The Walsh Society Annual Meeting Archives: Proceedings of the annual meeting of the Walsh Society, which is now part of the North American Neuro-Ophthalmology Association (NANOS) Annual Meeting. Contains records from the first meeting in 1969, through the present.
NOVEL: https://novel.utah.edu/
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| Title | Creator | History | ||
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| 1 |
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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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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... |
| 13 |
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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 ... |
| 14 |
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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 ... |
| 15 |
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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... |
| 16 |
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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... |
| 17 |
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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... |
| 18 |
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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... |
| 19 |
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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... |
| 20 |
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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... |
| 21 |
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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... |
| 22 |
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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... |
| 23 |
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A Trip Through the Wormhole | Anne R. Kao, MD | The patient initially presented to me at age 19 years with a 'throbbing, aching pressure' behind her right eye and swelling of the right upper eyelid. Her pain was worse in lateral gaze, although she denied diplopia. She had been prescribed 60mg of prednisone by the referring provider, which reduced... |
| 24 |
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A Zebra Among Zebras | Peter Mortensen, Gabrielle Bonhomme | 61-year-old man with Type 2 diabetes and hypertension presented to outside hospital ED with fever, headache, and neck pain. Onset of neck pain was one week prior, with worsening of symptoms following chiropractic manipulation. Patient was evaluated at outpatient clinic one day prior and given Medrol... |
| 25 |
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The Great Masquerade | Bart Chwalisz, Dean Cestari | A 56-year-old man with unremarkable prior history complained of visual and somatosensory disturbances. Five months prior, he had an episode of being unable to see oncoming traffic. He developed transient visual disturbances lasting minutes in the left hemifield, e.g., the right sides of people's fac... |
| 26 |
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Fire and Ice | Mary Maher, Joah Aliancy, Gul Moonis, Angela Lignelli, Michael Kazim, Jeffrey Odel | A 14 year-old boy, with ADHD on amphetamine and dextroamphetamine, presented with headache and bilateral decreased vision. Seven days prior, he began experiencing bilateral non-positional frontal headache unresponsive to NSAIDS that did not wake him from sleep. Five days prior, he felt fatigued and ... |
| 27 |
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A-deno What's Going On! | Christine Greer, Salina Teja, Jennifer Danesch, Anna Mathew, Vivek Patel, Kimberly Gokoffski | A 68 year-old Hispanic female with hypertension, type II diabetes mellitus, panhypopituitarism after pituitary adenoma resection 30 years prior and subsequent radiation therapy presented with decreased vision in the left eye and severe headache. The patient's vision in the left eye declined in the p... |
| 28 |
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A Sad Story - Video | Jason Peragallo, MD | A healthy 6-year-old boy had a two-week history of progressive headaches associated with nausea and vomiting. An ER diagnosed allergic rhinitis, treated with augmentin and steroids, however his symptoms worsened. At a second ER he was febrile to 103F. A classmate was recently diagnosed with Erlichio... |
| 29 |
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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... |
| 30 |
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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... |
| 31 |
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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... |
| 32 |
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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... |
| 33 |
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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... |
| 34 |
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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... |
| 35 |
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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... |
| 36 |
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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... |
| 37 |
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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... |
| 38 |
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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... |
| 39 |
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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... |
| 40 |
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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... |
| 41 |
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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... |
| 42 |
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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... |
| 43 |
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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... |
| 44 |
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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. ... |
| 45 |
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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, ... |
| 46 |
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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... |
