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76 Chiasmal SyndromesMitchell J. Wolin, MDThe 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...
77 Chiasmal SyndromesMitchell J. Wolin, MDThe 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...
78 Chiasmal SyndromesMitchell J. Wolin, MDThe 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...
79 Chiasmal SyndromesMitchell J. Wolin, MDThe 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...
80 Motility DisturbancesLarry P. Frohman, MDThis 5-year-old child presented with a 70 PD exotropia OS and a right face turn. She had a CT scan of the head at age 4 months that was normal , and she was felt to have an isolated left medial rectus paresis. Her acuity was 20/20 OU. She could fuse with a large face turn, and was orthomorphic is ex...
81 Motility DisturbancesLarry P. Frohman, MDThis 5-year-old child presented with a 70 PD exotropia OS and a right face turn. She had a CT scan of the head at age 4 months that was normal , and she was felt to have an isolated left medial rectus paresis. Her acuity was 20/20 OU. She could fuse with a large face turn, and was orthomorphic is ex...
82 Motility DisturbancesLarry P. Frohman, MDThis 5-year-old child presented with a 70 PD exotropia OS and a right face turn. She had a CT scan of the head at age 4 months that was normal , and she was felt to have an isolated left medial rectus paresis. Her acuity was 20/20 OU. She could fuse with a large face turn, and was orthomorphic is ex...
83 Motility DisturbancesLarry P. Frohman, MDThis 5-year-old child presented with a 70 PD exotropia OS and a right face turn. She had a CT scan of the head at age 4 months that was normal , and she was felt to have an isolated left medial rectus paresis. Her acuity was 20/20 OU. She could fuse with a large face turn, and was orthomorphic is ex...
84 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDA 25-year-old African-American woman presented with a 20/200 optic neuropathology and no other illness. Because this disc appearance of a granuloma led us to suspect occult sarcoidosis, she underwent systemic evaluation. She was ultimately shown to have systemic sarcoidosis, including pulmonary invo...
85 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDA 29-year-old African American woman presented with headaches, bilateral transient visual obscurations, blurred vision, numbness, and weakness of the lower extremities with myalgia and joint pains. She had an unplanned 12-pound weight loss over 2 months. A neurologist and internist diagnosed her wit...
86 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDA 29-year-old African American woman presented with headaches, bilateral transient visual obscurations, blurred vision, numbness, and weakness of the lower extremities with myalgia and joint pains. She had an unplanned 12-pound weight loss over 2 months. A neurologist and internist diagnosed her wit...
87 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDA 29-year-old African American woman presented with headaches, bilateral transient visual obscurations, blurred vision, numbness, and weakness of the lower extremities with myalgia and joint pains. She had an unplanned 12-pound weight loss over 2 months. A neurologist and internist diagnosed her wit...
88 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDA 35-year-old African-American woman had gradual bilateral painless visual loss over 3 months. When initially seen, the visual acuities were HM OD, NLP OS. The MRI showed diffused enhancement of the optic nerves and lacrimal glands. The evaluation strongly suggested sarcoidosis, with elevated angiot...
89 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDA 35-year-old African-American woman had gradual bilateral painless visual loss over 3 months. When initially seen, the visual acuities were HM OD, NLP OS. The MRI showed diffused enhancement of the optic nerves and lacrimal glands. The evaluation strongly suggested sarcoidosis, with elevated angiot...
90 Ocular Manifestations of Systemic DisordersLarry P. Frohman, MDA 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. ...
91 Isolated Congenital Optic Disc AnomaliesAnthony C. Arnold, MDThis image shows drusen that are especially prominent superotemporally. Pair with 92_64 and 92_67.
92 Optic Disc Drusen, Fluorescein AngiogramAnthony C. Arnold, MDImages 92_64 and 92_67 demonstrate the characteristics of optic disc drusen on flourescein angiography. This image shows the early arteriovenous phase, with irregular dye uptake and focal hypoflourescence superotemporally. Pair with 92_63 and 92_67
93 Optic Nerve Drusen, Late Fluorescein AngiogramAnthony C. Arnold, MDImages 92_64 and 92_67 demonstrate the characteristics of optic disc drusen on flourescein angiography. This image displays the nodular staining of the drusen without leakage. Pair with 92_63 and 92_64.
94 Isolated Congenital Optic Disc AnomaliesAnthony C. Arnold, MDThis is a photograph of peripheral drusen. The paired image 92_69 demonstrates the typical autofluorescence.
95 Optic Disc Drusen AutofluorescenceAnthony C. Arnold, MDThis case of optic disc drusen demonstrates the typical autofluorescence. Pair with 92_68. Imaging: Autoflourescence?
96 Isolated Optic Neuritis/NeuropathyAnthony C. Arnold, MDThis 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.
97 Trochlear Motility DisturbancesDon Bienfang, MDThis patient displays a posttraumatic left fourth nerve palsy sustained after having struck her head on the dashboard.
98 Motility DisturbancesDon Bienfang, MDThis patient displays a posttraumatic left fourth nerve palsy sustained after having struck her head on the dashboard.
99 Motility DisturbancesDon Bienfang, MDThis patient displays a posttraumatic left fourth nerve palsy sustained after having struck her head on the dashboard.
100 Motility DisturbancesDon Bienfang, MDThis patient displays a posttraumatic left fourth nerve palsy sustained after having struck her head on the dashboard.
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