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1 Is the Treatment Working? Yes, the Patient Is Getting Worse!Walid Bouthour, Heimo SteffenA 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 Warner, Kathleen DigreA 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 ProductGeorgia Kaidonis, Melike Pekmezci, Jessica Van Ziffle, Jonathan HortonA 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 AlmogA 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 OthersSteven A. NewmanA 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 MatterParker Bohm, Leanne Stunkel, Gregory Van StavernA 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 DiagnosisJenny Hepschke, J. Virdee, Richard Blanch
8 Waiting for That ‘Bing' Moment to Get the DiagnosisJenny Hepschke, J. Virdee, Richard BlanchA 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 R. Kao, MDA 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 CostelloA 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 NeuropathyHeather McDonald, Adrian Budhram, J Alexander Fraser, Lulu LCD BursztynA 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 DayJoseph Fong, James O'Brien, Anil PatelA 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 CystsLily Zhang, Folusakin Ayoade, Julio Diaz PerezA 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 LinesCarleigh Bruce, Thomas Clark, Gregory Griepentrog, Andrea Stahulak, Mariam RatianiA 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 CrossedJeffrey Gluckstein, Melanie Lang-Orsini, Joseph RizzoA 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 FamilyHomer Chiang, Shannon BeresA 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 NoduleNatalie Brossard, Kirill Zaslavski, Laila Al-Shafai, David Munoz, Edward MargolinA 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 A Nod to the NoduleNatalie Brossard, Kirill Zaslavski, Laila Al-Shafai, David Munoz, Edward MargolinA 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...
19 A Nod to the NoduleNatalie Brossard, Kirill Zaslavski, Laila Al-Shafai, David Munoz, Edward MargolinA 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...
20 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 Warner, Kathleen Digre
21 Is the Treatment Working? Yes, the Patient Is Getting Worse!Anne R. Kao, MD
22 The Inconspicuous CystsLily Zhang, Folusakin Ayoade, Julio Diaz Perez
23 Pseudo-Pseudotumor Cerebri?Etienne Benard-Seguin, Abdullah Al-Ani, Kris Langdon, Rajiv Midha, Paula de Robles, Fiona Costello
24 A 4-Year WaitDmitry Balian, Sachin Kedar, Michaelyn Everhart, Aleh Bobr, Liudmila MuinovA 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. ...
25 Frizzle FrazzledEric D. Gaier, Farrah Rajabi, Anne Fulton, Gyula Acsadi, David WaitzmanAn 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...
26 Frizzle FrazzledEric D. Gaier, Farrah Rajabi, Anne Fulton, Gyula Acsadi, David WaitzmanAn 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...
27 Frizzle FrazzledEric D. Gaier, Farrah Rajabi, Anne Fulton, Gyula Acsadi, David WaitzmanAn 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...
28 Oh My GAD!! Something Else?Olwen Murphy, Kemar Green, Olwen Murphy, John Probasco, Daniel GoldA 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...
29 A Small Leak Will Sink a Great ShipKonstantinos Douglas, Vivian Paraskevi Douglas, Cameron Sadegh, David Chow, Sigurros Davidsdottir, Ganesh Shankar, Bradley Buchbinder, Bart ChwaliszA 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 WaitDmitry Balian, Sachin Kedar, Michaelyn Everhart, Aleh Bobr, Liudmila MuinovA 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 A Definite MaybeRaghu C. Mudumbai, Alex Solomon73 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...
32 Orbiting a DiagnosisDaniel Liebman, Daniel Lefebvre, Emily Tam, Marie Lithgow, Bart Chwalisz, Eric Gaier, Joseph Kane
33 Never Too Young or Too OldBart Chwalisz, Laurel Tainsh, Mary Maher, Samantha Champion, Shuhei Nishiyima, Michael LevyAn 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, ...