| 47 |
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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... |
| 48 |
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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... |
| 49 |
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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... |
| 50 |
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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... |
| 51 |
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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... |
| 52 |
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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... |
| 53 |
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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... |
| 54 |
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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... |
| 55 |
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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... |
| 56 |
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Nobody's Perfect | Alexander Ksendzovsky, Steven A. Newman, MD, University of Virginia School of Medicine | In 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... |
| 57 |
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A Shot in the Dark | Joshua Pasol, Ricardo J. Komotar, Faisal Yamani | A 74 year-old man with a chief complaint of difficulty with night time driving for several years as well as difficulty going from a lighted room to a dark room. PMH of high cholesterol, BPH, hypothyroidism, GERD, glottic squamous cell cancer without recurrence, and a prior history of alcoholism. POH... |
| 58 |
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Some Like it Hot | Ahmara G. Ross, Islam M. Zaydan, Gabrielle R. Bonhomme, Ellen B. Mitchell, Tarek A. Shazly, Deborah C. Parish | A 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... |
| 59 |
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Requiem for a Cabinet Maker | Jennifer I. Doyle, Michael S. Vaphiades, MD, University of Alabama, James R. Hackney, Lanning B. Kline, Lina Nagia | A 54-year-old white male presents with 3 weeks of painless horizontal nystagmus and 6 months of left sided forehead numbness. He reports a 20 lbs weight loss. Medical history includes a renal transplant 30 years prior. He takes prednisone 30 mg QOD and azathioprine. Visual acuity is 20/20 OU, color ... |
| 60 |
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Using Muscle | Nagham Al-Zubidi, John E. Carter, Bundhit Tantawongski, Patricia Chevez-Barrios, Lyndon Tyler, Constance L. Fry | A 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... |
| 61 |
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Lights Out | John J. Brinkley, John J. Chen, Patricia A. Kirby, Reid A. Longmuir, Matthew J. Thurtell | A 78 year-old man presented with a one-month history of progressive painless binocular vision loss. He had sustained head trauma without loss of consciousness three days prior to the onset of vision loss. On the morning of his presentation to us, he had awoken with complete binocular vision loss and... |
| 62 |
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It's Not Just a FAD (EHR Fatigue Syndrome) | Jacqueline A. Leavitt, John J. Chen, Diva R. Salomao | A 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... |
| 63 |
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Speakeasy | Joseph G. Chacko, MD, University of Arkansas, Marcus W. Moody, Harry H. Brown, Sarkis M. Nazarian | A 64 year-old Caucasian gentleman presented with an unusual complaint. He stated that if he touched the inside of his right cheek with his tongue, he felt a tingly sensation in his R eyebrow. This had started one month ago. He also complained of foreign body sensation and discomfort in the right eye... |
| 64 |
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Shady Double Crosser | Francine B. Wein | History & Exam A 62-year-old woman presented with a one-month history of severe light sensitivity and headache, and a two week history of diplopia. Her photophobia was severe enough for her to wear sunglasses indoors. Her past medical history was significant for a cholecystectomy and Crohn's disease... |
| 65 |
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Joe & Jerry Flew the Coop | Lulu LCD Bursztyn, MD, Ivey Eye Institute; Dane A. Breker, MD, Sanford Neuroscience Clinic; Andrew W. Stacey, MD, University of Washington Medicine; Ashok Srinivasan, MBBS, University of Michigan; Mark W. Johnson, MD, Kellogg Eye Center; Jonathan Daniel Trobe MD, Michigan University | A 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... |
| 66 |
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The Man with No Face (About Face) | Michael S. Vaphiades, MD, University of Alabama; Jennifer I. Doyle, MD, Little Rock Eye Clinic; Lina Nagia, MD, Michigan State University; Kevin J. Bray, MD, Providence Health; Lanning B. Kline, MD, University of Alabama; Glenn H. Roberson, MD, University of Alabama; Adam E. Quinn, MD, Baptist Healt... | A 61-year-old man presented with one week history of decreased vision OS. Past medical history includes asthma and amblyopia OD, but with complete visual loss OD 18 years prior. He takes no medications. He is retired but worked for 21 years in social science research. The remarkable thing upon meeti... |
| 67 |
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Ataxia at the Masquerade Ball | Krista I. Kinard, Alison V. Crum, Judith E. A. Warner, MD, Moran Eye Center, University of Utah; Bradley J. Katz, Joshua A. Sonnen, Cheryl A. Palmer, Anne G. Osborn, L. Dana DeWitt, Kathleen B. Digre, MD, Professor of Neurology and Ophthalmology, Director of Neuro-Ophthalmology, John A. Moran Eye C... | A 52-year-old right-handed salesman presented in July 2007 with a 5-year history of slowly progressive imbalance. In 2002 he developed difficulty using his eyes together and then imbalance resulting in frequent backward falls. He reported oscillopsia and episodic vertigo. He later developed fatigue,... |
| 68 |
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It's Not the Tumor | Courtney E. Francis | A 58 year old woman with a history of metastatic parotid adenocarcinoma presented with bilateral vision loss over 2 months. She had undergone surgical resection of the tumor followed by fractionated external beam radiation with a total of 66.6 Gy 18 months prior to presentation. She was recently fou... |
