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TitleHistoryType
1 Apraxia Eyelid OpeningThis patient first presented to his PCP with increasing immobility. A diagnosis of Parkinson's disease was made. When his condition progressed, he was referred to the Neurology Clinic. Neuro-ophthalmological examination showed: Apraxia of eyelid opening Impaired initiation of horizontal saccades ...Image/MovingImage
2 Benign Essential BlepharospasmPatient is a 55 year old woman functionally blind from severe benign essential blepharospasm. She presented with frequent blinking.continuous spasms of eye closure and great difficulty opening her eyes i.e. blepharospasm associated "apraxia of eyelid opening". Symptomatic Inquiry negative for...Image/MovingImage
3 Bilateral Internuclear OphthalmoplegiaThe patient is a 25 year old woman who was in excellent health until 4 days prior to admission when she noted blurred vision and horizontal double vision on lateral gaze to right and left. Past History: Negative for strabismus as a child. No previous episodes of transient neurological symptoms. Fa...Image/MovingImage
4 Bilateral Internuclear OphthalmoplegiaThis case was reported by Cogan DG and Wray SH. Internuclear ophthalmoplegia as an early sign of brain tumor. Neurology 1970; 20:629-633. The patient is Case 1. He is a 4 ½ year old boy whose parents noted that the right eye had been "drifting" for four months. On examination the only signific...Image/MovingImage
5 Bilateral Internuclear Ophthalmoplegia (INO)The patient is a 48 year old woman who presented with horizontal double vision looking to the right and to the left. She also noted blurring of vision with the image jerking horizontally back and forth. Neuro-ophthalmological examination: Visual acuity 20/20 OU corrected Visual fields, pupils, and f...Image/MovingImage
6 Bilateral PtosisThe patient is a 65 year old physician who presented with intermittent drooping of his eyelids, particularly at the end of the day. He found that if he gently closed his eyes when he came to a stop in his car at a set of traffic lights, his eyelids opened more fully. He subsequently developed inte...Image/MovingImage
7 Bilateral Sixth Nerve PalsyThis patient was known to be a chronic alcoholic. He presented with acute onset of unsteadiness walking which he attributed to double vision. He was unable to give an accurate history and was disoriented for time and place. Neurological examination: Significant for impaired memory and cognitive ...Image/MovingImage
8 Congenital Horizontal Gaze PalsyThe patient is an 8 year old boy with a rare autosomal recessive disorder characterized by congenital absence of conjugate horizontal eye movements preservation of vertical gaze and convergence and progressive scoliosis (HGPPS) developing in childhood. The child was referred to Dr. Cogan with a ...Image/MovingImage
9 Congenital Nystagmus - Latent NystagmusThis boy was not recognized to have nystagmus until he accidentally discovered that he had blurred vision in one eye while pulling a sweater off over his head and blocking the vision of one eye. An ophthalmologist saw him and diagnosed latent nystagmus. He had no strabismus or any other ophthalmol...Image/MovingImage
10 Congenital Nystagmus: Oscillations of the EyesThis child has had nystagmus since childhood with a head turn to the left. He was seen by his pediatrician. Diagnosis: Horizontal jerk nystagmus (congenital motor nystagmus) Congenital nystagmus Classification: The Classification of Eye Movement Abnormalities and Strabismus Working Group has recomme...Image/MovingImage
11 Congenital Nystagmus: Oscillations of the Eyes-2This child was noted to have oscillations of the eyes in infancy and was given a diagnosis of congenital nystagmus.Image/MovingImage
12 Congenital Nystagmus; Latent NystagmusThis little girl has had nystagmus since birth. She has the classical constellation of signs, initially diagnosed as congenital motor nystagmus with: • Horizontal jerk nystagmus • A slight head turn to the right to place the eyes in the null position • Latent nystagmus • Inability to superi...Image/MovingImage
