Case Index: Neuro-Ophthalmology

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Acute Demyelinating Encephalomyelitis (ADEM) with associated optic neuritis: 9-year-old girl presents to an outside hospital with fatigue, poor appetite, and decreased activity for 3 weeks.

All-trans retinoic acid (ATRA) induced intracranial hypertension in a patient with acute promyelocytic leukemia: 19-year-old male ungergoing ATRA and Idarubicin induction therapy for APL with one-week complaint of intermittent headaches and transient visual obscurations.

ANCA-associated granulomatous vasculitis (Wegener's granulomatosis): 54-year-old male with binocular vertical diplopia 4 months prior to presentation and progressively worsening. Vision in the right eye was starting to "darken." Prior to presentation, patient was followed by an otolaryngologist for his sinus disease and nosebleeds.

Bilateral optic disk edema associated with cryptococcal meningitis in a young diabetic male: 26-year old male with type 1 diabetes mellitus presented for evaluation of severe headache and double vision.

Bilateral optic nerve hypoplasia, 2-month-old with: Highlighting the importance of a multi-disciplinary approach

Cranial Nerve IV (Trochlear Nerve) Palsy: 57-year-old male complaining of vertical diplopia after head trauma.

Dorsal Midbrain Syndrome (Parinaud's Syndrome) with Bilateral Superior Oblique Palsy: 43-year-old male referred for evaluation of binocular diplopia.

Dramatic Visual Recovery in Untreated Indirect Traumatic Optic Neuropathy: Severe vision loss in one eye immediately after motorcycle accident.

Ethambutol Toxicity and Optic Neuropathy: 60-year-old female with bilateral painless central vision loss

Facial Nerve Palsy: Ocular Complications and Management. 72-year-old male with left lower eyelid retraction in left facial nerve palsy secondary to metastatic lymphoma and radiation therapy. This case features 11 oculoplastic surgery videos.

Functional Visual Loss: 37-year-old male with decreased vision progressively worsening over the past year. The patient was referred because he could not read any of the letters on the chart and showed no improvement with refraction.

Horner's Syndrome (due to Cluster Headache): 46-year-old male presenting with HA and ptosis.

Horner syndrome due to ipsilateral internal carotid artery dissection: Right retroorbital pain radiating to the jaw

Idiopathic Intracranial Hypertension (Pseudotumor Cerebri): 31-year-old obese female presenting with a history of headaches and transient visual obscurations for six months.

Idiopathic Orbital Myositis: A Treatment Algorithm: 19-year-old female who presents with a one-week history of headache, one day of left "eye swelling," and pain that is worse with eye movement.

Internuclear Ophthalmoplegia: 40-year-old man presented to the emergency room complaining of acute onset blurry vision through his left eye (OS).

Juvenile ocular myasthenia gravis: 3-year-old with drooping of right upper eyelid

Leber Hereditary Optic Neuropathy:  A 17-year-old male presents with progressive, painless, bilateral vision loss

Miller Fisher Syndrome:  47-year-old male with sudden onset diplopia and bilateral ophthalmoplegia

Myasthenia Gravis: 32-year-old female with progressive LUL ptosis for several years.

Myelin Oligodendrocyte Glycoprotein (MOG)-IgG Associated Optic Neuritis: Progressive vision loss left > right

Neurofibromatosis Type 1 - Optic Nerve Glioma: 8-year-old white female with acute awareness of complete vision loss, left eye.

Ocular Tilt Reaction: 53-year-old female complaining of vertical diplopia following a stroke and found to have a skew deviation, fundus torsion, and torticollis

Ophthalmoplegic Migraine: 30-year-old male with migraine headaches and occasional diplopia

Optic Nerve Drusen: 19-year-old female with blurred vision

Optic Nerve Hypoplasia: 51-year-old female referred for consideration of cataract surgery. {Related Case: Communicating with patients about alternative therapies: A case of optic nerve hypoplasia in a 14-year-old male with poor vision since birth}

Optic Neuritis: A 40-year-old female noticed visual loss in her right eye accompanied by pain with eye movements and a dull retro-orbital ache, two weeks prior to her clinic visit.  She also noted decreased perception of color and contrast.

Orbital inflammation secondary to bisphosphonate therapy: 80-year-old female with right eyelid swelling, pain, decreased vision, diplopia

Parkinson's disease: a review of the ophthalmological features: 67-year-old man presented to the strabismus clinic with increased difficulty reading for the past year. He experienced intermittent, horizontal, binocular diplopia and blurring of his vision while reading, accompanied by fatigue and headaches.

Pituitary Adenoma Causing Compression of the Optic Chiasm: 49-year-old white female with painless progressive vision loss.

Posterior Ischemic Optic Neuropathy: 64-year-old male admitted to the intensive care unit following a spinal surgery reporting profoundly decreased vision in both eyes upon waking the following morning. His corrective lenses did not improve his vision.

Progressive Supranuclear Palsy in a Patient with Progressive Nonfluent Aphasia: A case of an 81-year-old woman with limited eye movements

Pseudoabducens palsy: When a VI nerve palsy is not a VI nerve palsy

Recurrent Neuroretinitis: 29-year-old white female with progressively worsened vision, right eye, diminished central vision, and pain with eye movements.

Sarcoidosis: 53-year-old A female with gradual, painless loss of vision in both eyes. (also see Ocular Sarcoidosis)

See-Saw Nystagmus: 64-year-old male who first noted the onset of oscillopsia five months prior to presentation.

Spinocerebellar Ataxia with Ophthalmoplegia: 46-year-old male presenting with progressive esotropia

Superior Orbital Fissure Syndrome: 74-year-old male with history of metastatic prostate cancer presented with 5 days of progressive difficulty opening his right eye.

Thyroid Eye Disease (Graves' ophthalmopathy): 51-year-old male seen in consultation from the internal medicine service for evaluation and management of "dry and red eyes.

Tumor Necrosis Factor Alpha Antagonist Precipitating Demyelinating Disease: A 34-year-old woman presents with optic neuritis and develops demyelinating brain lesions

Unilateral Optic Nerve Hypoplasia in a patient desiring surgical treatment for exotropia. 17-year-old male with a longstanding sensory left exotropiainquiring about strabismus surgery.

Vertical Oscillopsia: A Case of Superior Oblique Myokymia. A 39-year-old healthy male reported intermittent episodes of "objects bouncing up and down" in his vision in his left eye lasting for seconds to minutes for the previous two months. [video included]

Visual Snow Syndrome: A 59-year-old pilot with a history of visual aura since his teenage years and anxiety presented to the neuro-ophthalmology clinic with a primary complaint of seeing a "snow storm" for one year.

Wernicke Encephalopathy: A 40-year-old female, 2 months status post Roux-en-Y presented to an outside hospital for 3 weeks of lower extremity weakness, double vision, and urinary incontinence.

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