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51 Paraneoplastic Upbeat NystagmusThis case was presented to the Clinical Eye Movement Society at the American Neurological Association Meeting in October 2009. The patient is a 65 year old woman who was in good health until seven weeks prior to admission. On June 22/09 on the return flight from her daughter's wedding in Oregon she ...Image/MovingImage
52 Paroxysmal Skew DeviationIn 1970 I saw this unique case with Dr. Cogan. The patient is a 60 year old hypertensive woman with a ten year history of intermittent vertical double vision and oscillopsia. Neurological examination between attacks of diplopia showed: Visual acuity 20/25 OU Visual fields, pupils and fundus exami...Image/MovingImage
53 Pendular Vertical OscillationsThis 60 year old patient presented in 1979 for evaluation of blurred vision watching television and a sense of unsteadiness when walking down stairs. Past History: Hypertension for years A "small stroke" 3 months prior to this evaluation, presenting acutely with dizziness and vertical double vision....Image/MovingImage
54 Titubation OpsoclonusThis 52 year old woman presented with unsteady gait. She was admitted to an outside hospital where a diagnosis was made. 1. Paraneoplastic opsoclonus 2. Paraneoplastic cerebellar syndrome with bilateral limb and gait ataxia and titubation 3. Adenocarcinoma of the breast She was transferred to the M...Image/MovingImage
55 Unilateral Horizontal Gaze PalsyThe patient is a 62 year old woman with known hypertension. She was referred by her PCP because she could not move her eyes fully and look left. Neuro-ophthalmological examination: Visual acuity, fields, pupils and fundi normal Ocular Motility: • Slight head turn to the left • Conjugate dev...Image/MovingImage
56 Information Processing in the Visual System: David H. Hubel, Nobel Laureate Physiology or Medicine 1981David H. Hubel is the John Enders University Professor of Neurobiology at Harvard Medical School. Born in Canada of American parents, he grew up in Montreal, graduated from McGill Medical School, and received training in neurology at the Montreal Neurological Institute and Johns Hopkins Hospital. ...Image/MovingImage
57 Release HallucinationsThe patient is a 79 year old woman with a chief complaint of visual hallucinations. She carries a diagnosis of glaucoma and cataracts. The patient was in good health until two weeks prior to admission when she noted a black cloud in her visual field in the top central area. The cloud gradually c...Image/MovingImage
58 Lid LagThe classical eye signs of thyroid associated ophthalmopathy (TAO) of Graves' Disease is illustrated by case ID925-4. This 50 year old woman with TAO is included in the collection because she illustrates very well lid lag (persistent elevation of the upper eyelid in downgaze) - von Graefe sign E...Image/MovingImage
59 Bilateral PtosisPatient is a 65 year old woman who presented with acute onset of bilateral ptosis. She awoke one day and found her eyelids half shut and she was unable to see. The lids completely shut and she came to the Massachusetts General Hospital Emergency Room and was admitted. Past History: Negative for pt...Image/MovingImage
60 Retinal EmboliTemporary loss of vision in one eye, termed transient monocular blindness (TMB), is the most important visual symptom of arteriosclerotic vascular disease, arteritis and states of altered coagulability and thrombocytosis. In most patients, the visual disturbance during each individual attack of ...Image/MovingImage
61 Ocular Motor ApraxiaThis elderly patient was referred to the Movement Disorder Clinic for evaluation of abnormal head thrust movements when asked to look on command to the right or to the left. His random eye movements were full vertically and horizontally. Diagnosis: Acquired Ocular Motor Apraxia ...Image/MovingImage
62 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
63 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
64 Alexia Without AgraphiaThe patient is a 69 year old left handed man with a history of hypertension, insulin dependent diabetes mellitus and atrial fibrillation. Treated with coumadin, adjusted to keep the INR between 2 and 3. On the morning of admission he awoke at 4 a.m., sat momentarily on the side of the bed and then...Image/MovingImage
65 Visual NeglectThe patient following infarction of the non-dominant right parietal lobe has visual hemi-neglect on the left. Review: (ref 2) Patient's with hemi-neglect ignore or fail to attend to stimuli on the side of space contralateral to their lesion. Neglect can be multimodal in that all stimuli whether audi...Image/MovingImage
66 Congenital Nystagmus: Blurred visionThis 34 year old physician has had a life long problem with congenital nystagmus. He was an orphan and his adopted parents took him to see a pediatrician when he was very small. A missed diagnosis of a "lazy eye" was made. Subsequently, at the age of 9, when he complained of intermittent blurred ...Image/MovingImage
67 Upbeat NystagmusThe patient is a 56 year old woman who presented in 1982, at the age of 48, with a one week history of painless loss of vision in the left eye. Past History: Negative for a previous attack of optic neuritis or transient neurological symptoms. Family History: Negative for CNS disease Neuro-ophth...Image/MovingImage
68 Upbeat NystagmusThe patient is a 36 year old Korean doctor who arrived from Korea in November 1994. On 12/25/94 she developed a painful erythematous eruption along her upper back extending toward her right shoulder. A physician diagnosed herpes zoster and prescribed a five day course of Acyclovir with good resolut...Image/MovingImage
69 Upbeat NystagmusThe patient is a 50 year old woman who presented in November 1977 with a transient facial droop, nystagmus, diplopia, dysarthria and vertigo. She was admitted to New England Tufts Medical Center and had an extensive workup including an electroencephalogram, first generation CT brain scan, angiogram ...Image/MovingImage
70 Upbeat NystagmusThe patient, a 36 year old Italian, presented in October 1967, at the age of 27, with acute dizziness and ataxia. He was evaluated in Rome. A pneumoencephalogram showed hydrocephalus, attributed to arachnoiditis, and a ventriculo-atrial shunt was placed. Three months post shunt placement he ...Image/MovingImage
71 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
72 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
73 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
74 Congenital NystagmusThis young boy has oculocutaneous albinism. In 1979 he presented for evaluation of oscillations of his eyes present since birth. He had no head turn or head tremor. Diagnosis: Albinism Congenital sensory nystagmus Ocular Albinism: Infants with albinism of all types are typically slow to see, ofte...Image/MovingImage
75 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
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