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TitleCreatorHistory
176 Eyes and Bowels Bottled Up - VideoKristopher Kowal, Jonathan Daniel Trobe, MD, Michigan University, Theodore T. BrownA 56 year-old man presented with diplopia and ptosis. Actually he was more concerned about severe constipation that had started about the same time. Abdominal x-rays had shown stool loading; laxatives had been ineffective. Our exam showed bilateral ptosis with complete ophthalmoplegia in both eyes. ...
177 "Not Right in the Head" - VideoMelinda Y. Chang, MD, Janet Lee, MD, Robert A. Goldberg, MD, Stacy L. Pineles, MDA 55 year old man presented with eight months of progressive left orbital swelling. His past ocular history was significant for LASIK of the right eye with monovision. His past medical history was significant for melanoma of the left arm, treated by surgical excision, with two negative lymph nodes, ...
178 In the Thick of ItKannan M. Narayana, Ritesh A. Ramdhani, Bradford Tannen, Laura J. Balcer, Steven L. Galetta, Janet C. RuckerA 38 year-old woman with a history of premature birth with significant developmental delay was sent for neuroophthalmic evaluation for excessive head movements with gaze shifting. As an adult, she was verbal and able to take the bus alone to a day program. Over the past two years, language and cogni...
179 Is It or Isn't It? - VideoPeter W. MacIntosh, Scott Jones, Milena Stocic, Amy Lin, Heather MossA 58-year-old woman with recurrent left idiopathic orbital inflammation (IOI) presented with one day of rapidly progressive bilateral proptosis, edema, right eye redness, photophobia, and blurry vision. Her right eye had previously been asymptomatic. Her left eye had macular scarring with reduced vi...
180 A 4-Year WaitDmitry Balian, Sachin Kedar, Michaelyn Everhart, Aleh Bobr, Liudmila MuinovA 64 year old male with past history of hypertension, arthritis and chronic headache developed transient tingling and numbness of his left face in February 2016 and was diagnosed to have "trigeminal neuralgia". Two months later, he presented to the ED with sudden onset of binocular tilted diplopia. ...
181 Frizzle FrazzledEric D. Gaier, Farrah Rajabi, Anne Fulton, Gyula Acsadi, David WaitzmanAn otherwise healthy 12-year-old boy originally from Palestine was referred for refractory papilledema secondary to familial IIH. He has a history of fully accommodative esotropia with onset age 2-3. At age 9, elevated optic nerves prompted a neuro-ophthalmic referral. Best corrected visual acuities...
182 Oh My GAD!! Something Else?Olwen Murphy, Kemar Green, John Probasco, Daniel GoldA 43 -year-old man presented with oscillopsia, dizziness, binocular vertical diplopia, and gait difficulties. He reported a six-month history of abdominal pain, anorexia and 50-pound weight loss, and a 3-month history of mood and cognitive changes. Torsional nystagmus, a left 4th nerve palsy (NP), u...
183 Never Too Young or Too OldBart Chwalisz, Laurel Tainsh, Mary Maher, Samantha Champion, Shuhei Nishiyima, Michael LevyAn 81-year-old woman with history of ocular myasthenia gravis presented with sequential bilateral vision loss. Six days before presentation, she discovered that vision of her left eye was reduced to light perception. She did not have any eye pain, pain with eye movement, headache, scalp tenderness, ...
184 Gone but Not ForgottenJonathan Micieli, Adriana Krizova, Walter MontaneraA 52 -year-old healthy woman presented with a 1-week history of blurred vision and "soreness" in her left eye. Neuro-ophthalmic examination revealed a visual acuity of 20/20 OD, 20/40 OS, left RAPD and left superior arcuate defect on Humphrey visual field testing. Dilated fundus examination demonstr...
185 A Small Leak Will Sink a Great ShipKonstantinos Douglas, Vivian Paraskevi Douglas, Cameron Sadegh, David Chow, Sigurros Davidsdottir, Ganesh Shankar, Bradley Buchbinder, Bart ChwaliszA 68 -year-old right -handed man presented for evaluation of progressive and fluctuating polyopia, gait instability and cognitive changes of about 14 months. Prior medical history was notable for Crohn's disease in remission, atrial fibrillation, a single episode of aseptic meningitis 12 years prior...
186 Orbiting a DiagnosisDaniel Liebman, Daniel Lefebvre, Emily Tam, Marie Lithgow, Bart Chwalisz, Eric Gaier, Joseph KaneA 75 -year-old male with a history of chronic/small lymphocytic leukemia (CLL/SLL) presented for one day of left retro-orbital headache, painful eye movements, eyelid swelling, and diplopia. One week prior, his WBC count was 39.9 K/uL with 86% lymphocytes. Three days prior to presentation, the patie...
187 'X' Marks the SpotLuis Andre Leal Ferman, Leslie Bruch, John Buatti, Jeremy GreenleeThis 24 year-old man presented with several months of progressive visual loss in both eyes. His past medical, surgical and ocular history was unremarkable. There was no family history of phacomatosis. He complained of occasional binocular diplopia, but denied headaches or any other neurological symp...
188 Sometimes a Biopsy is BestKevin Chodnicki, Natalie Wolkow, Michael Yoon, Bart ChwaliszA 30 -year-old pregnant woman without significant medical or ocular history presented with decreased right eye vision. In her 2nd trimester, she was diagnosed with Lyme disease with a bulls-eye rash and positive Lyme antibodies; she was treated with two weeks of amoxicillin. At 33 weeks pregnant she...
189 A Definite MaybeRaghu C. Mudumbai, Alex Solomon73 yo man French-Canadian presented to our institution for another opinion for a long standing diagnosis of Oculopharyngeal Dystrophy given at an outside institution. 17 years ago, the patient developed unfluctuating double vision that progressed to include severe, unfluctuating ptosis and mild dysp...
190 A Nod to the NoduleNatalie Brossard, Kirill Zaslavski, Laila Al-Shafai, David Munoz, Edward MargolinA 67-year-old man presented to emergency department in March'21 with 6hours h/o fever, headache, confusion, right- sided weakness and urinary incontinence. He had h/o hypertension, rheumatoid arthritis, spinal stenosis and was taking etanercept/leflunomide/sulfasalazine. Non-contrasted CT showed lef...
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