34 A Definite MaybeRaghu C. Mudumbai, Alex Solomon73 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...
35 Sometimes a Biopsy is BestKevin Chodnicki, Natalie Wolkow, Michael Yoon, Bart ChwaliszA 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 SpotLuis Andre Leal Ferman, Leslie Bruch, John Buatti, Jeremy GreenleeThis 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 A Small Leak Will Sink a Great ShipKonstantinos Douglas, Vivian Paraskevi Douglas, Cameron Sadegh, David Chow, Sigurros Davidsdottir, Ganesh Shankar, Bradley Buchbinder, Bart ChwaliszA 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...
38 Oh My GAD!! Something Else?Olwen Murphy, Kemar Green, John Probasco, Daniel GoldA 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...
39 Never Too Young or Too OldBart Chwalisz, Laurel Tainsh, Mary Maher, Samantha Champion, Shuhei Nishiyima, Michael LevyAn 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, ...
40 Gone but Not ForgottenJonathan Micieli, Adriana Krizova, Walter MontaneraA 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...
41 A Small Leak Will Sink a Great ShipKonstantinos Douglas, Vivian Paraskevi Douglas, Cameron Sadegh, David Chow, Sigurros Davidsdottir, Ganesh Shankar, Bradley Buchbinder, Bart ChwaliszA 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...
42 Orbiting a DiagnosisDaniel Liebman, Daniel Lefebvre, Emily Tam, Marie Lithgow, Bart Chwalisz, Eric Gaier, Joseph KaneA 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...
43 'X' Marks the SpotLuis Andre Leal Ferman, Leslie Bruch, John Buatti, Jeremy GreenleeThis 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...
44 Sometimes a Biopsy is BestKevin Chodnicki, Natalie Wolkow, Michael Yoon, Bart ChwaliszA 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...
45 A Definite MaybeRaghu C. Mudumbai, Alex Solomon73 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...
46 A 4-Year WaitDmitry Balian, Sachin Kedar, Michaelyn Everhart, Aleh Bobr, Liudmila MuinovA 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. ...
47 Oh My GAD!! Something Else?Olwen Murphy, Kemar Green, John Probasco, Daniel GoldA 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...
48 Never Too Young or Too OldBart Chwalisz, Laurel Tainsh, Mary Maher, Samantha Champion, Shuhei Nishiyima, Michael LevyAn 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, ...
49 Orbiting a DiagnosisDaniel Liebman, Daniel Lefebvre, Emily Tam, Marie Lithgow, Bart Chwalisz, Eric Gaier, Joseph KaneA 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...
50 Gone but Not ForgottenJonathan Micieli, Adriana Krizova, Walter MontaneraA 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...
51 Sometimes a Biopsy is BestKevin Chodnicki, Natalie Wolkow, Michael Yoon, Bart ChwaliszA 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...
52 'X' Marks the SpotLuis Andre Leal Ferman, Leslie Bruch, John Buatti, Jeremy GreenleeThis 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...
53 Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (Video)David DeLeon, Mariel Rojas, Francisco Sanchez, Rosa Tang, Julie Patel, Jade SchiffmanA 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 From Brainstem to Stern (Video)Neena Cherayil, Angela Viane, Grant Liu, Ali HamedaniA 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...
55 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 ...
56 Smoke Gets in Your Eyes (PDF)Tatiana Bakaeva, John Gittinger, Jr.
57 A Myel-In, a Long Way to Go (Video)Aishwarya Pareek, Timothy Lotze, Gail Demmler, Brandon Tran, William Whitehead, Carrie Mohila, Veeral ShahA 9-year-old previously healthy female with two recent admissions for presumed diagnosis of ADEM re-presented with persistent headache and ataxic gait. During her initial admissions, she presented with fever, acute onset of ataxia, facial asymmetry and abnormal eye movements. Inpatient ocular exam s...
58 From Brainstem to Stern (Slides)Neena Cherayil, Angela Viane, Grant Liu, Ali HamedaniA 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...
59 You're Too Young for That! (Slides)Sravanthi Vegunta, Kathleen Digre, Bradley Katz, Meagan Seay, Alison Crum, Edward Quigley, Sean Kennedy, Nick Mamalis, Judith WarnerAn 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...
60 Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (Slides)Jorge Kattah, Scott Eggers, Sarah BachA 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...
61 Close Encounters of the Third Kind (Slides)Trishal Jeeval-Patel, Danny MandellA 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...