| 69 |
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Blame it on the Pill | Sachin S. Kedar, Padmaja Sudhakar, Stuart Tobin, William O. Connor, Fernando Decastro | Three months earlier, he had been evaluated for malaise and weight loss and found to have lymphopenia, elevated TSH (20.3) and anti-thyroid peroxidase antibody (2874) with normal T3, ESR, B12 and folate. |
| 70 |
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Muscle Bound or Unbound? | Dane A. Breker, Jonathan Daniel Trobe, MD, Michigan University, Ann A. Little, Sandra I. Camelo-Piragua | A 52 year old former Olympic athlete developed myalgias, cramping, and stiffness in the upper arms, chest, thigh, and calves in 2009 after a blood transfusion for hematochezia attributed to antiplatelet treatment following coronary stenting. Symptoms were worst in the morning, when he could not walk... |
| 71 |
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Renal Red Herring | John J. Chen, John J. Brinkley, Namrata Singh, Amanda C. Maltry, Bruno A. Policeni, Richard C. Allen, Reid A. Longmuir, Matthew J. Thurtell | A 71 year-old Caucasian male with a history of Wegener's granulomatosis presented with vision loss OU and horizontal binocular diplopia. His past medical history was significant for Wegener's granulomatosis, which was diagnosed in 2000 on the basis of a renal biopsy. He was previously treated with v... |
| 72 |
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Is it a Crime to be Blind? I plead the 4th! | Jasmine Gopwani, Edward Margolin, Tran Le, Wayne T. Cornblath, MD, Clinical Professor, Ophthalmology and Visual Sciences, Professor, Department of Neurology, University of Michigan, Rasmus Kiehl | A 30 year old previously healthy man from Sudan presented to a community hospital with a seizure. MRI revealed a 'right frontal lobe tumor'. Brain biopsy was performed but the pathology findings were inconclusive. Initial interpretation was "brain tissue with increased cellularity consistent with gl... |
| 73 |
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I Can't Stand the Double Vision | Iris B. B. Mizrachi, Ruth Huna-Baron, Rivka Inzelberg, Yonathan Sharabi | A 37 year-old woman was referred to our clinic due to bilateral ptosis and vertical binocular diplopia. She denied diurnal variations, muscle weakness or bulbar symptoms. In the past year she had been suffering from bouts of abdominal pain, diarrhea, and severe weight loss (>40 pounds), and she pres... |
| 74 |
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A Candid Look at a Missed Diagnosis | Edward Margolin, Jasmine Gopwani, Robert Willinsky | She was diagnosed with migraine, stress, and 'drug seeking' presumed from a history of past (intravenous?) heroin use. |
| 75 |
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Almost Catastrophic | Danielle S. Rudich, Samuel Yun, Anne Liebling, Jonathan E. SIlbert, 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 Medicine | A 36 year-old Caucasian male presented to his ophthalmologist with one month of headache, blurry vision, and intermittent diplopia. The patient denied transient visual obscurations, tinnitus, prior medical problems or use of steroids/Vitamin A/antibiotics. He was 235 pounds and 5'9". Because examina... |
| 76 |
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A TAAD Bit Unusual | Nisreen K. Mesiwala, Susan T. Stefko | A 12 year-old previously healthy boy presented to the emergency room with a five-day history of progressive frontal headaches and acute onset of horizontal, binocular diplopia on left gaze. He had no significant medical history and his only significant ocular history was mild myopia and X-linked col... |
| 77 |
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Innocent until Proven Guilty | Heather E. Moss, Tiffany Stroup, Amy Lin, Oliver Graf, Jeffrey Borgeson, Aaron Halfpenny, Howard Lipton, Tibor G. Valyi-Nagy | A 31 year-old male experienced right eye blurring and pain. He was diagnosed with optic neuritis and treated with IV steroids. Nine days later he developed headache, worsening vision, speech trouble and right-sided weakness. Two days later he developed low-grade fever and trouble walking. He had NLP... |
| 78 |
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More Than a Cu-bit of Vision Loss | Philip M. Skidd, Rebecca C. Stacy, Waqar Waheed, Mohamed-Ali Babi | A 45 year-old, right-handed, man, presented after awakening with no vision in his left eye. Two days earlier he had experienced a brief episode of binocular horizontal, and then oblique, diplopia. One week prior, he developed left facial numbness and "sinus pain" on the same side; a five day course ... |
| 79 |
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Much-Ado About Acute Vision Loss | Mahsa A. Sohrab, Andrea Birnbaum, Michael Sidiropoulos, Lois Polatnick, Nicholas J. Volpe, MD, Northwestern University | Progressive fatigue and right face, arm, and leg pain. |
| 80 |
|
Burned by Diplopia | Bonnie M. Keung, Reuben M. Valenzuela, Meena Gujrati, Jeffrey R. DeSanto, Jorge C. Kattah, John H. Pula | In March 2012 he sustained a concussion and forehead laceration from a motor vehicle accident. In August 2012, he developed painless, binocular, vertical diplopia, which limited him from painting art. In November 2012, his examination showed -2 limitation of up-gaze OD. |
| 81 |
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Wear and Tear Vision | Konrad P. Weber, Caterina Schweier, Veronika Kana, Thomas Guggi, Katarzyna Byber, Klara Landau, MD, FEBO, University of Zurich | A 66-year-old woman presented with a four-month history of insidious bilateral visual loss. Ophthalmologic examination revealed visual acuity reduced to finger counting in both eyes. On fundus examination, maculae and optic discs appeared normal. Visual fields showed bilateral central scotoma with m... |
| 82 |
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Which One is The Real Zebra | Madhura A. Tamhankar, Julia Kharlip, Robert Lustig, Jon Burnham, Karuna Shekdar, Michele Paessler, Lucy Rorke, Kristina Cole | A 15-year-old male complained of headaches and nausea, two months after appendectomy. |
| 83 |
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A Case of Cotton Wool Spots | Golnaz Moazami, Hermann D. Schubert, Jacinda Sampson, Claire Riley | A 31 year old Caucasian male was admitted to a local ER after being found unresponsive on a couch at home, incontinent of urine, and having vomited with tongue bruising. He was arousable in the ER but febrile to 102 F with WBC= 19,000. He was loaded with dilantin, and emergency CT showed a left post... |
