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226 Isolated congenital optic disc anomaliesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis optic disc displays multiple drusen. Note the pseudopapilledema here. One can differentiate this from true papilledema in that there is no obscuration of the vessel by the peripapillary nerve fiber layer as they cross the disc margin. This photograph was taken with barrier filters in place, but...
227 Optic disc drusen with autofluorescenceAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis photograph of optic disc drusen demonstrates autoflourescence with flourescein barrier filters in place.
228 Optic disc drusen visual fieldsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis is the visual field of patient with optic nerve drusen. Whereas they typically do not cause central field loss, optic disc drusen may cause nerve fiber bundle layer defects and, thus, peripheral field defects, including altitudinal defects (seen inferiorly in the left eye) or arcuate defects (s...
229 Isolated congenital optic disc anomaliesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyAn optic pit is a small defect in the optic disc that may be asymptomatic in isolation. Patients may develop an associated serous detachment of the macula. The condition is usually unilateral but may be bilateral. A fluorescein angiogram may demonstrate the serous detachment, and laser photocoagulat...
230 Isolated congenital optic disc anomaliesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyAn optic pit is a small defect in the optic disc that may be asymptomatic in isolation. The pit can be small or large, and central or peripheral.
231 Isolated congenital optic disc anomaliesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyPatients with hypoplasia of the optic nerve may have normal or subnormal visual acuity or visual field. The condition may be unilateral or bilateral. Optic nerve hypoplasia is usually idiopathic, but maternal diabetes, or maternal use of anti-epileptic drugs or alcohol are predisposing factors. Opti...
232 Peripapillary staphylomaAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyPatients with ectasia of the outer layers of the eye may exhibit a posterior protrusion that appears on funduscopy as an area of deep excavation of the retina (posterior staphyloma). When it occurs around the optic disc, as in this case, it is termed a peripapillary staphyloma. This may occur in ass...
233 Motility DisturbancesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe patient is a 53-year-old man with diplopia from right oculomotor nerve palsy and left hemiparesis (Weber's syndrome), with associated left lung hilar mass. The spinal tap showed pleocytosis consistent with carcinomatous meningitis. This image demonstrates oculomotor nerve metastatic carcinomatos...
234 Isolated congenital optic disc anomaliesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyBenign tumors of blood vessels (hemangiomas) may occur on the optic nerve and may mimic optic disc edema.
235 Isolated congenital optic disc anomaliesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyOptociliary shunt vessels are venous collaterals that form in response to chronic venous obstruction, shunting the venous blood from the retinal circulation into the choroidal circulation. Although they may be congenital, they may occur in patients with chronic disc edema, following central retinal ...
236 Retinal coloboma underneath a relatively normal optic nerveAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyOptic nerve colobomas appear as enlarged, white optic discs that are deeply excavated, often with some sapring of the superior rim. They result from an abnormal fusion of the proximal embryonic fissure. Optic nerve colobomas occur unilaterally or bilaterally with a similar frequency and can result i...
237 Isolated Optic Neuritis/NeuropathyAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyPapilledema is a term reserved for optic disc edema related to increased intracranial pressure (eg. Papilledema, sixth nerve palsy, headache), a normal neuroimaging study, and an elevated opening pressure with normal cerebrospinal fluid contents.
238 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 1-year-old child with familial erythrophagocytic lymphohistiocytosis was readmitted with a fever and was noted to have bilateral blindness. The spinal tap showed a protein of 148, with 178 WBC with 98% ""lymphocytes."" This MRI image demonstrates the optic nerve infiltration. He was treated wit...
239 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 1-year-old child with familial erythrophagocytic lymphohistiocytosis was readmitted with a fever and was noted to have bilateral blindness. The spinal tap showed a protein of 148, with 178 WBC with 98% ""lymphocytes."" This MRI image demonstrates the optic nerve infiltration. He was treated wit...
240 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 1-year-old child with familial erythrophagocytic lymphohistiocytosis was readmitted with a fever and was noted to have bilateral blindness. The spinal tap showed a protein of 148, with 178 WBC with 98% ""lymphocytes."" This MRI image demonstrates the optic nerve infiltration. He was treated wit...
241 Ocular Manifestations of Systemic DisordersAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe same young woman from Case 77 (Image 92_57) presented 8 years after the orbital biopsy with this retinal lesion, presumably from her underlying disorder. The eye has 20/20 vision and no other disturbances. This is a fundus photo.
242 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyA patient with small-cell lung carcinoma that was metastatic to the optic nerves, ciliary body, and brain. This is a fundus photo.
243 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 48-year-old female was seen in May 1996 with a history of 2 months of diplopia from a right abducens palsy. This was due to the recurrence of myeloma that had initially been diagnosed and treated with radiation and chemotherapy 9 years before and required further therapy, including bone marrow ...
244 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 48-year-old female was seen in May 1996 with a history of 2 months of diplopia from a right abducens palsy. This was due to the recurrence of myeloma that had initially been diagnosed and treated with radiation and chemotherapy 9 years before and required further therapy, including bone marrow ...
245 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 48-year-old female was seen in May 1996 with a history of 2 months of diplopia from a right abducens palsy. This was due to the recurrence of myeloma that had initially been diagnosed and treated with radiation and chemotherapy 9 years before and required further therapy, including bone marrow ...
246 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 48-year-old female was seen in May 1996 with a history of 2 months of diplopia from a right abducens palsy. This was due to the recurrence of myeloma that had initially been diagnosed and treated with radiation and chemotherapy 9 years before and required further therapy, including bone marrow ...
247 Ocular Manifestations of Systemic DisordersAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyA 17-year-old girl had undergone multiple superficial biopsies of the orbit for what was felt to be refractory orbital pseudotumor. Initial evaluation revealed the saddle-nose deformity, which the patient confirmed was acquired. More extensive biopsy was consistent with lymphomatoid granulomatosis. ...
248 Systemic Disorders With Optic Nerve and Retinal FindingsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 8-year-old girl had a history of acute lymphoblastic leukemia with neurologic involvement, with remission induced with radiation and chemotherapy. Her relapse showed as an isolated optic neuropathy with this fundus appearance. The other eye was normal. The MRI and spinal tap at this point were ...
249 Isolated Optic Neuritis/NeuropathyAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 48-year-old man presented with a 1-month history of headache. Both discs had the appearance seen in this image, with prominent peripapillary nerve fiber layer myelination; the disc itself is hyperemic, with dilated, telangiectatic surface vasculature, suggesting true disc edema as well.
250 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
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