62 Look in the Back (Slides)Tatiana Deveney, Aristides Capizzano, Jonathan TrobeA 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...
63 Undiscovered Islands - So Close, Yet So Far (PDF)Magdalena Wirth, Farahna Sabiq, Mehdi Agoumi
64 Tumefictive MS (Slides)Anthony J. Brune III, Hemant Parmar, Sandra Camelo-Piragua, Lindsey De Lott
65 Tumefictive MS (PDF)Anthony J. Brune III, Hemant Parmar, Sandra Camelo-Piragua, Lindsey De Lott
66 Bones of the Past (Slides)Bart K. Chwalisz, Konstantinos Douglas, Vivian Douglas, Otto Rapalino
67 Bones of the Past (PDF)Bart K. Chwalisz, Konstantinos Douglas, Vivian Douglas, Otto Rapalino
68 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
69 Not All Men with Thick Skulls Have High Testosterone (Slides)Yosbelkys Martin Paez, MD
70 Not All Men with Thick Skulls Have High Testosterone (PDF)Yosbelkys Martin Paez, MD
71 A Myel-In, a Long Way to Go (PDF)Aishwarya Pareek, Timothy Lotze, Gail Demmler, Brandon Tran, William Whitehead, Carrie Mohila, Veeral Shah
72 A Myel-In, a Long Way to Go (Slides)Aishwarya Pareek, Timothy Lotze, Gail Demmler, Brandon Tran, William Whitehead, Carrie Mohila, Veeral Shah
73 A Par 3 Macular Hole? (Slides)Archana Srinivasan, Jerald Gong, Mark Moster
74 Are We "Tilting At Windmills"? (PDF)Michael Vaphiades, DO
75 Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (Slides)David DeLeon, Mariel Rojas, Francisco Sanchez, Rosa Tang, Julie Patel, Jade Schiffman
76 Well Here Is Another Uveo-Meningeal Syndrome You Might Muck Up (PDF)David DeLeon, Mariel Rojas, Francisco Sanchez, Rosa Tang, Julie Patel, Jade Schiffman
77 Close Encounters of the Third Kind (PDF)Trishal Jeeval-Patel, Danny Mandell
78 From Brainstem to Stern (PDF)Neena Cherayil, Angela Viane, Grant Liu, Ali Hamedani
79 Look in the Back (PDF)Tatiana Deveney, Aristides Capizzano, Jonathan Trobe
80 Tissue Is the Issue (PDF)Christine Greer, Jasmine Francis, Eli Diamond, Charles Eberhart, Marc Dinkin
81 A Par 3 Macular Hole? (PDF)Archana Srinivasan, Jerald Gong, Mark Moster
82 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
83 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
84 Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (PDF)Jorge Kattah, Scott Eggers, Sarah Bach
85 Are We "Tilting At Windmills"? (Video)Michael Vaphiades, DOA 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...
86 Are We "Tilting At Windmills"? (Slides)Michael Vaphiades, DOA 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...
87 Undiscovered Islands - So Close, Yet So Far (Slides)Magdalena Wirth, Farahna Sabiq, Mehdi AgoumiA 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...
88 Tissue Is the Issue (Slides)Christine Greer, Jasmine Francis, Eli Diamond, Charles Eberhart, Marc Dinkin
89 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 RasoolA 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 ...
90 Objects Jumping, Body Bumping, Hearing Slumping…Quick, He is Crumping (Video)Jorge Kattah, Scott Eggers, Sarah BachA 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...
91 Undiscovered Islands - So Close, Yet So Far (Video)Magdalena Wirth, Farahna Sabiq, Mehdi AgoumiA 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...
92 Tumefictive MS (Video)Anthony Brune III, Hemant Parmar, Sandra Camelo-Piragua, Lindsey De LottA 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...
93 Bones of the Past (Video)Bart Chwalisz, Konstantinos Douglas, Vivian Douglas, Otto RapalinoA 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...
94 You're Too Young for That! (Video)Sravanthi Vegunta, Kathleen Digre, Bradley Katz, Meagan Seay, Alison Crum, Edward Quigley, Sean Kennedy, Nick Mamalis, Judith WarnerAn 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...