| 84 |
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It's Deja Vu All Over Again | Aileen A. Antonio-Santos, Yanny L. Phillips, Baha El Khatib, Howard T. Chang, David I. Kaufman, DO, Chair, Neurology & Ophthalmology, Michigan State University; Eric R. Eggenberger, DO, Mayo Clinic | A 51-year-old male with a history of amblyopia OD presented in February 1999 with hyperemia, swelling and periorbital pain of the left eye. Visual acuity (VA) was 20/80 OD and 20/25 OS; color vision was 10/11 Ishihara plates OU, and Goldmann perimetry showed an inferior quadrantanopia OS. There was ... |
| 85 |
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Beware the Trojan Horse | Denize Atan, Nithin Nair, Mrinal Rana, Swarupsinh V. Chavda, Andrew Jacks | Systemic hypertension, hypercholesterolemia, and cerebrovascular disease treated with an antiplatelet drug, thiazide diuretic, ACE inhibitor and statin. |
| 86 |
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An Ironclad Case of Vision Loss | Marc J. Dinkin, George Parlitsis, Sarju Patel, Alexander E. Merkler, Audrey Schuetz, Cristiano Oliveira | A 43-year-old man with AIDS and a CD4 count of 4, non-compliant with HAART, presented with four days of headache, photophobia and vision loss in his left eye. There was a history of treated syphilis and CMV retinopathy. On neuro- ophthalmological examination, visual acuities were 20/40 OD (formerly ... |
| 87 |
 |
Double Vision? - Give Your Head a Shake | Vivek Patel, Danah Albreiki | 3 month history of constant binocular oblique diplopia with mild worsening, progressive disequilibrium, and a wide based gait. No vertigo, loss of coordination, loss of vision or oscillpsia, hearing loss, or tinnitus. No history of cancer, hypothyroidism, GI malabsorption or anemia. Occupational his... |
| 88 |
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Spots, Spots Everywhere, And Not A Spot To See | Sarkis M. Nazarian, Kelli Y. Shaon, Kenneth R. Habetz, Ayman Al-Salaimeh, John D. Schwankhaus, Joseph G. Chacko, MD, University of Arkansas | Additional history revealed that the patient had suffered a tick bite about two weeks prior to the onset of his rash. |
| 89 |
 |
A Wolf in Bear's Clothing | Peter W. MacIntosh, Agatha Bogard, Pete Setabutr, Heather E. Moss | An eleven-month-old African-American girl with medical history of reactive airway disease developed a bump and bags under both eyes which her mother attributed to minor trauma. There were no signs of systemic illness. A week later, her mother noticed more prominent right eye edema and a new bump beh... |
| 90 |
 |
Golden Grapes | Heather E. Moss, Sean Zivin, Amy Lin, Vinay Aakalu, Senad Osmanovic, Omar Al Heeti, Stockton Mayer, Mahesh Patel | A 71 year-old African American woman presented with a painful right retrobulbar optic neuropathy and weight loss. ESR was 74. She was treated with steroids. Temporal artery biopsy did not show arteritis. Nine days later, while on a steroid taper, she developed fevers, worsening right eye vision, pto... |
| 91 |
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Diabetes Does Not Explain It All | Philip M. Skidd, Joseph F. Rizzo III, MD, Florian S. Eichler, Dean M. Cestari | Systemic hypertension, type II diabetes mellitus, hypercholesteremia, anxiety and depression. |
| 92 |
 |
No Rhabdo? | Mark R. Melson | A 5 year-old girl presented for evaluation of a right orbital mass displacing the globe superiorly. She had a 5 week history of swelling around her right eye. Her pediatrician diagnosed a blocked tear duct and referred her to an ophthalmologist. She failed empiric treatment for orbital cellulitis an... |
| 93 |
 |
Sacramentum Gladiatorium | Michael S. Vaphiades, MD, University of Alabama, Jennifer Doyle | Medical history includes hypertension and hyperlipidemia. |
| 94 |
 |
Raise Your Grade Point Average | Hilary M. Grabe, Jeffrey L. Myers, Douglas J. Quint, Victor M. Elner, Jonathan Daniel Trobe MD, Michigan University | Two years earlier, he had had persistent hearing loss in the left ear attributed elsewhere to infection. One year later, he developed left facial weakness diagnosed as Bell's palsy, treated with corticosteroids without recovery. A few months later, he became hoarse and had difficulty swallowing. |
| 95 |
 |
Ain't No Sunshine When You Are Gone! | Veeral S. Shah, Linda L. Sternau, Michelle Felicella, Sanders Dubovy, Chris Alabiad, Norman J. Schatz, MD, Bascom Palmer Eye Institute; Byron L. Lam | An 18 year-old Latin American female presented with progressive visual loss OD over 6 weeks. She initially had blurry vision and photophobia OD with a central scotoma OD on HVF testing. At that time, examination revealed a right swollen optic nerve with retinal hemorrhages. She was otherwise healthy... |
| 96 |
 |
Some Orbital Confusion | Steven A. Newman, MD, University of Virginia School of Medicine, David T. Bourne | In September 2006 he had been referred for a second opinion regarding a 5 year history of intermittent swelling around the right orbit, worsening over 7 months associated with double vision, and proptosis (C,D). |
| 97 |
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Clues Hidden in the Skin | Janet C. Rucker, Catherine Cho, James Weisfeld-Adams, Scott E. Brodie | She underwent neurological evaluation at age 32 (neuroimaging, serologies, lumbar puncture, muscle biopsy) with no resultant diagnosis (records unavailable). She required a wheelchair by age 36 and gradually developed slurred speech, cognitive decline, and worsened motor function. Simultaneous with ... |
| 98 |
 |
Occam's Razor or Gamma Knife? | Kaushal M. Kulkarni, Linda L. Sternau, Byron L. Lam | Hypertension, end-stage renal disease on hemodialysis, and an episode of anterior uveitis in the right eye 10 years earlier. |
| 99 |
 |
‘Tis Nobler in the Mind to Suffer... Or to Take Arms Against a Sea of Troubles and by Opposing End Them? (Hamlet act 3, scene 1) (Presentation Video) | Heather E. Moss | 41-year old female with a shadow over the left eye. |
| 100 |
 |
When Life Gives You Lymphocytes, Make Limeade (Presentation Video) | Melissa W. Ko, MD, FAAN, CPE | A 62-year old female; hypercholesterolemia. |
| 101 |
 |
What's In a Name? (Presentation Video) | Nicholas J. Volpe, MD, Northwestern University | 76-year old male; five year history of muscle pain and arthralgia; four year history of PMR symptoms; gastrointestinal illness. |
| 102 |
 |
