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Title | Creator | History |
176 |
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Not a Meatball - Video | Steven Newman; James Mandell; Colleen Druzgal; John Jane Jr.; Spencer Payne; Sugoto Mukherjee; Beatriz Lopes | In April 2015, a 10 year old girl was referred for a four day history of ptosis and double vision. On examination, visual acuity was 20/20-OU; near vision was 3pt OU. Visual fields showed subtle arcuate visual field changes. External examination revealed palpebral fissures of 6.5 and 9 with an upper... |
177 |
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Eyes and Bowels Bottled Up - Video | Kristopher Kowal; Jonathan D. Trobe; Theodore T. Brown | A 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. ... |
178 |
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Not Right in the Head' - Video | Melinda Y. Chang; Janet Lee; Robert A. Goldberg; Stacy L. Pineles | A 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, ... |
179 |
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In the Thick of It | Kannan Narayana; Ritesh Ramdhani; Bradford Tannen; Laura Balcer; Steven Galetta; Janet Rucker | A 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... |
180 |
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A Sad Story - Video | Jason Peragallo | A healthy 6-year-old boy had a two-week history of progressive headaches associated with nausea and vomiting. An ER diagnosed allergic rhinitis, treated with augmentin and steroids, however his symptoms worsened. At a second ER he was febrile to 103F. A classmate was recently diagnosed with Erlichio... |
181 |
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A Trip Through the Wormhole | Anne Kao | The patient initially presented to me at age 19 years with a 'throbbing, aching pressure' behind her right eye and swelling of the right upper eyelid. Her pain was worse in lateral gaze, although she denied diplopia. She had been prescribed 60mg of prednisone by the referring provider, which reduced... |
182 |
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A Zebra Among Zebras | Peter Mortensen; Gabrielle Bonhomme | 61-year-old man with Type 2 diabetes and hypertension presented to outside hospital ED with fever, headache, and neck pain. Onset of neck pain was one week prior, with worsening of symptoms following chiropractic manipulation. Patient was evaluated at outpatient clinic one day prior and given Medrol... |
183 |
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The Great Masquerade | Bart Chwalisz; Dean Cestari | A 56-year-old man with unremarkable prior history complained of visual and somatosensory disturbances. Five months prior, he had an episode of being unable to see oncoming traffic. He developed transient visual disturbances lasting minutes in the left hemifield, e.g., the right sides of people's fac... |
184 |
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Fire and Ice | Mary Maher; Joah Aliancy; Gul Moonis; Angela Lignelli; Michael Kazim; Jeffrey Odel | A 14 year-old boy, with ADHD on amphetamine and dextroamphetamine, presented with headache and bilateral decreased vision. Seven days prior, he began experiencing bilateral non-positional frontal headache unresponsive to NSAIDS that did not wake him from sleep. Five days prior, he felt fatigued and ... |
185 |
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A-deno What's Going On! | Christine Greer; Salina Teja; Jennifer Danesch; Anna Mathew; Vivek Patel; Kimberly Gokoffski | A 68 year-old Hispanic female with hypertension, type II diabetes mellitus, panhypopituitarism after pituitary adenoma resection 30 years prior and subsequent radiation therapy presented with decreased vision in the left eye and severe headache. The patient's vision in the left eye declined in the p... |
186 |
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Are We 'Tilting At Windmills'? (Video) | Michael Vaphiades | A 52-year-old African American woman presented to her primary care physician with a 4 week history of headaches, nausea, vomiting, fever and ataxia. Her medical history includes rheumatoid arthritis, hypertension and a recent diagnosis of pulmonary; sarcoidosis for which she was taking 20 mg of pred... |
187 |
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Smoke Gets in Your Eyes (Video) | Tatiana Bakaeva; John Gittinger, Jr | A 61-year-old woman, active smoker with history of COPD, presented with bilateral progressive vision loss and ataxia. Four months prior to her presentation she developed 'black spot' in her right eye (OD) and was found to have 'OD disc edema and right hypertropia' by an outside ophthalmologist. She ... |
188 |
