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.
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| Title | Creator | History | ||
|---|---|---|---|---|
| 1 |
 |
Is the Treatment Working? Yes, the Patient Is Getting Worse! | Walid Bouthour; Heimo Steffen | A 46-year-old woman from Gambia with no prior medical history presented to the ophthalmology clinic for progressive; blurred vision, headache, and weight loss over the past two months. Her best corrected visual acuity was finger count in the; right eye and 20/20 in the left eye. There was an asymmet... |
| 2 |
 |
Hydrocephalus Appetizer, TED Entrée, Side of Bipolar Disease. Would You Like a Meatball With That? | Eric Caskey; Bradley Katz; Bhupendra Patel; Roger Harrie; Meagan Seay; Benjamin Witt; Yoshimi Anzai; Alison Crum; Judith Warner1, Kathleen Digre | A 74-year-old man presented with a one year history of progressive, asymmetric proptosis. His past medical history by bilateral optic neuropathy, thyroid eye disease complicated by lithium treatment for bipolar disease, benign prostatic included hydrocephalus associated with aqueductal stenosis, sta... |
| 3 |
 |
WD-40: A Multi-Use Product | Georgia Kaidonis; Melike Pekmezci; Jessica Van Ziffle; Jonathan Horton | A 15-year-old female with a history of syndactyly, brachydactyly and patent ductus arteriosus presented with declining; vision and new onset of headache. She was referred for neuro-ophthalmology evaluation. Best corrected acuity was 20/40; in the right eye and 20/100 in the left eye. The pupillary r... |
| 4 |
 |
Just a Flu? | Lily 'Tali' Okrent Smolar; Veronika Yehezkeli; Fani Segev; Feda Fanadka; Sachin Kedar; Yehoshua Almog | A thirteen-year-old boy with no significant past medical history presented to the pediatric emergency department (ED) with; progressive right eyelid swelling, decreased appetite, general malaise and obtundation. A week prior to presentation, he; had flu like illness with fever, headache, ear pain, n... |
| 5 |
 |
Some Heads Are Harder Than Others | Steven Newman | A 56 year old right handed patient was referred for an 'orbital problem.' Ten years earlier he had been told that nothing; could be done about the fact that his right eye position was not normal. In August 2015 vision was 20/50 OD and 20/300; OS, with the decreased vision on the left felt related to... |
| 6 |
 |
The Grey Area of White Matter | Parker Bohm; Leanne Stunkel; Gregory Van Stavern | A 76 year-old man presented with two months of progressive confusion, vision loss, and left-sided weakness. His medical; history was notable for hypothyroidism, type 2 diabetes mellitus, coronary artery disease, basal cell carcinoma of the; forehead status-post excision, deep vein thrombosis, and se... |
| 7 |
 |
Waiting for That ‘Bing' Moment to Get the Diagnosis | Jenny Hepschke; J. Virdee; Richard Blanch | A 55yo Caucasian female initially presented to her GP with a new onset headaches, scalp tenderness, shoulder arthralgia,; night sweats and loss of appetite. Bloods platelets of 379, ESR 26 and CRP of 4. She was diagnosed with Giant cell arteritis; (GCA) and empirically treated with oral Prednisolone... |
| 8 |
 |
Waiting for That ‘Bing' Moment to Get the Diagnosis | Jenny Hepschke; J. Virdee; Richard Blanch | A 55yo Caucasian female initially presented to her GP with a new onset headaches, scalp tenderness, shoulder arthralgia,; night sweats and loss of appetite. Bloods platelets of 379, ESR 26 and CRP of 4. She was diagnosed with Giant cell arteritis; (GCA) and empirically treated with oral Prednisolone... |
| 9 |
 |
Not Another IgG4 Case! | Anne Kao | A 34 year-old woman was referred from the allergist for painless swelling of bilateral upper eyelids for 11 months, after; moving from Alabama to her current state of residence. Her past medical history was significant for anemia. Review of; systems was notable for fatigue, daily headaches, and inte... |
| 10 |
 |
Pseudo-Pseudotumor Cerebri? | Etienne Benard-Seguin; Abdullah Al-Ani; Kris Langdon; Rajiv Midha; Paula de Robles; Fiona Costello | A 23-year-old female to male transgender patient (BMI=30) on testosterone therapy presented to the urgent clinic with; bilateral disc swelling and preserved optic disc function (Figure 1a-1b). He had a 5 day history of general malaise. Past; medical history was pertinent for scoliosis surgery at age... |
| 11 |
 |