Another Case of Guillain-Alajouanine-Garcin Syndrome [also known as Bertolotti-Garcin syndrome, Garcin's syndrome, Garcin-Guillain syndrome, Hartmann's syndrome (Friedrich Hartmann), Schmincke tumor-unilateral cranial paralysis syndrome...] (Presentation Video) | Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine | A 37-year old male with multiple right-side cranial nerve palsies. Previous history significant for hypertension and sleep apnea. Family history remarkable for diabetes, glaucoma and thyroid disease. |
| 103 |
 |
Tics and Fleas (Presentation Video) | Nancy J. Newman, MD, Emory Eye Center | A 61-year old female with tic douloureux and diplopia. Previous history significant for squamous cell skin cancer below right eye, surgically resected. Dx atypical trigeminal neuralgia after neurological consult following administration of local anesthetic for basal cell carcinoma resection. |
| 104 |
 |
Combing the Globe for Terrorism (Presentation Video) | Norah S. Lincoff MD, University at Buffalo | An 83-year old male; hypertension; atrial fibrillation; type II diabetes mellitus; squamous cell carcinoma of the face; prostate cancer (treated). |
| 105 |
 |
Pseudo Pseudo Pseudo Tumor Cerebri (Presentation Video) | Marc J. Dinkin, MD, Weill Cornell Medicine | A 27-year old male with visual disturbances and worsening headache. |
| 106 |
 |
Poor Visual Recovery Following Treatment of Panuveitis in a 62 Year-old Man with Biopsy-proven Sarcoidosis (Presentation Video) | Jeffrey Gelfand | A 62-year old male with blurred vision OS, progressive gait instability, episodic falling and confusion. Previous history significant for LP that revealed meningitis and lung and hilar lymph node biopsies that demonstrated sarcoidosis. |
| 107 |
 |
Bad Eyes, Bad Walking and Bad Judgement (Presentation Video) | Clare Fraser | A 20-year old male with deteriorating vision OS and a 13-year history of combined variable immunodeficiency. Previous history significant for atypical mycobacterium. |
| 108 |
 |
Twice Bitten, Once Shy (Presentation Video) | Robert Shin | A 57-year old female with fatigue, confusion and headache associated with a right inferior quadrantanopsia. |
| 109 |
 |
A Case of Net Visual Loss and Gain (Presentation Video) | Thomas Slamovits | A 68-year old female with a sudden loss of vision OU. Previous history significant for anemia, presumed by patient to account for her presenting symptoms. |
| 110 |
 |
Non-Functional Sinus Disease (Presentation Video) | Julie Shelton | A 6-year old female with a 1-week history of worsening vision OU > OD and a 2-month history of worsening headaches. |
| 111 |
 |
Trouble Reading (Presentation Video) | Rebecca Stacy | A 60-year old female with a 4-week history of progressive difficulty reading and word comprehension. Previous history significant for a 20-year history of recurrent granulomatous iritis in OU and chronic variable immune deficiency (CVID), diagnosed 23 years previous with associated hepatitis and der... |
| 112 |
 |
A Bright Spot Causing Darkness (Presentation Video) | Thomas N. Hwang | A 20-year old male with a 2-week history of headache and blurred vision. |
| 113 |
 |
To Biopsy Or Not To Biopsy? That Is the Question (Presentation Video) | Michael Yoon | A 16-year old female with an 8-week history of intense vertigo, headache, poor naming, blurred vision and gait instability. |
| 114 |
 |
Egg in Your Face (Presentation Video) | Padmaja Sudhakar | An 8-year old female with a 2-day history of confusion, headache and vomiting. |
| 115 |
 |
Some Hairy Gossyp (Presentation Video) | Ivey Thornton | A 13-year old female with a perceived whiteness affecting her right field of vision. Previous history significant for seizure-like spikes affecting sleep and ventricular and atrial septal defects, the latter of which, surgically repaired. |
| 116 |
 |
A Case of Recurrent Encephalopathy, Seizures, and Retinopathy (Presentation Video) | Ryan Walsh | A 45-year old male with right hemisphere encephalitis and a Dx of macular degeneration at age 43. Previous history significant for a learning disability and a complex partial seizure disorder diagnosed 20 years earlier subsequently managed with an anti-epileptic. |
| 117 |
 |
Not a Benign Tumor (Presentation Video) | Hong Jiang | A 43-year old female with blurred vision OU. Previous history signicant for a 10-year history of recurrent colon cancer Tx antineoplastic agents, pituitary mass, hypopituitarism and diabetes insipidus. |
| 118 |
 |
Get Me Out of Here; It's Too Crowded (Presentation Video) | Melissa W. Ko, MD, FAAN, CPE | A 54-year old female with 6-week history of progressive deteriorating vision OU, headache and pain associated with eye movement. Previous history significant for multiple sclerosis. |
| 119 |
 |
A Golf and Shopping Hazard (Presentation Video) | Steven J. Yoon | A 69-year old male with scalp tenderness, headache and loss of vision OD. Previous history significant for chronic sinusitis and bronchitis. |
| 120 |
 |
My Orbits Are Melting (Presentation Video) | Thomas N. Hwang | A 40-year old female with progressive bilateral enophthalmos. Previous history significant for ruptured left basilar artery aneurysm 15 years prior to presentation associated with intracranial hemorrhage and increased intracranial pressure. |
| 121 |
 |
A Bad Case of Sinusitis (Presentation Video) | Alex Fraser | A 17-year old male with Crohn's disease maintained on azathioprine and prednisone developed abdominal pain and bloody stools eight days after prednisone taper. NG flushes produced cold pressure sensation behind right eye, photophobia and headache. |
| 122 |
 |
A Long and Winding Road (Presentation Video) | Christopher Glisson | A 42-year old male with headache and vision loss OD. Previous history significant for blurred vision OS. |
| 123 |
 |
Unilateral Vision Loss in an Altered State of Immunity (Presentation Video) | Drew Chronister | An 82-year old male with left-sided headache and temporal tenderness. Previous history significant for hypertension, hyperlipidemia, atrial fibrillation, and chronic macrocytic anemia. |
| 124 |
 |
Back Pain, Ophthalmoplegia, and More... (Presentation Video) | Matthew Thurtell | A 73-year old male with lumbar pain without associated neurologic symptoms. Previous history significant for hypertension, dyslipidemia, ischemic heart disease and sciatica. |
| 125 |
 |
It's Just A Rash' (Presentation Video) | Timothy McCulley | A 76-year old male with a 3-month history of an enlarging, painless rashing starting on the right lowere eyelid. Previous history significant for diverticulitis, chronic hepatitis C and Hashimoto thyroiditis |
| 126 |
 |