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Oh Oh Oh It's Magic, You Know…Never Believe It's Not So! (Video) | Zeeshan Haq; Jeremy Tanner; Christine Glastonbury; Cathryn Cadwell; Brooks Crawford; Elan Guterman; Maulik Shah; Megan Richie; Nailyn Rasool | A 72-year-old man with chronic sinusitis, obstructive sleep apnea, and recent extensive travel presented with right-sided headaches, vision changes, and allergy symptoms. A head CT demonstrated a sinus infection and he was treated with amoxicillin-clavulanate; and prednisone. His headache persisted ... |
189 |
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Undiscovered Islands - So Close, Yet So Far (Video) | Magdalena Wirth; Farahna Sabiq; Mehdi Agoumi | A 30-year old female, visiting Canada from India, presented to ophthalmology with a 2-day history of right periorbital swelling, painful proptosis, fevers and chills. Initial examination suggested a clinical diagnosis of post-septal cellulitis with mild motility restriction, without optic nerve comp... |
190 |
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Tumefictive MS (Video) | Anthony Brune III; Hemant Parmar; Sandra Camelo-Piragua; Lindsey De Lott | A 26-year-old woman with history of diabetes insipidus and hypothyroidism presented for evaluation of painless vision loss in her right eye. She was evaluated by a local neurologist and multiple sclerosis (MS) specialist who diagnosed acute optic neuritis. MRI brain showed an enhancing T2 hyperinten... |
191 |
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Bones of the Past (Video) | Bart Chwalisz; Konstantinos Douglas; Vivian Douglas; Otto Rapalino | A 44-year-old woman presented with two episodes of binocular horizontal diplopia within one year. She had a history of Cushing's syndrome status post transsphenoidal resection and bilateral adrenalectomy 4 years prior, hypertension, and secondary diabetes mellitus. Nine months prior she developed se... |
192 |
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You're Too Young for That! (Video) | Sravanthi Vegunta; Kathleen Digre; Bradley Katz; Meagan Seay; Alison Crum; Edward Quigley; Sean Kennedy; Nick Mamalis; Judith Warner | An 11-year old boy presented with right orbital pain for two months with recent double vision. He had no recent viral illnesses or sick contacts. He had no past medical history. His brother had Kawasaki disease; his paternal grandmother had rheumatoid arthritis; and his father died of a myocardial i... |
193 |
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Not All Men With Thick Skulls Have High Testosterone (Video) | Prem Subramanian | A 54-year-old retired USAF fighter pilot was referred in Aug 2016 for evaluation of possible bilateral optic disc swelling noted on routine optometric examination. His past medical history included low testosterone discovered 2 years prior in the context of fatigue and exercise intolerance. MRI brai... |
194 |
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Close Encounters of the Third Kind (Video) | Trishal Jeeval-Patel; Danny Mandell | A 65-year old woman started experiencing headaches which increased in severity over two weeks. She eventually sought care in the emergency department. Neurological examination was reported as normal. Unenhanced CT of the brain was performed and reported as normal. Headaches continued and she was pre... |
195 |
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Look in the Back (Video) | Tatiana Deveney; Aristides Capizzano; Jonathan Trobe | A 59-year old man with Graves disease developed increasing proptosis and diplopia. Attributing these abnormalities to worsening of the Graves disease, an ophthalmologist treated him with high-dose oral and intravenous corticosteroids. When improvement did not occur, he underwent orbital x-irradiatio... |
196 |
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A Par 3 Macular Hole? (Video) | Archana Srinivasan; Jerald Gong; Mark Moster | A 78-year old woman with 3-week history of sudden onset 'visual blur' OU and difficulty reading was evaluated by her ophthalmologist and suspected to have macular hole secondary to posterior vitreous detachment and vitreomacular traction (VMT). Her past medical history was significant for hypertensi... |
197 |
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A 4-Year Wait | Dmitry Balian; Sachin Kedar; Michaelyn Everhart; Aleh Bobr; Liudmila Muinov | A 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. ... |
198 |
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Frizzle Frazzled | Eric Gaier; Farrah Rajabi; Anne Fulton; Gyula Acsadi; David Waitzman | An 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... |
199 |
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Oh My GAD!! Something Else? | Olwen Murphy; Kemar Green; John Probasco; Daniel Gold | A 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... |
200 |
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Never Too Young or Too Old | Bart Chwalisz; Laurel Tainsh; Mary Maher; Samantha Champion; Shuhei Nishiyima; Michael Levy | An 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, ... |