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76 Isolated Congenital Optic Disc AnomaliesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis patient demonstrates bilateral tilted optic discs. Patients with this congenital optic disc anomaly may be asymptomatic or have bitemporal visual field defects that do not respect the vertical midline. Disease/Diagnosis: Tilted Discs.
77 Isolated Congenital Optic Disc AnomaliesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis patient demonstrates bilateral tilted optic discs. Patients with this congenital optic disc anomaly may be asymptomatic or have bitemporal visual field defects that do not respect the vertical midline. Disease/Diagnosis: Tilted Discs.
78 Ocular Manifestations of Congenital/Inherited DiseasesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis girl was 8 years old when these photographs were taken. She had been referred by pediatric neurology with ataxia. When seen, the findings of ataxia, poor convergence, early head thrusting maneuvers, and relatively preserved motility, in conjunction with the conjunctival findings as seen in the ...
79 Ocular Manifestations of Congenital/Inherited DiseasesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis girl was 8 years old when these photographs were taken. She had been referred by pediatric neurology with ataxia. When seen, the findings of ataxia, poor convergence, early head thrusting maneuvers, and relatively preserved motility, in conjunction with the conjunctival findings as seen in the ...
80 Ocular Manifestations of Congenital/Inherited DiseasesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 22-year-old woman has neurofibromatosis, type 2. Acuity, color plates, pupillary responses, slit-lamp examination, IOP, fields, and funduscopy are all normal. There is a 3 mm proptosis OS. The patient has recently undergone gamma knife for the acoustic tumor, and she has residual facial nerve p...
81 Ocular Manifestations of Congenital/Inherited DiseasesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyNeurofibromatosis, type 1, is an autosomal dominant phakomatosis characterized by Lisch nodules of the iris (hamartomas) plexiform neurofibromas, café-au-lait spots on the skin, and axillary freckling. Intracranial tumors such as optic pathway gliomas may occur. Disease/Diagnosis: Neurofibromatosis...
82 Ocular Manifestations of Congenital/Inherited DiseasesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyOn optic nerve CT scan, this patient with neurofibromatosis, type 1, shows the classic railroad-track sign of optic nerve meningioma and the kink sign of optic nerve glioma. Disease/Diagnosis: Neurofibromatosis, Type 1.
83 Ocular Manifestations of Congenital/Inherited DiseasesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 22-year-old woman has neurofibromatosis, type 2. Acuity, color plates, pupillary responses, slit-lamp examination, IOP, fields, and funduscopy are all normal. There is a 3 mm proptosis OS. The patient has recently undergone gamma knife for the acoustic tumor, and she has residual facial nerve p...
84 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...
85 Isolated Congenital Optic Disc AnomaliesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyNormally, there is no visible myelination of the nerve fiber layer in the retina. Occasionally, visible myelination occurs that takes on a characteristic white, arcuate, feathery appearance that follows the contour of the nerve fiber layer. Disease/Diagnosis: Myelinated Nerve Fiber.
86 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. Disease/Diagnosis: Optic Nerve Hemangioma.
87 Motility DisturbancesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe trochlear nerve (fourth nerve) runs from the midbrain, exits dorsally, crosses in the anterior medullary velum, enters the subarachnoid space, travels within the lateral wall of the cavernous sinus, and enters the orbit through the superior orbital fissure. A trochlear nerve palsy may be due to ...
88 Motility DisturbancesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe trochlear nerve (fourth nerve) runs from the midbrain, exits dorsally, crosses in the anterior medullary velum, enters the subarachnoid space, travels within the lateral wall of the cavernous sinus, and enters the orbit through the superior orbital fissure. A trochlear nerve palsy may be due to ...
89 Neuro-Ophthalmic Imaging-CT ScanAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis is a patient with trauma leading to enucleation, with swelling years later over the implant. This is a presumed chronic abscess between orbit and dura.
90 Neuro-Ophthalmic Imaging-CT ScanAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyIdiopathic orbital pseudotumor is an inflammatory disorder that may effect any part of the ocular anatomy. The site of inflammation determines the nomenclature. For example, involvement of the sclera is referred to as scleritis. And involvement of one or more of the extraocular muscles is referred t...
91 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...
92 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...
93 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...
94 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...
95 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...
96 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...
97 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...
98 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...
99 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.
100 Ocular Manifestations of Congenital/Inherited DiseasesAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyPatients with olivopontocerebellar atrophy may exhibit signs of ocular motor deficits, such as ocular motor apraxia or cerebellar eye signs, and peripheral pigmentary retinopathy and optic atrophy. Pair with 94_55.
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