Parkinsonitis (Presentation Video) | Alice Kim | An 83-year old male with a 2-year history of motor, left gaze palsy and cognitive slowing. Previous history significant for hypertension, hypercholesterolemia, Gilbert syndrome, and atrial fibrillation. |
| 127 |
 |
Oh, You Have Metastatic Cancer' (Presentation Video) | Elena Sokolava | A 59-year old male noted when driving the cars approaching disappear and reappears further to the side in his peripheral vision. |
| 128 |
 |
A Twinkle in Her Eye? (Presentation Video) | Jennifer K. Hall | A 46-year old female developed a nasal voice and upper extremity weakness at age 16. EMG and muscle biopsy showed evidence of myopathy. Her condition showed little progression until age 30 when she developed left sided hearing loss. |
| 129 |
 |
Urgent, Double Vision, and Head Games (Presentation Video) | Joseph G. Chacko, MD, University of Arkansas | A 64-year old female with 3-month history of horizontal and vertical double vision and a droopy right upper lid. Previous history significant for diabetes and hypertension. Family history remarkable for stroke and cerebral aneurysm. |
| 130 |
 |
Snowballs and Curveballs (Presentation Video) | Nicholas J. Volpe, MD, Northwestern University | A 34-year old male with complaints of pain, photophobia, redness, and decreased vision OD. Previous history significant for tuberculosis. |
| 131 |
 |
Here's the Story of a Man Who's Brady (Kinetic) (Presentation Video) | Maysaa Basha | A 49-year old male with progressive neurodegenerative disease. Previous history significant for congenital toxoplasmosis OS and dyslipidemia. |
| 132 |
 |
Don't Ignore the Obvious (Presentation Video) | Zina Almer | A 51-year old male with bilateral loss of vision. Previous history significant for HIV. |
| 133 |
 |
I Can't Seem to Find My Glasses (Presentation Video) | Susan C. Benes | A 55-year old male with progressive loss of vision OS. |
| 134 |
 |
Do Not Take Diplopia Lightly (Presentation Video) | William Hills | A 37-year-old female with a 6-week history of diplopia, nausea and headache. Previous history significant for migraine with occasional aura and minor head trauma as a child. |
| 135 |
 |
WHAT?!? (Presentation Video) | Beau Bruce, MD, PhD, Emory University | A 49-year old male with a 3-week history of headache, nausea and blurred vision OD, followed by 2 days of vertigo and hearing loss. Previous history significant for obesity, obstructive sleep apnea, amblyopia OD, LASIK OS, and a 10-year history of vertigo. |
| 136 |
 |
Don't Give Up Under Pressure (Presentation Video) | Marc J. Dinkin, MD, Weill Cornell Medicine | A 20-year old male with a 6-year history of headache, sometimes accompanied by vomiting and snycope most often brought on by standing up or bending over. Followed by pediatric neurology for a previous diagnosis of migraine. |
| 137 |
 |
Rectifying the Apposite Diagnosis (Presentation Video) | Beau Bruce, MD, PhD, Emory University | A 65-year old male with a 6 week history of progressive balance difficulties, bilateral hearing loss and loss of vision OD. Previous history significant for hypertension and rectal cancer Tx surgery, antineoplastic agents and XRT. |
| 138 |
 |
Painful Red Eye in a 69-Year Old Female With Sensorineural Hearing Loss (Presentation Video) | Engelbert, Micahel | A 63-year old female with a 6-year history of ulcerative colitis and erythema nodosum. Previous history significant for bilateral hearing loss, diffuse headache preceded by intermittent vertigo and tinnitus. |
| 139 |
 |
You Shake My Nerves and You Rattle My Brain; presentation video | Ai Sakonju, David Newman-Toker, MD, PhD, Associate Professor, Departments of Neurology, Ophthalmology, & Otolaryngology, The Johns Hopkins University School of Medicine | A 39-year-old man with a remote history of traumatic brain injury (TBI) and well-controlled seizures. |
| 140 |
 |
Do You See Mike? (Presentation Video) | Deborah I. Friedman, MD, MPH, Professor, Neurology & Neurotherapeutics, University of Texas Southwestern | A 59-year old male with progressive right facial numbness, right facial pain, diplopia, headache and a 10-pound weight loss. |
| 141 |
 |
Horrible Hallucinations (Presentation Video) | Melissa W. Ko, MD, FAAN, Upstate University Hospital | A 34-year old female with a history of irritable bowel and polycystic ovarian syndrome. |
| 142 |
 |
A Mercurial Course (Presentation Video) | Melissa W. Ko, MD, FAAN, Upstate University Hospital | A 61-year old male with a 9-month history of progressive diplopia, dysarthria, ataxic gait, worsening memory impairment, anxiety depression, sleep disturbances and a 30-pound loss of weight. |
| 143 |
 |
Klinging to My Failing Corneas (Presentation Video) | Vivek Patel | A 46-year old female with a 10-year history of bilateral scleritis and peripheral ulcerative keratitis secondary to presumed rheumatoid arthritis. |
| 144 |
 |
Back to the Doctor (Presentation Video) | Benjamin Osborne | A 46-year old male with changes in vision. Previous history significant for diskectomy/laminectomy L4-5, diabetes, hyperlipidemia and hypertension. |
| 145 |
 |
An Unusual ‘Optic Neuritis' (Presentation Video) | Manoj Parulekar | A 37-year old female with a history of sudden onset of 'darkness' in the lower visual field OS. |
| 146 |
 |
Small Surprises Along the Journey (Presentation Video) | Janet C. Rucker | 29-year old female with a 2-year history oscillopsia. Previous history significant for Dx ovarian cancer three years before Tx surgery and chemotherapy. |
| 147 |
 |
An Obscure Diagnosis (Presentation Video) | Kalliopi Stasi | A 57-year old African-American male with transient visual obscurations brought on by exercise. Painless black vision associated with neck and lower back pain. Occipital headache, left facial numbness and bilateral leg weakness. Previous medical history significant for HIV, pneumonia, facial zoster, ... |
| 148 |
 |
Sticky Situation (Presentation Video) | Joshua Pasol | A 25-year old female with a 9-month history of decreasing vision OS. Previous history significant for hypersensitivity to dust and pollen. Self-reported 12-year history of migraine headache. |
| 149 |
 |
My, What Asthenia You Have (Presentation Video) | Michael Lee | A 59-year old female with a 3-year history of ptosis and diplopia. Family history significant for myasthenia gravis. |
| 150 |
 |
A Case of Bilateral Optic Nerve Atrophy (Presentation Video) | Thomas N. Hwang | A 2 1/2-year old male with bilateral optic atrophy, multi-system abnormalities, tonic-clonic seizures, spastic paresis, sensorineural hearing loss and ataxia. |
