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TitleCreatorHistory
101 Under PressureNathan H. Kung; Collin M. McClelland; Gregory P. Van StavernA 29-year-old woman was referred to neuro-ophthalmology clinic for 1 year of headaches and papilledema discovered 2 months earlier. She complained of recently blurred vision but no positional headache, pulsatile tinnitus, transient visual obscurations, or other neurologic issues. She used no medicat...
102 Who Deserves a Second Chance?Lina Nagia; Jennifer Doyle; Lanning KlineAn 81-year-old woman presents with a one-month history of blurred vision OS, acutely worse in the past 5 days. She reports pain with left gaze, left sided forehead tenderness and some weight loss. Medical history includes hypertension, borderline diabetes, cerebral vascular accident and basal cell c...
103 A Weak PresentationReuben M. Valenzuela; Bradley Katz; Alison Crum; Kathleen B. Digre; Nick Mamalis; Hans C. Davidson; Judith WarnerAn 82-year-old right-handed man with myasthenia gravis presented in May 2014 with double vision and right facial numbness and weakness. He was first seen in 1998 with horizontal diplopia. He had an abduction deficit of the right eye, and right nasolabial fold flattening. He was diagnosed with myasth...
104 Three Weeks in FloridaAndrew R. Carey; J. Antonio Bermudez-Magner; Sander R. Dubovy; Norman J. Schatz; Linda L. Sternau; Byron L. LamA 36 year-old man presented with severe headaches, bilateral leg numbness, and bilateral decreased vision. He was born in Ecuador where he received BCG vaccination and immigrated to US at age 19. In 2005 he enrolled in nursing school and volunteered in homeless shelters. PPD was positive with a nega...
105 Requiem for a Cabinet MakerJennifer I. Doyle; Michael S. Vaphiades; James R. Hackney; Lanning B. Kline; Lina NagiaA 54-year-old white male presents with 3 weeks of painless horizontal nystagmus and 6 months of left sided forehead numbness. He reports a 20 lbs weight loss. Medical history includes a renal transplant 30 years prior. He takes prednisone 30 mg QOD and azathioprine. Visual acuity is 20/20 OU, color ...
106 Lights OutJohn J. Brinkley; John J. Chen; Patricia A. Kirby; Reid A. Longmuir; Matthew J. ThurtellA 78 year-old man presented with a one-month history of progressive painless binocular vision loss. He had sustained head trauma without loss of consciousness three days prior to the onset of vision loss. On the morning of his presentation to us, he had awoken with complete binocular vision loss and...
107 The Man with No Face (About Face)Michael Vaphiades; Jennifer Doyle; Lina Nagia; Kevin Bray; Kline Lanning; Glenn Roberson; Adam Quinn; Joel Cure; Katherine FeningA 61-year-old man presented with one week history of decreased vision OS. Past medical history includes asthma and amblyopia OD, but with complete visual loss OD 18 years prior. He takes no medications. He is retired but worked for 21 years in social science research. The remarkable thing upon meeti...
108 A Shot in the DarkJoshua Pasol; Ricardo Komotar; Feisal YamaniA 74 year-old man with a chief complaint of difficulty with night time driving for several years as well as difficulty going from a lighted room to a dark room. PMH of high cholesterol, BPH, hypothyroidism, GERD, glottic squamous cell cancer without recurrence, and a prior history of alcoholism. POH...
109 Some Like it HotAhmara G. Ross; Islam Zaydan; Gabrielle Bonhomme; Ellen Mitchell; Tarek Shazly; Deborah ParrishA 71 year old Caucasian man with a past medical history of hypertension, hyperlipidemia, Type 2 DM, ESRD status post renal transplant, facial melanoma, currently on ASA for a stable left sided putaminal hemorrhage presented with new right sided ptosis and lower extremity weakness. Brain MRI obtained...
110 SpeakeasyJoseph G. Chacko; Marcus Moody; Harry H. Brown; Sarkis NazarianA 64 year-old Caucasian gentleman presented with an unusual complaint. He stated that if he touched the inside of his right cheek with his tongue, he felt a tingly sensation in his R eyebrow. This had started one month ago. He also complained of foreign body sensation and discomfort in the right eye...
111 Shady Double CrosserFrancine WeinHistory & Exam A 62-year-old woman presented with a one-month history of severe light sensitivity and headache, and a two week history of diplopia. Her photophobia was severe enough for her to wear sunglasses indoors. Her past medical history was significant for a cholecystectomy and Crohn's disease...
112 It's Not the TumorCourtney E. FrancisA 58 year old woman with a history of metastatic parotid adenocarcinoma presented with bilateral vision loss over 2 months. She had undergone surgical resection of the tumor followed by fractionated external beam radiation with a total of 66.6 Gy 18 months prior to presentation. She was recently fou...