95 Not All Men With Thick Skulls Have High Testosterone (Video)Yosbelkys Martin Paez, MDA 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...
96 Close Encounters of the Third Kind (Video)Trishal Jeeval-Patel, Danny MandellA 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...
97 Look in the Back (Video)Tatiana Deveney, Aristides Capizzano, Jonathan TrobeA 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...
98 Tissue Is the Issue (Video)Christine Greer, Jasmine Francis, Eli Diamond, Charles Eberhart, Marc DinkinA 34-year-old man with a past medical history of bilateral corneoscleral lesions and brainstem, thalamic, and temporal lobe lesions presented with progressive vision loss over seven months. He described graying out of vision with light sensitivity. Bilateral, retrobulbar, deep ocular pain started 2 ...
99 A Par 3 Macular Hole? (Video)Archana Srinivasan, Jerald Gong, Mark MosterA 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...
100 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 ...
101 A Trip Through the WormholeAnne R. Kao, MD
102 A Trip Through the WormholeAnne R. Kao, MD
103 A Trip Through the WormholeAnne R. Kao, MD
104 Three's a CrowdKanwal S. Matharu, MD
105 Three's a CrowdKanwal S. Matharu, MD
106 Three's a CrowdKanwal S. Matharu, MD
107 Turbulence, Fluid Waves, and the Black HoleStella Y. Chung, MD, MS
108 Every Rose Has Its ThornWilliam J. Anderson, BS
109 A Zebra Among ZebrasPeter Mortensen, Gabrielle Bonhomme
110 A Zebra Among ZebrasPeter Mortensen, Gabrielle Bonhomme
111 The Great MasqueradeBart Chwalisz, Dean Cestari
112 Unexplained Becomes ExplainedJinu Han, Hye Young Kim, Sueng-Han Han
113 Fire and IceMary Maher, Joah Aliancy, Gul Moonis, Angela Lignelli, Michael Kazim, Jeffrey Odel
114 Fire and IceMary Maher, Joah Aliancy, Gul Moonis, Angela Lignelli, Michael Kazim, Jeffrey Odel
115 Go With Your Gut FeelingPaul R. Freund, MD, MSc, FRCSC
116 Fooled ThriceJonathan A. Micieli, MD, CM
117 Not the Rolling StonesAri A. Shemesh, MD
118 Turbulence, Fluid Waves, and the Black HoleStella Y. Chung, MD, MS
119 A Zebra Among Zebras (Slides)Peter Mortensen, Gabrielle Bonhomme
120 At the CrossroadsKonstantinos Douglas, MD, DVM, MBA
121 Don't Drink the WaterDevon A. Cohen, MD
122 Fire and IceMary Maher, Joah Aliancy, Gul Moonis, Angela Lignelli, Michael Kazim, Jeffrey Odel
123 A-deno What's Going On!Christine Greer, Salina Teja, Jennifer Danesch, Anna Mathew, Vivek Patel, Kimberly Gokoffski
124 Just the Two of UsDan Milea, MD, PhD
125 Every Rose Has Its ThornWilliam J. Anderson, BS
126 Chalky Pallid EdemaDaniel Kornberg, David Pisapia, Cynthia Magro, Cristiano Oliveira, Marc Dinkin
127 The Great MasqueradeBart Chwalisz, Dean Cestari
128 A-deno What's Going On!Christine Greer, Salina Teja, Jennifer Danesch, Anna Mathew, Vivek Patel, Kimberly Gokoffski
129 Go With Your Gut FeelingPaul R. Freund, MD, MSc, FRCSC
130 Chalky Pallid EdemaDaniel Kornberg, David Pisapia, Cynthia Magro, Cristiano Oliveira, Marc Dinkin
131 A-deno What's Going On!Christine Greer, Salina Teja, Jennifer Danesch, Anna Mathew, Vivek Patel, Kimberly Gokoffski
132 Don't Drink the WaterDevon A. Cohen, MD
133 Unexplained Becomes ExplainedJinu Han, Hye Young Kim, Sueng-Han Han
134 Don't Drink the WaterDevon A. Cohen, MD
135 Not the Rolling StonesAri A. Shemesh, MD
136 Fooled ThriceJonathan A. Micieli, MD, CM