The Nidus of the Neuropathy | Heather McDonald; Adrian Budhram; J. Alexander Fraser; Lulu LCD Bursztyn | A 57-year-old female presented with a one-year history of paresthesias, gait instability, slurred speech, peripheral; numbness, and fatigue. A non-contrast CT Head showed lower density in the corpus callosum. Follow-up MR Head showed; T2/FLAIR hyperintensity and diffusion restriction in the splenium... |
| 12 |
 |
An Apple a Day | Joseph Fong; James O'Brien; Anil Patel | A 73-year-old female presented with a 4-month-history of gradually worsening binocular oblique diplopia, right upper; eyelid ptosis, right-sided facial weakness, and facial pain and paresthesia in the right V1 and V2 distribution. She presented; with a prior diagnosis of trigeminal neuralgia as a re... |
| 13 |
 |
The Inconspicuous Cysts | Lily Zhang; Folusakin Ayoade; Julio Diaz Perez | A previously healthy 40-year-old male, with a past medical history significant for latent tuberculosis s/p treatment 15 years; ago, presented with blurry vision and progressively worsening headaches for 6 months. He was originally from Guatemala; and moved to the US in 2001 (crossed the deserts thro... |
| 14 |
 |
Thinking Outside of the Lines | Carleigh Bruce; Thomas Clark; Gregory Griepentrog; Andrea Stahulak; Mariam Ratiani | A 61-year-old male with past medical history of long-standing cocaine abuse presented with ten days of painless acute; vision loss in his right eye (OD). Initial exam revealed a visual acuity (VA) 20/100 OD, relative afferent pupillary defect; (rAPD) OD, dyschromatopsia OD, hypertropia with impaired... |
| 15 |
 |
Double Crossed | Jeffrey Gluckstein; Melanie Lang-Orsini; Joseph Rizzo | A 58-year-old man presented for the development of new stabbing headaches and blurry vision in the right eye. Over; several months, his symptoms progressed to 'smudging' of his temporal field in the right eye, difficulty separating similar; colors, and binocular horizontal diplopia worse at near. Me... |
| 16 |
 |
All in the Family | Homer Chiang; Shannon Beres | A previously healthy 2-year-old male presented to neuro-ophthalmology clinic for a head turn that started 1.5 months ago; and his left eye began turning in over the last 2 weeks. He had no recent infections, vaccinations, or illnesses. With the birth; of his new baby sister 6 weeks prior the family ... |
| 17 |
 |
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... |
| 18 |
 |
Frizzle Frazzled | Eric 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... |
| 19 |
 |
Frizzle Frazzled | Eric 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... |
| 20 |
 |
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... |
| 21 |
 |
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... |
| 22 |
 |
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. ... |
| 23 |
 |
A Definite Maybe | Raghu 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... |
| 24 |
 |
Orbiting a Diagnosis | Daniel Liebman; Daniel Lefebvre; Emily Tam; Marie Lithgow; Bart Chwalisz; Eric Gaier; Joseph Kane | 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... |
| 25 |
 |
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, ... |
| 26 |
 |
A Definite Maybe | Raghu 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... |
| 27 |
 |
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... |
| 28 |
 |
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... |
| 29 |
 |
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... |
| 30 |
 |
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. ... |
| 31 |
 |
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... |
| 32 |
 |
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, ... |
| 33 |
 |
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... |
| 34 |
 |
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... |
| 35 |
 |
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... |
| 36 |
 |
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... |
| 37 |
 |
Smoke Gets in Your Eyes (Slides) | 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 ... |
| 38 |
 |
Smoke Gets in Your Eyes (PDF) | 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 ... |
| 39 |
 |
You're Too Young for That! (Slides) | 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... |
| 40 |
 |
Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (Slides) | Jorge Kattah; Scott Eggers; Sarah Bach | A 45 y/o man developed insidious unsteadiness and bilateral hearing impairment. A neurosurgeon diagnosed possible myelopathy, and despite an anterior cervical discectomy, he noted progressive gait difficulty, poor handwriting, and inability to play the guitar. Additionally, dysarthria, oscillopsia a... |
| 41 |
 |
Close Encounters of the Third Kind (Slides) | 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... |
| 42 |
 |
Look in the Back (Slides) | 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... |
| 43 |
 |
Undiscovered Islands - So Close, Yet So Far (PDF) | 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... |
| 44 |
 |
Tumefictive MS (Slides) | 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... |
| 45 |
 |
Tumefictive MS (PDF) | 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... |
| 46 |
 |
Bones of the Past (Slides) | 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... |
| 47 |
 |
Bones of the Past (PDF) | 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... |
| 48 |
 |
You're Too Young for That! (PDF) | 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... |
| 49 |
 |
Not All Men with Thick Skulls Have High Testosterone (Slides) | Prem Subramanian | 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... |
| 50 |
 |
Not All Men with Thick Skulls Have High Testosterone (PDF) | Prem Subramanian | 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... |
| 51 |
 |
A Par 3 Macular Hole? (Slides) | 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... |
| 52 |
 |
Are We 'Tilting At Windmills'? (PDF) | Michael Vaphiades | 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... |
| 53 |
 |
Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (Slides) | David DeLeon; Mariel Rojas; Francisco Sanchez; Rosa Tang; Julie Patel; Jade Schiffman | A 16 y/o Caucasian female with a BMI of 24, went for an eye exam for blurry vision which corrected with refraction, however bilateral disc edema was found. There was a 4-year history of headaches that were intermittent and escalating in nature around 5 days a week, about 1 hour after awakening, and ... |
| 54 |
 |
Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (PDF) | David DeLeon; Mariel Rojas; Francisco Sanchez; Rosa Tang; Julie Patel; Jade Schiffman | A 16 y/o Caucasian female with a BMI of 24, went for an eye exam for blurry vision which corrected with refraction, however bilateral disc edema was found. There was a 4-year history of headaches that were intermittent and escalating in nature around 5 days a week, about 1 hour after awakening, and ... |
| 55 |
 |
Close Encounters of the Third Kind (PDF) | 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... |
| 56 |
 |
From Brainstem to Stern (PDF) | Neena Cherayil; Angela Viane; Grant Liu; Ali Hamedani | A previously healthy 32-year-old man complained of diplopia and one month of worsening positional headaches. He then acutely developed confusion and chills, prompting ER referral. Further history was limited by altered mental status. On presentation, he was afebrile and encephalopathic. Serum WBC wa... |
| 57 |
 |
Look in the Back (PDF) | 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... |
| 58 |
 |
Tissue Is the Issue (PDF) | Christine Greer; Jasmine Francis; Eli Diamond; Charles Eberhart; Marc Dinkin | The pathologic specimen demonstrated atypical histiocytic proliferation and infiltration with abundant cytoplasm, CD68+, S100+, consistent with Rosai Dorfman (RDD). The patient had been treated with steroids with a partial response and disease stabilization with radiation therapy with subsequent pro... |
| 59 |
 |
A Par 3 Macular Hole? (PDF) | 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... |
| 60 |
 |
Oh Oh Oh It's Magic, You Know…Never Believe It's Not So! (PDF) | 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 ... |
| 61 |
 |
Oh Oh Oh It's Magic, You Know…Never Believe It's Not So! (Slides) | 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 ... |
| 62 |
 |
Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (PDF) | Jorge Kattah; Scott Eggers; Sarah Bach | A 45 y/o man developed insidious unsteadiness and bilateral hearing impairment. A neurosurgeon diagnosed possible myelopathy, and despite an anterior cervical discectomy, he noted progressive gait difficulty, poor handwriting, and inability to play the guitar. Additionally, dysarthria, oscillopsia a... |
| 63 |
 |
