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176 Neuro-Ophthalmic Vascular DiseaseLarry P. Frohman, MDThis 23-year-old woman has had insulin-dependent diabetes mellitus since age 3. She was diagnosed with Sydenham's chorea in early childhood and had grand mal seizures from age 13 to 15. She has been hypertensive since age 18. Her vision was 20/25 OD and 20/40 OS, with dyschromatopsia OS, and a 1.8 l...
177 Neuro-Ophthalmic Imaging-CT ScanLarry P. Frohman, MDThis 70-year-old woman sustained traumatic optic neuropathy in a motor vehicle accident. Note the funnel-shaped hemorrhage within the optic nerve sheath just posterior to the globe.
178 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDThis 48-year-old female was seen in May 1996 with a history of 2 months of diplopia from a right abducens palsy. This was due to the recurrence of myeloma that had initially been diagnosed and treated with radiation and chemotherapy 9 years before and required further therapy, including bone marrow ...
179 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDThis 1-year-old child with familial erythrophagocytic lymphohistiocytosis was readmitted with a fever and was noted to have bilateral blindness. The spinal tap showed a protein of 148, with 178 WBC with 98% ""lymphocytes."" This MRI image demonstrates the optic nerve infiltration. He was treated wit...
180 Chiasmal SyndromesLarry P. Frohman, MDThis 36-year-old woman presented in 1988 with 3 weeks of vertical binocular diplopia. She was a known amblyope OD. Her examination was notable for a right hyperdeviation of 1 PD present in right gaze and a subtle left noncongruous homonymous field defect. She was lost to follow-up, but 5 years later...
181 Ocular Manifestations of Congenital/Inherited DiseasesLarry P. Frohman, MDThis 14-year-old boy presented with sudden visual loss of the right eye that occurred 3 weeks before and due to a central retinal vein occlusion. His ocular history was quite complicated. He had had a resection of a lymphangioma of the left upper lid at age 7 months and underwent left orbitotomy for...
182 Ocular Manifestations of Congenital/Inherited DiseasesLarry P. Frohman, MDThis 14-year-old boy presented with sudden visual loss of the right eye that occurred 3 weeks before and due to a central retinal vein occlusion. His ocular history was quite complicated. He had had a resection of a lymphangioma of the left upper lid at age 7 months and underwent left orbitotomy for...
183 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDThis 1-year-old child with familial erythrophagocytic lymphohistiocytosis was readmitted with a fever and was noted to have bilateral blindness. The spinal tap showed a protein of 148, with 178 WBC with 98% ""lymphocytes."" This MRI image demonstrates the optic nerve infiltration. He was treated wit...
184 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_62, ...
185 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_62, ...
186 Isolated Congenital Optic Disc AnomaliesLarry P. Frohman, MDThis 63-year-old man with amblyopia OD was seen for a question of ischemic optic neuropathy with a pale, swollen disc OD. The correct diagnosis is an exophytic capillary angioma of the optic nerve head. Disease/Diagnosis: Capillary Angioma.
187 Neuro-Ophthalmic Imaging-CT ScanLarry P. Frohman, MDThis patient was assaulted with a blunt object and suffered acute blindness due to traumatic optic neuropathy. Note how the lateral orbital wall has been fractured and displaced posteromedially into the region of the anterior optic canal.
188 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...
189 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...
190 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...
191 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDThis 8-year-old girl had a history of acute lymphoblastic leukemia with neurologic involvement, with remission induced with radiation and chemotherapy. Her relapse showed as an isolated optic neuropathy with this fundus appearance. The other eye was normal. The MRI and spinal tap at this point were ...
192 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;...
193 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;...
194 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;...
195 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;...
196 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. Disease/Diagnosis: Syphilitic optic neuritis/perineuritis, fundus, OS -...
197 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDThis is a 32-year-old HIV-positive man with anterior uveitis, vitritis, and bilateral papillitis from syphilis. With intravenous penicillin treatment, the optic discs and vision returned to normal.
198 Chiasmal SyndromesLarry P. Frohman, MDThis 39-year-old HIV-positive man presented in 1982 with 1 month of bilateral vision loss. His prior evaluation had included 2 CT scans, which suggested a fullness to the chiasm, and a spinal tap that showed 6 monocytes, 14 red cells, a protein of 81 mg/dl, and a glucose of 56 mg/dl, with a negative...
199 Systemic Disorders With Optic Nerve and Retinal FindingsLarry P. Frohman, MDThis 25-year-old man presented to the eye service with a history of 3 days of decreased vision OD. His past medical history was unremarkable. His examination showed acuities of 20/25 OU, with intact color plates, a 0.3 log unit of RAPD OD, and an inferior arcuate scotoma. The photos (Images 95_42, 9...
200 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...
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