| 151 |
 |
Up and Down and Around and Around; presentation video | Elizabeth Waller | A 39-year old female with a 5-day history of nausea, vomiting, diarrhea, headache and myalgias. |
| 152 |
 |
Diplopia, Dysarthria, and Dizziness from Subarachnoid Fat? (Presentation Video) | Neil R. Miller, MD, Professor of Ophthalmology, Johns Hopkins University | A 66-year old female with sudden oblique double vision, isolated left IV nerve palsy and bilateral peripheral vestibular dysfunction. Previous history significant for hypertension, colonic polyps and degenerative joint disease of the spine which required several surgeries. |
| 153 |
 |
Isolated Third Nerve Palsy Caused by Intracranial Spread (Presentation Video) | Celia Chen | A 53-year old male with a 1-month history of diplopia and swelling OD. Previous history significant for systemic lupus erythematosus. |
| 154 |
 |
A Rare Cause of Acquired Ocular Motor Apraxia (Presentation Video) | Edward Atkins | A 71-year old male with a sudden onset of delusional speech and inappropriate laughter. |
| 155 |
 |
The Largest Ventricular Tumor on Earth (Presentation Video) | Alberto Gálvez, Jonathan Daniel Trobe, MD, Michigan University; Sachin Gujar, Andrew Lieberman | A 20-year old male with a history of congenital nystagmus, high myopia, and subnormal visual acuity OU. |
| 156 |
 |
Steroid Non-Responsive Optic Neuropathy (Presentation Video) | Ruth Huna-Baron, MD, The Goldschleger Eye Institute | A 75-year old with painless, progressive loss of vision. Previous history significant for BPH and excised skin malignant melanoma. |
| 157 |
 |
A 29-Year Old Woman with Bilateral Visual Loss, Amenorrhea and Hyperprolactinemia (Presentation Video) | M. Tariq Bhatti, MD, Duke Health | A 29-year old female with episodic complete loss of vision followed by a progressive decline in vision OU. Previous history significant for miscarriage, amenorrhea, excessive thirst, joint pain and decrease in hearing AS. |
| 158 |
 |
Blurry Vision (Presentation Video) | Donna L. Hill, MD, UFJP-Neuroscience Institute | A 50-year old female with with bi-frontal headache and blurred vision OU. Previous history significant for hyperlipidemia and gastroesophageal reflux disease. |
| 159 |
 |
A 28 Year-Old Man with Visual Loss and Pain on Eye Movement (Presentation video) | Mark L. Moster, MD, Thomas Jefferson University | A 28-year old male with loss of vision OS associated with soreness on eye movement over an 8-day period. |
| 160 |
 |
A Lebanese Woman with Progressive Visual Loss; presentation video | Gregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of Medicine | A 69-year old female with progressive loss of vision OD. |
| 161 |
 |
Oh Great, I Get to Follow the Post-Op Homonymous Hemianopsia (Presentation Video) | Robert F. Saul, MD, Virginia Tech Carilion | A 32-year old female with a right homonymous hemianopsia and 1-month history of severe headache. |
| 162 |
 |
An Unusual Origin of Balint's Syndrome (Presentation Video) | Iris Ben-Bassat Mizrachi, MD, The Goldschleger Eye Institute | A 50-year old female with progressive visual problems and cognitive deterioration over a 3-month period. |
| 163 |
 |
Confusing Diplopia (Presentation Video) | Dan Boghen, MD, FRCP(C), Neuro-Ophthalmology Section, Neurology Service, Hôtel-Dieu Hospital, Quebec | A 45-year old female with diplopia. |
| 164 |
 |
A 48 Year-Old Man with Loss of Vision OD (Presentation Video) | Joseph G. Chacko, MD, University of Arkansas | A 48-year-old male with blurred vision and pain associated with eye movement OD. |
| 165 |
 |
Just Another Sixth Nerve Palsy in a Teenager (Presentation Video) | Julio A. Rodriguez | A 17-year old female with a sudden onset of diplopia, left peri-orbital pain. Previous history significant for bronchial asthma and sinusitis. |
| 166 |
 |
A Bad Place To Be (Presentation Video) | Judy I. Ou | A 6-year old female with a 1-week history of headache, right-sided ptosis and painful ophthalmoplegia with diplopia. |
| 167 |
 |
A 28 Year-Old Male with Progressive Vertical Diplopia (Presentation Video) | Mark Gans | A 28-year old male with a 4-month history of double vision. Previous history significant for hypercholesterolemia subsequently responding to diet control. |
| 168 |
 |
A 68-Year Old Woman with New Onset Vertical Diplopia and Pain (Presentation Video) | Jennifer T. Scruggs | A 68-year old female with mild headache and diplopia. Previous history significant for thyroidectomy. |
| 169 |
 |
Multiple Cranial Neuropathies Over Multiple Months (Presentation Video) | Kara F. Warden | A 50-year old female with a 2-day history of diplopia, and 4 months of left facial numbness. Previous history significant for rheumatoid arthritis. |
| 170 |
 |
A Tale As Old As Time (Presentation Video) | G. Moazami | A 78-year old male with a 2-moth history of progressive blurred vision OD. Three months prior to presentation, diffuse right-sided headaches followed by two episodes of dimming vision OD lasting seconds to hours. |
| 171 |
 |
Insidious Unilateral Vision Loss (Presentation Video) | Gabrielle R. Bonhomme | A 47-year old female with a 4-month history of self-reported shadowy vision and poor depth perception OD. Previous history significant for rheumatoid arthritis, diabetes mellitus and hypothyroidism. Contributory: A 10-year history of smoking and exposure to anti-rheumatic agents. |
| 172 |
 |
Vertical Gaze Palsy and Fever in a 53 Year-Old, HIV-Positive Man; (Presentation Video) | Nicholas J. Volpe, MD, Northwestern University | A 53-year old male with a 2-day history of vertical, binocular diplopia accompanied by worsening headache, slurred speech, unsteady gait and right face, arm and leg numbness the week previous. Previous history significant for HIV infection, hepatitis B and C and Hodgkin's lymphoma. |
| 173 |
 |
A Man with Horner's Syndrome and Optic Neuropathy (Presentation Video) | Hideki Chuman | A 48-year old male with sudden onset of painless blurred vision OD. Previous history significant for diabetes and hypertension. |
| 174 |
 |
A Star is Born (MRI) | Nadia Kazim, MD, FACS, Kazim Eyelid Surgery | A 47-year old female with persistent painless blurred vision OD preceded by peri-orbital headache. Previous history significant for anemia and arthritis. SH: Positive for tobacco use (1 PPD x 30yrs). |
| 175 |
 |
A Star is Born (Presentation Video) | Nadia Kazim, MD, FACS, Kazim Eyelid Surgery | A 47-year old female with persistent painless blurred vision OD preceded by peri-orbital headache. Previous history significant for anemia and arthritis. SH: Positive for tobacco use (1 PPD x 30yrs). |
