry P. Frohman, MDThe patient is a 66-year-old man with a history of ethanol abuse. He presented with 3 months of right-sided headache and a few days of progressive visual loss OD to hand motions only. When seen by the orbital service, he had nearly complete ophthalmoplegia and ptosis. Sinus biopsy showed fungus, whi...
18 Optic NeuropathiesLarry P. Frohman, MDThe patient is a 66-year-old man with a history of ethanol abuse. He presented with 3 months of right-sided headache and a few days of progressive visual loss OD to hand motions only. When seen by the orbital service, he had nearly complete ophthalmoplegia and ptosis. Sinus biopsy showed fungus, whi...
19 Neuro-Ophthalmic Imaging-CT ScanLarry P. Frohman, MDThis 39-year-old woman's initial sign was painless, progressive, symmetric ptosis OU, without diurnal variation, that manifested when she was age 17 living in the Dominican Republic. At that time, she had no diplopia or systemic signs. She had no family history of ocular or muscle disease, and no ot...
20 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
21 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
22 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
23 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
24 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
25 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
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