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101 Optic Tract Syndrome Due to Carotid Artery DolichoectasiaLarry P. Frohman, MDThis 43-year-old man was referred for evaluation of 6 months of visual loss OU. In retrospect, he had noticed increasing difficulty with his tennis game dating back over 3 years, as balls would pass him unexpectedly when hit to his backhand (left) side. The patient did not think this was progressive...
102 Isolated Congenital Optic Disc AnomaliesRosa A. Tang, MDThis patient has optic disc drusen and evidence of a superimposed optic neuropathy, including loss of visual field, an ipsilateral afferent pupillary defect, and optic atrophy. Although optic disc drusen typically causes visual field loss without visual acuity loss superimposed, ischemic optic neuro...
103 Orbital TumorsMitchell J. Wolin, MDCavernous hemangiomas of the orbit usually result in painless orbital signs such as proptosis or visual loss. Orbital imaging of the lesion, which usually is a well-defined orbital mass, is demonstrated in this study. The lesion is benign and usually occurs in young to middle-aged adults. Surgical e...
104 Neuro-Ophthalmic Manifestations of Brain TumorsSteven Galetta, MDThe patient is a 45-year-old recluse found to harbor this frontal lobe mass. Remarkably, this patient had only mild bilateral optic neuropathies with visual acuities in the 20/25 range. This right disc was mildly swollen and the left mildly pale. He could not fit into the fundus camera for disc phot...
105 Motility DisturbancesRosa A. Tang, MDSkew deviation is a vertical deviation that is not localized to any one muscle or muscle group. The deviation may be comitant or not, and intermittent or constant. Skew deviation is often defined by the company it keeps, that is, skew usually occurs in association with other brain-stem signs, and is...
106 Motility DisturbancesRosa A. Tang, MDSkew deviation is a vertical deviation that is not localized to any one muscle or muscle group. The deviation may be comitant or not, and intermittent or constant. Skew deviation is often defined by the company it keeps, that is, skew usually occurs in association with other brain-stem signs, and is...
107 Pupillary SyndromeJeffrey G. Odel, MDIntermittent dilation of the pupils may occur as a benign phenomenon in healthy young adults. In the absence of other third nerve signs, (eg, ptosis, diplopia, ophthalmoplegia), an isolated transient dilation of the pupil in an otherwise healthy adult is unlikely to represent a third nerve palsy. Tr...
108 Pupillary SyndromeJeffrey G. Odel, MDIntermittent dilation of the pupils may occur as a benign phenomenon in healthy young adults. In the absence of other third nerve signs, (eg, ptosis, diplopia, ophthalmoplegia), an isolated transient dilation of the pupil in an otherwise healthy adult is unlikely to represent a third nerve palsy. Tr...
109 Acquired Disc ChangesRosa A. Tang, MDAlthough optociliary shunt vessels are venous collaterals that form in response to chronic venous obstruction, they may occur in patients with chronic open-angle glaucoma.
110 Acquired Disc ChangesRosa A. Tang, MDAlthough optociliary shunt vessels are venous collaterals that typically form in response to chronic venous obstruction, they may occur on a congenital basis as seen here.
111 Isolated Optic Neuritis/NeuropathyRosa A. Tang, MDPapilledema is a term reserved for optic disc edema related to increased intracranial pressure. Fluid within the optic nerve sheath or elevation of the intraocular optic nerve head may be visible on magnetic resonance imaging studies of the head and orbit.
112 Neuro-Ophthalmic Imaging-MRIRosa A. Tang, MDAneurisms may result in neuro-ophthalmologic sign and symptoms by direct compression of the afferent or efferent systems or by the secondary effects of hemorrhage. Basilar aneurisms may result in ocular motor deficits such as a unilateral or bilateral third nerve palsy.
113 Acquired Disc ChangesRosa A. Tang, MDOptociliary shunt vessels are venous collaterals that form in response to chronic venous obstruction. They may occur in patients following central retinal vein occlusion.
114 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
115 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
116 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
117 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
118 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
119 Isolated Optic Neuritis/NeuropathyLarry P. Frohman, MDThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
120 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDA 42-year old woman presented with a history of severe brow pain and 4 days of progressive visual loss OD. There was no increased pain on ocular rotation. Aside from heavy menses, she denied any significant past medical history. Her examination revealed acuity NLP OD, 20/25 OS; color vision 9/10 OS;...
121 Neuro-Ophthalmic Vascular DiseaseSteven A. Newman, MDOcclusion 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...
122 Systemic Disorders With Optic Nerve and Retinal FindingsJohn A. Charley, MDA hypercoagulable state may result from deficiency of various factors involved in the clotting pathway, such as factor V. This may result in venous thrombosis and a branch or central retinal vein occlusion. Consideration for testing for an underlying coagulopathy, including the factor V deficiency, ...
123 Systemic Disorders With Optic Nerve and Retinal FindingsJohn A. Charley, MDA hypercoagulable state may result from deficiency of various factors involved in the clotting pathway, such as factor V. This may result in venous thrombosis and a branch or central retinal vein occlusion. Consideration for testing for an underlying coagulopathy, including the factor V deficiency, ...
124 Orbital TumorsLarry P. Frohman, MDThis 30-year-old man had a retrobulbar intraconal mass OS. The CT scans showed a heterogeneous lobulated enhancing mass, 2.2 x 1.9 x 1.8 cm. The case beautifully exhibits chorodial folds. The ultrasound showed internal reflectivity. The patient refused surgery. Pair with Images 97_60, 97_62, 97_63, ...
125 Orbital TumorsLarry P. Frohman, MDThis 30-year-old man had a retrobulbar intraconal mass OS. The CT scans showed a heterogeneous lobulated enhancing mass, 2.2 x 1.9 x 1.8 cm. The case beautifully exhibits chorodial folds. The ultrasound showed internal reflectivity. The patient refused surgery. Pair with Images 97_60, 97_61, 97_63, ...
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