137 Just the Two of UsDan Milea, MD, PhD
138 Every Rose Has Its ThornWilliam J. Anderson, BS
139 At the CrossroadsKonstantinos Douglas, MD, DVM, MBA
140 Turbulence, Fluid Waves, and the Black HoleStella Y. Chung, MD, MS
141 At the CrossroadsKonstantinos Douglas, MD, DVM, MBA
142 Fooled ThriceJonathan A. Micieli, MD, CM
143 Just the Two of UsDan Milea, MD, PhD
144 Go With Your Gut FeelingPaul R. Freund, MD, MSc, FRCSC
145 Unexplained Becomes ExplainedJinu Han, Hye Young Kim, Sueng-Han Han
146 The Great MasqueradeBart Chwalisz, Dean Cestari
147 Chalky Pallid EdemaDaniel Kornberg, David Pisapia, Cynthia Magro, Cristiano Oliveira, Marc Dinkin
148 Tissue Is the IssueChristine Greer, Jasmine Francis, Eli Diamond, Charles Eberhart, Marc Dinkin
149 What Don't You See? - SlidesJames O'Brien, R. Michael Siatkowski
150 A Tough Nut to Crack! - SlidesLauren Maloley, Sachin Kedar, Deepta Ghate, Dominick DiMaio, Jason Helvey, Sachin Kedar
151 Lumps and Bumps - SlidesWayne Tie, Martha P. Schatz, MD
152 One Peak is Worth Twenty Finesses - SlidesSteven Newman, James MandellAn 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...
153 Gee...What's Causing that Pap? - SlidesSusan Mollan, Daniel White, Santhosh Nagaraju, Swarupsinh Chavda, Tom Hayton, Saiju Jacob
154 It's Always Been Like That - SlidesEric Gaier, William Butler, Joseph RizzoAn 18 year-old Caucasian boy presented with left upper eyelid ptosis, headaches, and iris heterochromia. The patient and his family reported the left iris being darker than the right since early childhood. Over the 5 years preceding his presentation, the patient's mother noted progressive ptosis of ...
155 Cold Fever - SlidesShannon BeresA 34-year old rock-climbing-mountain man woke with bilateral painless blurry vision along with alternating conjunctival erythema and eyelid edema. A headache began without associated migrainous features. Prior history revealed an untreated mysterious ‘new form of TB' followed by the CDC at age 2 d...
156 When the Problem Becomes the Solution - SlidesAri Shemesh, Timo Krings, Dalia Rotstein, David Munoz, Waleed Brinjikji, Laila Al Shafai, Edward Margolin25 year-old man noticed slow progressive decrease in vision in left eye. Vision was 20/20 OD and 20/40 OS, there was swelling of left optic nerve head. MRI demonstrated white matter lesions in left frontal lobe; cerebrospinal fluid composition was normal. Patient was seen in MS clinic and treatment ...
157 A Sad Story - SlidesJason Peragallo, MDA 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...
158 A Giant (Cell) Mistake - SlidesBehzad Mansouri, Paul Wawryko, Frank Bovell71-year-old, left-handed woman, who was referred with ptosis, loss of vision in the right eye and headache. In July 2015 she presented to ER with severe right temporal headache and watery right eye. Her exam and head CT was normal. Her ESR/CRP were elevated. She was allegedly diagnosed with GCA and ...
159 Testing the Hypophysis - SlidesAlberto Distefano, Julie Cho, Adeniyi Fisayo, Mahsa SohrabA 60 year-old female with history of hypertension, hyperlipidemia, and Lyme disease 12 years ago treated with doxycycline, developed extreme thirst and polyuria four years ago and was diagnosed with central diabetes insipidus. Magnetic resonance imaging (MRI) at that time showed enhancement of the p...