113 Blame it on the PillSachin Kedar; Padmaja Sudhakar; Stuart Tobin; William O. Connor; Fernando DecastroThree months earlier, he had been evaluated for malaise and weight loss and found to have lymphopenia, elevated TSH (20.3) and anti-thyroid peroxidase antibody (2874) with normal T3, ESR, B12 and folate.
114 Muscle Bound or Unbound?Dane A. Breker; Jonathan D. Trobe; Ann A. Little; Sandra I. Camelo-PiraguaA 52 year old former Olympic athlete developed myalgias, cramping, and stiffness in the upper arms, chest, thigh, and calves in 2009 after a blood transfusion for hematochezia attributed to antiplatelet treatment following coronary stenting. Symptoms were worst in the morning, when he could not walk...
115 A TAAD Bit UnusualNisreen K. Mesiwala; Susan T. StefkoA 12 year-old previously healthy boy presented to the emergency room with a five-day history of progressive frontal headaches and acute onset of horizontal, binocular diplopia on left gaze. He had no significant medical history and his only significant ocular history was mild myopia and X-linked col...
116 Wear and Tear VisionKonrad P. Weber; Caterina Schweier; Veronika Kana; Thomas Guggi; Katarzyna Byber; Klara LandauA 66-year-old woman presented with a four-month history of insidious bilateral visual loss. Ophthalmologic examination revealed visual acuity reduced to finger counting in both eyes. On fundus examination, maculae and optic discs appeared normal. Visual fields showed bilateral central scotoma with m...
117 It's Deja Vu All Over AgainAileen A. Antonio-Santos; Yanny L. Phillips; Baha El Khatib; Howard T. Chang; David I. Kaufman; Eric R. EggenbergerA 51-year-old male with a history of amblyopia OD presented in February 1999 with hyperemia, swelling and periorbital pain of the left eye. Visual acuity (VA) was 20/80 OD and 20/25 OS; color vision was 10/11 Ishihara plates OU, and Goldmann perimetry showed an inferior quadrantanopia OS. There was ...
118 Beware the Trojan HorseDenize Atan; Nithin Nair; Mrinal Rana; Swarupsinh V. Chavda; Andrew JacksSystemic hypertension, hypercholesterolemia, and cerebrovascular disease treated with an antiplatelet drug, thiazide diuretic, ACE inhibitor and statin.
119 Double Vision? - Give Your Head a ShakeVivek Patel; Danah Albreiki3 month history of constant binocular oblique diplopia with mild worsening, progressive disequilibrium, and a wide based gait. No vertigo, loss of coordination, loss of vision or oscillpsia, hearing loss, or tinnitus. No history of cancer, hypothyroidism, GI malabsorption or anemia. Occupational his...
120 Spots, Spots Everywhere, And Not A Spot To SeeSarkis M. Nazarian; Kelli Y. Shaon; Kenneth R. Habetz; Ayman Al-Salaimeh; John D. Schwankhaus; Joseph G. ChackoAdditional history revealed that the patient had suffered a tick bite about two weeks prior to the onset of his rash.
121 Diabetes Does Not Explain It AllPhilip M. Skidd; Joseph F. Rizzo; Florian S. Eichler; Dean CestariSystemic hypertension, type II diabetes mellitus, hypercholesteremia, anxiety and depression.
122 Raise Your Grade Point AverageHilary M. Grabe; Jeffrey L. Myers; Douglas J. Quint; Victor M. Elner; Jonathan D. TrobeTwo years earlier, he had had persistent hearing loss in the left ear attributed elsewhere to infection. One year later, he developed left facial weakness diagnosed as Bell's palsy, treated with corticosteroids without recovery. A few months later, he became hoarse and had difficulty swallowing.
123 Clues Hidden in the SkinJanet C. Rucker; Catherine Cho; James Weisfeld-Adams; Scott BrodieShe underwent neurological evaluation at age 32 (neuroimaging, serologies, lumbar puncture, muscle biopsy) with no resultant diagnosis (records unavailable). She required a wheelchair by age 36 and gradually developed slurred speech, cognitive decline, and worsened motor function. Simultaneous with ...
124 Occam's Razor or Gamma Knife?Kaushal M. Kulkarni; Linda Sternau; Byron L. LamHypertension, end-stage renal disease on hemodialysis, and an episode of anterior uveitis in the right eye 10 years earlier.
125 A Wolf in Bear's ClothingPeter W. MacIntosh; Agatha Bogard; Pete Setabutr; Heather E. MossAn eleven-month-old African-American girl with medical history of reactive airway disease developed a bump and bags under both eyes which her mother attributed to minor trauma. There were no signs of systemic illness. A week later, her mother noticed more prominent right eye edema and a new bump beh...
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