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Title | Creator | History |
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Go With Your Gut Feeling | Paul Freund; Ari Shemesh; Gabriella Mankovskii; Ana Pejovic-Milic; David Howarth; Edward Margolin | 71 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.... |
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Unexplained Becomes Explained | Jinu Han; Hye Young Kim; Sueng-Han Han | 7 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... |
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Fooled Thrice | Jonathan Micieli; Hui-Kuo Shu; Alessandra Schmitt; Nancy Newman | A 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... |
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Just the Two of Us | Dan Milea; Pratik Chougule; Ming Lee | A 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... |
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Every Rose Has Its Thorn | William Anderson; Aseem Sharma; Miguel Guzman; Sophia Chung | A 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 ... |
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Chalky Pallid Edema | Daniel Kornberg; David Pisapia; Cynthia Magro; Cristiano Oliveira; Marc Dinkin | A 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... |
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Don't Drink the Water | Devon Cohen; Muhammad Bhatti; John Chen | A 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... |
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Turbulence, Fluid Waves, and the Black Hole | Stella Chung; Daniel Rubinstein; Leon Rafailov; Nilo Toledo; Paul Langer; James Liu; Roger Turbin | A 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... |
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At the Crossroads | Konstantinos Douglas; Michael Yoon; Frederick Jakobiec; Joseph Rizzo III; Bart Chwalisz | A 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 ... |
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Lumps and Bumps - Video | Wayne Tie; Martha Schatz | A 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... |
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Testing the Hypophysis - Video | Alberto Distefano; Julie Cho; Adeniyi Fisayo; Mahsa Sohrab | A 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... |
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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 | A 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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A Can of Worms - Video | Ali Hamedani; Madhura Tamhankar | A 67 year-old man presented to the ophthalmology clinic with one day of binocular horizontal diplopia. He also complained of one week of bilateral periorbital pain which was worse on the right than the left. Four days prior, he had undergone partial right nephrectomy for grade II papillary renal cel... |
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It's Always Been Like That - Video | Eric Gaier; William Butler; Joseph Rizzo | An 18 year-old Caucasian boy presented with left upper eyelid ptosis, headaches, and iris heterochromia. The patient and his family reported the left iris being darker than the right since early childhood. Over the 5 years preceding his presentation, the patient's mother noted progressive ptosis of ... |
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Gee...What's Causing that Pap? - Video | Susan Mollan; Daniel White; Santhosh Nagaraju; Swarupsinh Chavda; Tom Hayton; Saiju Jacob | A 36 year old woman presented with history of Myasthenia Gravis (MG) since the age of 18. She was known to have dry eyes and hypothyroidism. Past surgical history included a thymectomy (age 23 years). The MG had been difficult to control with past medications including corticosteroids, azathioprine,... |
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Cold Fever - Video | Shannon Beres | A 34-year old rock-climbing-mountain man woke with bilateral painless blurry vision along with alternating conjunctival erythema and eyelid edema. A headache began without associated migrainous features. Prior history revealed an untreated mysterious ‘new form of TB' followed by the CDC at age 2 d... |
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Triple Take - Video | Johanna Beebe; Liang Cheng; Shira Simon; Michael Wall; Randy Kardon; Alkapalan Deema; Ian Han; Matthew Thurtell | A 42 year-old male noticed difficulty reading labels while stocking shelves at work. Over the next three weeks, he developed a dark 'cloud' in his central vision in the left eye, and then the right eye. He did not have associated pain. When evaluated by the retina service, his visual acuities were 2... |
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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 | 25 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 ... |
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A Tough Nut to Crack! - Video | Lauren Maloley; Sachin Kedar; Deepta Ghate; Dominick DiMaio; Jason Helvey; Sachin Kedar | A 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... |
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A Giant (Cell) Mistake - Video | Behzad Mansouri; Paul Wawryko; Frank Bovell | 71-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 ... |
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One Peak is Worth Twenty Finesses - Video | Steven Newman; James Mandell | An 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... |
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What Don't You See? - Video | James O'Brien; R. Michael Siatkowski | A four-year old male presented for evaluation of abnormal eye movements and strabismus which had been present since approximately 6 weeks of age. He was previously diagnosed with nystagmus, ocular torticollis, and esotropia by another provider. An MRI of the brain was performed at approximately 4 we... |
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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 | A 43-year old Indian man presented with two years of progressive gait imbalance, dysarthria, and cognitive decline. Neurological exam revealed supranuclear gaze palsy with impaired downgaze and loss of OKN quick phases, impaired horizontal pursuit, ideomotor apraxia, facial and arm dystonia, foot an... |
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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... |
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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... |