160 Coming to a Rapid Conclusion - SlidesLeanne Stunkel, Namita Sinha, Nathan Kung, Robi Maamari, Cole Ferguson, Sonika Dahiya, George Harocopos, Gregory Van StavernA 21-year-old man presented to a retina specialist for 2.5 weeks of painless central vision loss OD. His initial examination was notable for visual acuity 20/200 OD and 20/20 OS. Fundus examination was significant for several macular areas of retinal pigment epithelial (RPE) atrophy with associated ...
161 A Can of Worms - SlidesAli Hamedani, Madhura TamhankarA 67 year-old man presented to the ophthalmology clinic with one day of binocular horizontal diplopia. He also complained of one week of bilateral periorbital pain which was worse on the right than the left. Four days prior, he had undergone partial right nephrectomy for grade II papillary renal cel...
162 Whipping Up a New Flavor - SlidesMeagan Seay, Tory Johnson, Benjamin Larman, Avindra Nath, Myoung-Hwa Lee, Janet Rucker, Jonathan Howard, Ilya Kister, Matija Snuderl, Laura Balcer, Steven Galetta
163 Triple Take - SlidesJohanna Beebe, Liang Cheng, Shira Simon, Michael Wall, Randy Kardon, Alkapalan Deema, Ian Han, Matthew ThurtellA 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...
164 Light at the End of the Tunnel - SlidesNoel Chan, Tak Lap Poon, Joyce Chow, Wai Lun Poon, Sherman Lo, Wing Hung Lau, Ka Hong Au, Carmen ChanA 24-year-old Chinese man presented with 1-year history of progressive blurring of vision of the right eye. He had no significant past ocular nor medical history except moderate myopia and migraine. On ophthalmologic examination, his corrected visual acuity at distance was 20/100 OD and 20/30 OS. Is...
165 When the Problem Becomes the Solution - VideoAri Shemesh, Timo Krings, Dalia Rotstein, David Munoz, Waleed Brinjikji, Laila Al Shafai, Edward Margolin
166 When the Problem Becomes the Solution - AbstractAri Shemesh, Timo Krings, Dalia Rotstein, David Munoz, Waleed Brinjikji, Laila Al Shafai, Edward Margolin
167 A Tough Nut to Crack! - VideoLauren Maloley, Sachin Kedar, Deepta Ghate, Dominick DiMaio, Jason Helvey, Sachin Kedar
168 A Tough Nut to Crack! - AbstractLauren Maloley, Sachin Kedar, Deepta Ghate, Dominick DiMaio, Jason Helvey, Sachin Kedar
169 Lumps and Bumps - AbstractWayne Tie, Martha P. Schatz, MD
170 Lumps and Bumps - VideoWayne Tie, Martha P. Schatz, MD
171 Testing the Hypophysis - VideoAlberto Distefano, Julie Cho, Adeniyi Fisayo, Mahsa Sohrab
172 A Giant (Cell) Mistake - VideoBehzad Mansouri, Paul Wawryko, Frank Bovell
173 A Sad Story - VideoJason Peragallo, MD
174 A Giant (Cell) Mistake - AbstractBehzad Mansouri, Paul Wawryko, Frank Bovell
175 Testing the Hypophysis - AbstractAlberto Distefano, Julie Cho, Adeniyi Fisayo, Mahsa Sohrab
176 One Peak is Worth Twenty Finesses - AbstractSteven Newman, James Mandell
177 One Peak is Worth Twenty Finesses - VideoSteven Newman, James Mandell
178 Coming to a Rapid Conclusion - AbstractLeanne Stunkel, Namita Sinha, Nathan Kung, Robi Maamari, Cole Ferguson, Sonika Dahiya, George Harocopos, Gregory Van Stavern
179 Coming to a Rapid Conclusion - VideoLeanne Stunkel, Namita Sinha, Nathan Kung, Robi Maamari, Cole Ferguson, Sonika Dahiya, George Harocopos, Gregory Van Stavern
180 A Can of Worms - AbstractAli Hamedani, Madhura Tamhankar
181 A Can of Worms - VideoAli Hamedani, Madhura Tamhankar
182 A Sad Story - AbstractJason Peragallo, MD, Emory University, Atlanta, Georgia