13 Congenital Ocular Motor ApraxiaThis little boy was born at term after a normal pregnancy. There was no family history of a neurological or ophthalmological disease. His mother noted from birth that he turned his head instead of his eyes and frequently tried to fix objects on either side by making a quick turn of the head past...Image/MovingImage
14 Congenital Ocular Motor ApraxiaThis 3 year old boy was referred for evaluation of inattention. He was born at term after a normal pregnancy. He had been noted, in early childhood, to have difficulty looking to the right and to the left and was slow to read.Image/MovingImage
15 Congenital Ocular Motor ApraxiaThis baby was born at term after an uneventful pregnancy and normal delivery. He was the first and only child. There was no family history of any This baby was born at term after an uneventful pregnancy and normal delivery. He was the first and only child. There was no family history of any neurol...Image/MovingImage
16 Downbeat NystagmusThis patient carries a diagnosis of Type I Chiari malformation. Neurological symptoms of a Chiari malformation may not develop until adolescence or adult life as in this man. The symptoms may be those of: 1. Increased intracranial pressure, mainly headache 2. Progressive cerebellar ataxia 3. Progre...Image/MovingImage
17 Downbeat NystagmusThe patient is a 72 year old man who was found down and admitted as an emergency in coma. Neurological examination: Patient in coma failed to respond to painful stimuli. Downbeat nystagmus Lid nystagmus Pupils 2 mm OU responsive to light Corneal reflexes absent Oculocephalic reflex absent No resp...Image/MovingImage
18 Downbeat Nystagmus - Periodic Alternating NystagmusThis patient carries a diagnosis of multiple sclerosis.Image/MovingImage
19 Familial NystagmusThe mother and her infant son both have conjugate horizontal pendular nysagmus. Diagnosis: Congenital sensory nystagmus Familial Infantile Nystagmus Syndrome (INS) The little boy is a bright active child with normal development. He has pendular nystagmus in central gaze without a head turn or h...Image/MovingImage
20 Fascicular Third Nerve PalsyThe patient is a 76 year old woman who woke one morning unable to see out of her right eye because of ptosis. She came to the Massachusetts General Hospital emergency room and was admitted. Neurological Examination: Right third nerve palsy involving the pupil Ataxia of the left hand on finger-nose t...Image/MovingImage
21 Fisher's One and a Half SyndromeThis 28 year old woman had severe multiple sclerosis with a spastic paraparesis due to a lesion of the spinal cord. She was admitted to the Intensive Care Unit complaining of dizziness and double vision. Neuro-ophthalmologic examination: Visual acuity 20/30 OU Pupils, visual fields and fundi normal ...Image/MovingImage
22 Fisher's One and a Half SyndromeThis young patient presented with double vision and was found to have on examination the classical findings of Fisher's one-and-a-half syndrome which are: • Right internuclear ophthalmoplegia on gaze left with adduction weakness OD • Right horizontal gaze paresis with gaze evoked nystagmus • F...Image/MovingImage
23 Hemifacial Spasm: Eyelid TwitchingThis patient is an atypical case of hemifacial spasm because he is a young college student only 29 years of age. Hemifacial spasm usually develops in the fifth and sixth decade of life and affects women more than men. It often begins insidiously in the orbicularis oculi muscle in the early stage...Image/MovingImage
24 Jaw WinkingThis little boy was born with congenital ptosis of the left eyelid, which "flicked up and down" when his jaw moved. The pediatrician made a diagnosis of the Marcus-Gunn jaw winking phenomenon was made. The first case of this unusual synkinesis between the pterygoid muscles and the levator musc...Image/MovingImage
25 Latent NystagmusThis is one of the first cases of latent nystagmus that I saw with Dr. Cogan in the 1970's. The presence of latent nystagmus was unknown to this patient, a little girl who was found to have latent nystagmus by the ophthalmologist at school trying to test the vision of each eye separately. When she...Image/MovingImage
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