| 176 |
 |
Bright Meninges; Dim Doctors (Presentation Video) | Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine | A 32-year old male with headache and diplopia. |
| 177 |
 |
Her XT Made Me Go ET (Presentation Video) | Norah S. Lincoff MD, University at Buffalo | A 16-year old female with a 10-year history of headache and progressive loss of vision OD. |
| 178 |
 |
Mackenzie's Legacy (Presentation Video) | Elena, R. Drudy, MD, Meridian Health | A 55-year old female with a 4-year history of seeing yellow light to the right accompanied by a 1-year history of bi-frontal headache. |
| 179 |
 |
Invasion of the Nerve Snatchers, Part III (Presentation Video) | Donna L. Hill, MD, UFJP-Neuroscience Institute | A 45-year old male with a 3-day history of worsening headache and double vision. |
| 180 |
 |
Star Light, Star Bright (Presentation Video) | Shannon C. Lynch, MD, University of Nebraska Medical Center | An 83-year female with ptosis and binocular oblique diplopia. |
| 181 |
 |
When All Else Fails, Lay on Hands (Presentation Video) | Roger E. Turbin, MD, Rutgers New Jersey Medical School | A 57-year old female with an 8-month history of photopsia and dark spots OS 1 month after second renal transplant. Renal failure attributed to biopsy-proven renal sarcoidosis. |
| 182 |
 |
Diagnosis of Inclusion (Presentation Video) | Iris Ben-Bassat Mizrachi, MD, The Goldschleger Eye Institute | A 50-year old female with a 2-day history of headache and fever found unresponsive at home. |
| 183 |
|
Hard to Get (Presentation Video) | Ruth Huna-Baron, MD, The Goldschleger Eye Institute | A 77-year old male with headache and visual loss OD. Previous history significant for hypertension, ischemic heart disease, basal cell carcinoma and invasive transitional cell carcinoma Tx cystectomy and chemotherapy. |
| 184 |
 |
Highly Impossible (Presentation Video) | William A. Fletcher, MD, Departments of Clinical Neurosciences & Surgery, University of Calgary | A 4-year old male with a 1 1/2-year history of visual loss OU. Previous history significant for macrocephaly. |
| 185 |
 |
Obvious Case of Giant Cell Arteritis (Presentation Video) | Kevin M. Barrett | A 64-year-old male with a 6-month history of fatigue, weight loss, shoulder/hip girdle discomfort, jaw pain when chewing and episodic monocular loss of vision. Previous history significant for hypertension, prostate cancer (s/p prostatectomy), adenomatous hyperplasia (s/p thyroidectomy) and kidney c... |
| 186 |
 |
Pseudo-Pseudo Orbital Tumor (Presentation Video) | Nicholas T. Monsul | A 53-year old male with orbital fullness, pain associated with red eyes and diplopia. |
| 187 |
 |
Giant Step for Mankind (Presentation Video) | Orin Zwick | A 29-year old male with a 2-month history of blurred vision OD, headache and progressive eyelid swelling and expanding mass right temporal region. Previous history significant for chronic renal failure. |
| 188 |
 |
Once Upon an MRI Dreary (Presentation Video) | Richard L. Levy | A 59-year old African-American female with hypercholesterolemia, benign colonic polyps and stress-related headaches. |
| 189 |
 |
19-year-old Man with Dizziness and Blackout Spells (Presentation Video) | Neil R. Miller, MD, Professor of Ophthalmology, Johns Hopkins University | A 19-year old male with history of bizarre behavior, dizziness and black-out spells. Initial manifestation a self-described head rush followed by a black-out spell while at work. 2 months later, patient developed a right facial droop and expressive aphasia. |
| 190 |
|
Junction, Junction What's Your Function? (Presentation Video) | Joseph G. Chacko, MD, University of Arkansas | A 38-year old male with a sudden onset of decreased vision OS, accompanied by headache. Previous history significant for low back pain, anemia and thrombocytopenia (resolved with blood transfusions). Previous ocular history significant for bilateral retinal hemorrhages during the episode of anemia 3... |
| 191 |
 |
Man with a Rush (Presentation Video) | Nicola G. Ghazi, MD, Department of Ophthalmology, Texas Tech University Health Sciences Center | A 42-year old male with headache, tinnitus and persistent color retention. Previous history significant for sciatica. |
| 192 |
 |
MacKenzie's Legacy (Radiology CT) | Elena, R. Drudy, MD, Meridian Health | A 55-year old female with a 4-year history of seeing yellow light to the right accompanied by a 1-year history of bifrontal headache. |
| 193 |
 |
MacKenzie's Legacy (Radiology CT 2) | Elena, R. Drudy, MD, Meridian Health | A 55-year old female with a 4-year history of seeing yellow light to the right accompanied by a 1-year history of bifrontal headache. |
| 194 |
 |
Invasion of the Nerve Snatchers, Part III (MRI) | Donna L. Hill, MD, UFJP-Neuroscience Institute | A 45-year old male with a 3-day history of worsening headache and double vision. |
| 195 |
 |
Highly Impossible (Follow-Up MRI Coronal) | William A. Fletcher, MD, Departments of Clinical Neurosciences & Surgery, University of Calgary | A 4-year old male with a 1 1/2-year history of visual loss OU. Previous history significant for megacephaly. |
| 196 |
 |
Highly Impossible (Follow-Up MRI Coronal) | William A. Fletcher, MD, Departments of Clinical Neurosciences & Surgery, University of Calgary | A 4-year old male with 1 1/2-year history of visual loss OU. Previous history significant for megacephaly. |
| 197 |
 |
Highly Impossible (Follow-Up MRI Axial with Gadolinium) | William A. Fletcher, MD, Departments of Clinical Neurosciences & Surgery, University of Calgary | A 4-year old male with a 1 1/2-year history of visual loss OU. Previous history significant for macrocephaly. |
| 198 |
 |
When All Else Fails, Lay on Hands (Angiograms RICA) | Roger E. Turbin, MD, Rutgers New Jersey Medical School | A 57-year old female with an 8-month history of photopsia and dark spots OS 1 month after second renal transplant. Renal failure attributed to biopsy-proven renal sarcoidosis. |
| 199 |
 |
When All Else Fails, Lay on Hands (MRI Axial) | Roger E. Turbin, MD, Rutgers New Jersey Medical School | A 57-year old female with an 8-month history of photopsia and dark spots OS 1 month after second renal transplant. Renal failure attributed to biopsy-proven renal sarcoidosis. |
| 200 |
 |
When All Else Fails, Lay on Hands (MR Contaxial) | Roger E. Turbin, MD, Rutgers New Jersey Medical School | A 57-year old female with an 8-month history of photopsia and dark spots OS 1 month after second renal transplant. Renal failure attributed to biopsy-proven renal sarcoidosis. |