183 It's Always Been Like That - AbstractEric Gaier, William Butler, Joseph Rizzo
184 It's Always Been Like That - VideoEric Gaier, William Butler, Joseph Rizzo
185 Gee...What's Causing that Pap? - AbstractSusan Mollan, Daniel White, Santhosh Nagaraju, Swarupsinh Chavda, Tom Hayton, Saiju Jacob
186 Gee...What's Causing that Pap? - VideoSusan Mollan, Daniel White, Santhosh Nagaraju, Swarupsinh Chavda, Tom Hayton, Saiju Jacob
187 Cold Fever - VideoShannon Beres
188 Cold Fever - AbstractShannon Beres
189 Whipping Up a New Flavor - AbstractMeagan Seay, Tory Johnson, Benjamin Larman, Avindra Nath, Myoung-Hwa Lee, Janet Rucker, Jonathan Howard, Ilya Kister, Matija Snuderl, Laura Balcer, Steven Galetta
190 Whipping Up a New Flavor - VideoMeagan Seay, Tory Johnson, Benjamin Larman, Avindra Nath, Myoung-Hwa Lee, Janet Rucker, Jonathan Howard, Ilya Kister, Matija Snuderl, Laura Balcer, Steven Galetta
191 Triple Take - AbstractJohanna Beebe, Liang Cheng, Shira Simon, Michael Wall, Randy Kardon, Alkapalan Deema, Ian Han, Matthew Thurtell
192 Triple Take - VideoJohanna Beebe, Liang Cheng, Shira Simon, Michael Wall, Randy Kardon, Alkapalan Deema, Ian Han, Matthew Thurtell
193 Light at the End of the Tunnel - AbstractNoel Chan, Tak Lap Poon, Joyce Chow, Wai Lun Poon, Sherman Lo, Wing Hung Lau, Ka Hong Au, Carmen Chan
194 Light at the End of the Tunnel - VideoNoel Chan, Tak Lap Poon, Joyce Chow, Wai Lun Poon, Sherman Lo, Wing Hung Lau, Ka Hong Au, Carmen Chan
195 What Don't You See? - AbstractJames O'Brien, R. Michael Siatkowski
196 What Don't You See? - VideoJames O'Brien, MD, R. Michael Siatkowski, MD, Bradley K. Farris, MD
197 Uncertainty with a Twist of Lyme (slideshow)Amrita-Amanda Lakraj, Sang Hong, Jennifer Connelly, Elizabeth CochranThe patient is a 59-year-old woman who presented with vision loss. Her ophthalmologic history is significant for; myopic astigmatism and presbyopia. Her past medical history is notable for left breast cancer (T2N0 invasive lobular carcinoma, ER/PR positive, HER2/neu negative) s/p left mastectomy, ch...
198 Uncertainty with a Twist of Lyme (abstract)Amrita-Amanda Lakraj, Sang Hong, Jennifer Connelly, Elizabeth CochranThe patient is a 59-year-old woman who presented with vision loss. Her ophthalmologic history is significant for; myopic astigmatism and presbyopia. Her past medical history is notable for left breast cancer (T2N0 invasive lobular carcinoma, ER/PR positive, HER2/neu negative) s/p left mastectomy, ch...
199 Uncertainty with a Twist of Lyme (video)Amrita-Amanda Lakraj, Sang Hong, Jennifer Connelly, Elizabeth CochranThe patient is a 59-year-old woman who presented with vision loss. Her ophthalmologic history is significant for; myopic astigmatism and presbyopia. Her past medical history is notable for left breast cancer (T2N0 invasive lobular carcinoma, ER/PR positive, HER2/neu negative) s/p left mastectomy, ch...
200 Alcohol is Never the Answer, but it Does Make You Forget the Question (video)Ali Saber Tehrani, Diana Londono, Thomas Rashid, Manuel Doria, Julia Biernot, Jorge KattahA 63-year old male with a history of alcohol abuse presented with two weeks of confusion and imbalance. On exam, he had left beating nystagmus on left gaze, and right beating and torsional nystagmus on right gaze. Head impulse test was abnormal in all canals bilaterally with video head impulse test ...
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