Are We 'Tilting At Windmills'? (Slides) | Michael Vaphiades | 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... |
| 64 |
 |
Undiscovered Islands - So Close, Yet So Far (Slides) | 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... |
| 65 |
 |
Tissue Is the Issue (Slides) | Christine Greer; Jasmine Francis; Eli Diamond; Charles Eberhart; Marc Dinkin | The pathologic specimen demonstrated atypical histiocytic proliferation and infiltration with abundant cytoplasm, CD68+, S100+, consistent with Rosai Dorfman (RDD). The patient had been treated with steroids with a partial response and disease stabilization with radiation therapy with subsequent pro... |
| 66 |
 |
A Trip Through the Wormhole | Anne Kao | 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... |
| 67 |
 |
A Trip Through the Wormhole | Anne Kao | 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... |
| 68 |
 |
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... |
| 69 |
 |
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... |
| 70 |
 |
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... |
| 71 |
 |
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 ... |
| 72 |
 |
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... |
| 73 |
 |
Not the Rolling Stones | Ari Shemesh; Anthony Brune; Lilja Solnes; Avindra Nath; John Probasco; Daniel Gold | A 68-year-old woman presented to the clinic complaining of "bouncing" vision when waking up at night for one month. Two years ago, she experienced discrete episodes of spinning for seconds provoked by head movements, which resolved spontaneously. Her ocular motor and vestibular exams were normal asi... |
| 74 |
 |
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... |
| 75 |
 |
A Zebra Among Zebras (Slides) | 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... |
| 76 |
 |
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 ... |
| 77 |
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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... |
| 78 |
 |
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 ... |
| 79 |
 |
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... |
| 80 |
 |
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... |
| 81 |
 |
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 ... |
| 82 |
 |
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... |
| 83 |
 |
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... |
| 84 |
 |
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... |
| 85 |
 |
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.... |
| 86 |
 |
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... |
| 87 |
 |
Not the Rolling Stones | Ari Shemesh; Anthony Brune; Lilja Solnes; Avindra Nath; John Probasco; Daniel Gold | A 68-year-old woman presented to the clinic complaining of "bouncing" vision when waking up at night for one month. Two years ago, she experienced discrete episodes of spinning for seconds provoked by head movements, which resolved spontaneously. Her ocular motor and vestibular exams were normal asi... |
| 88 |
 |
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... |
| 89 |
 |
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... |
| 90 |
 |
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 ... |
| 91 |
 |
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 ... |
| 92 |
 |
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.... |
| 93 |
 |
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... |
| 94 |
 |
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... |
| 95 |
|
Tissue Is the Issue | Christine Greer; Jasmine Francis; Eli Diamond; Charles Eberhart; Marc Dinkin | The pathologic specimen demonstrated atypical histiocytic proliferation and infiltration with abundant cytoplasm, CD68+, S100+, consistent with Rosai Dorfman (RDD). The patient had been treated with steroids with a partial response and disease stabilization with radiation therapy with subsequent pro... |
| 96 |
 |
What Don't You See? - Slides | 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... |
| 97 |
 |
A Tough Nut to Crack! - Slides | 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... |
| 98 |
 |
Lumps and Bumps - Slides | 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... |
| 99 |
 |
One Peak is Worth Twenty Finesses - Slides | 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... |
| 100 |
 |
Triple Take - Slides | 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... |