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26 Chiasmal SyndromesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyA 52-year-old, morbidly obese man with a past medical history that included ischemic cardiac disease with a history of angioplasty, COPD, hypertension, and NIDDM, presented with a severe headache. The next day he had a frozen OD, complete right ptosis, and an unreactive middilated right pupil with V...
27 Chiasmal SyndromesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyA 52-year-old, morbidly obese man with a past medical history that included ischemic cardiac disease with a history of angioplasty, COPD, hypertension, and NIDDM, presented with a severe headache. The next day he had a frozen OD, complete right ptosis, and an unreactive middilated right pupil with V...
28 Optic NeuropathiesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyOptic disc edema with a macular star figure has been referred to as neuroretinitis.
29 Optic NeuropathiesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyOptic disc edema with a macular star figure may occur in infectious diseases (eg, cat-scratch disease, syphilis, tuberculosis, Lyme disease), inflammatory diseases (eg, sarcoid), ischemic diseases (anterior ischemic optic neuropathy), and in papilledema. Infectious causes should be sought in patient...
30 Ocular Manifestations of Systemic DisordersAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThyroid eye disease is the most common cause of unilateral or bilateral proptosis in the adult patient. Other signs of thyroid eye disease should be sought, including lid retraction, inferior scleral show, and lid lag. Patients with markedly asymmetric or strictly unilateral proptosis should probabl...
31 Ocular Manifestations of Systemic DisordersAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThyroid eye disease is the most common cause of unilateral or bilateral proptosis in the adult patient. Other signs of thyroid eye disease should be sought, including lid retraction, inferior scleral show, and lid lag. Patients with markedly asymmetric or strictly unilateral proptosis should probabl...
32 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyCarotid cavernous fistulas (CCFs) are connections between the arterial blood flow from the carotid artery system and the cavernous sinus. CCFs may be direct high-flow fistulas or indirect low-flow fistulas. Most direct CCFs are due to trauma. Enlargement of the superior ophthalmic vein may be demons...
33 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyCarotid cavernous fistulas (CCFs) are connections between the arterial blood flow from the carotid artery system and the cavernous sinus. CCFs may be direct high-flow fistulas or indirect low-flow fistulas. Most direct CCFs are due to trauma. Enlargement of the superior ophthalmic vein may be demons...
34 Isolated Optic Neuritis/NeuropathyAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 36-year-old man noticed blurry vision in his right eye when attempting to sight a gun. He also reported bifrontal headaches responsive to aspirin. Acuity was 20/50 OD, 20/13 OS. His right eye could be refracted to 20/20 with a +2.50 sphere. A 0.3 right relative afferent pupillary defect was pre...
35 Chiasmal SyndromesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe patient is a 60-year-old woman with a chief complaint of decreased vision. In 1986 she was diagnosed with a poorly differentiated breast cancer in her left breast. She underwent mastectomy, and all nodes were negative. She did well until 1991, when she was found to have a chest wall mass. This m...
36 Chiasmal SyndromesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe patient is a 60-year-old woman with a chief complaint of decreased vision. In 1986 she was diagnosed with a poorly differentiated breast cancer in her left breast. She underwent mastectomy, and all nodes were negative. She did well until 1991, when she was found to have a chest wall mass. This m...
37 Chiasmal SyndromesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe patient is a 60-year-old woman with a chief complaint of decreased vision. In 1986 she was diagnosed with a poorly differentiated breast cancer in her left breast. She underwent mastectomy, and all nodes were negative. She did well until 1991, when she was found to have a chest wall mass. This m...
38 Chiasmal SyndromesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe patient is a 60-year-old woman with a chief complaint of decreased vision. In 1986 she was diagnosed with a poorly differentiated breast cancer in her left breast. She underwent mastectomy, and all nodes were negative. She did well until 1991, when she was found to have a chest wall mass. This m...
39 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyImage 93_28 shows the fundus before the attack.
40 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyIn image 93_29, taken during the episode, note the change in caliber of the blood vessels.
41 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyImage 93_30 is immediately after the attack, note the slight redness to the macula.
42 Migraine SyndromeAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe image shows a patient with cluster headache and eye displaying Horner's syndrome.
43 Neuro-Ophthalmic Imaging-MRIAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyAxial view of Arnold-Chiari malformation on a patient with downbeat nystagmus. Note the presence of the cerebellar tonsils posterior to the caudal medulla. In addition to downbeat nystagmus, Arnold-Chiari malformations can sometimes lead to increased intracranial pressure and papilledema.
44 Neuro-Ophthalmic Imaging-MRIAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietySagittal view of Arnold-Chiari malformation on a patient with downbeat nystagmus. The compression of the cervicomedullary junction is clearly depicted in the sagittal view.
45 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyOcclusion of a branch or central retinal artery may result in acute visual loss. The ophthalmoscopic findings are retinal whitening due to ischemic retina in the distribution of the occluded artery. Sparing or selective involvement of cilioretinal artery branches may occur. Patients with a central r...
46 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyOcclusion of a branch or central retinal artery may result in acute visual loss. The ophthalmoscopic findings are retinal whitening due to ischemic retina in the distribution of the occluded artery. Sparing or selective involvement of cilioretinal artery branches may occur. Patients with a central r...
47 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyOcclusion of a branch or central retinal artery may result in acute visual loss. The ophthalmoscopic findings are retinal whitening due to ischemic retina in the distribution of the occluded artery. Sparing or selective involvement of cilioretinal artery branches may occur. Patients with a central r...
48 Neuro-Ophthalmic Vascular DiseaseAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyOcclusion of a branch or central retinal artery may result in acute visual loss. The ophthalmoscopic findings are retinal whitening due to ischemic retina in the distribution of the occluded artery. Sparing or selective involvement of cilioretinal artery branches may occur. Patients with a central r...
49 Neuro-Ophthalmic Imaging-MRIAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyA 59-year-old untreated hypertensive man had a sudden onset of vomiting, gait ataxia, dysarthria, and left-sided weakness. The eyes were deviated downward and to the left. (Note position of gaze in 94_11). Extraocular motility was full. There was rotary nystagmus with the fast phase to the left; the...
50 Neuro-Ophthalmic Imaging-MRIAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 23-year-old right-handed man had a history of idiopathic recurrent optic neuritis. The patient presented with acuity of 20/400 OD and 20/100 OS, with a central scotoma OD and a complete temporal defect OS. MRI with fat suppression and gadolinium revealed enhancement of the intracranial nerve an...
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