Available Courses

Nuclear 3rd CN Palsy with Vertical Gaze Palsy

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Bashaer Aldhahwani, MBBS, MD
Faculty Discussant(s): Hilda Capo, MD; Byron L. Lam, MD
Presenter/Faculty: Aldhahwani, Capo, Lam
Nuclear 3rd CN Palsy with Vertical Gaze Palsy A patient with significant vasculopathy risk factors (DM, HTN, dyslipidemia), had a stroke affecting the right thalamus, midbrain, and right cerebellum due to basilar artery occlusion. He had a successful mechanical thrombectomy with a stent retriever a…

Idiopathic Intracranial Hypertension

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Zachary Snow, MD
Faculty Discussant(s): Harry W. Flynn, Jr., MD; Byron L. Lam, MD
Presenter/Faculty: Flynn, Lam, Snow
Idiopathic Intracranial Hypertension A patient with slow and progressive, painless, visual decline OD for two weeks presents to BPEI ED. She also notes moderate intensity full-day headaches and TVOs in the same time period. She saw an outside provider and was referred to BPEI ED for optic nerve hea…

Neuromyleitis Optica

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Akaanksh Shetty, MD
Faculty Discussant(s): Byron L. Lam, MD
Presenter/Faculty: Lam, Shetty
Neuromyleitis Optica A child presented to the ER with blurry vision and eye pain. Exam disclosed unilateral optic nerve edema and decreased color vision; subsequent MRI disclosed optic neuritis. Lab testing demonstrated +Aqp4 antibodies, and the patient subsequently developed longitudinally extensi…

Idiopathic Intracranial Hypertension

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Christopher Burrell, MD
Faculty Discussant(s): Byron L. Lam, MD
Presenter/Faculty: Burrell, Lam
Idiopathic Intracranial Hypertension A patient presented with two weeks of vision loss alongside a year-long complaint of left-sided neck stiffness and headaches. Past medical history was remarkable for end-stage renal disease on peritoneal hemodialysis. Examination was notable for blood pressure o…

Miller Fisher Syndrome

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Maria A. Vera-Silva, MD
Faculty Discussant(s): Carlos E. Mendoza Santiesteban, MD
Presenter/Faculty: Mendoza, Vera-Silva
Miller Fisher Syndrome A patient with no significant PMH presented with acute onset of diplopia associated with loss of balance 2 weeks after having an influenza infection. On examination: a bilateral limitation in adduction with end gaze nystagmus in the abducted eye was noted. Also, dilated and n…

Radiation Optic Neuropathy

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Jonathan Yi, MD
Faculty Discussant(s): Byron L. Lam, MD; Joshua Pasol, MD
Presenter/Faculty: Lam, Pasol, Yi
Radiation Optic Neuropathy A patient with a history of proton beam therapy for a chordoma near the clivus presented with 1 week of blurry vision in the left eye. On presentation, patient’s exam was notable for a visual acuity of 20/25 in the right eye and 20/50 in the left eye. Intraocular pressu…

Ethambutol Induced Optic Neuropathy

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Christopher Morais, MD
Faculty Discussant(s): Joshua Pasol, MD
Presenter/Faculty: Morais, Pasol
Ethambutol Induced Optic Neuropathy A patient with a past medical history of chronic Mycobacterium avium infection, on anti-mycobacterial medication for 5 months, presented with bilateral, painless, progressive visual loss for 1 month. Previous medical history significant for B cell lymphoma and ma…

Prothrombin G20210A Mutation and Hyperhomocysteinemia in Young Patient with Non-Arteritic Ischemic Optic Neuropathy

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Maria A. Vera-Silva, MD
Faculty Discussant(s): Carlos E. Mendoza Santiesteban, MD
Presenter/Faculty: Mendoza, Vera-Silva
Prothrombin G20210A Mutation and Hyperhomocysteinemia in Young Patient with Non-Arteritic Ischemic Optic Neuropathy A patient devoid of significant medical history presented with a sudden onset of painless vision loss in his right eye upon awakening. While the anterior segment appeared unremarkable…

Posterior Cortical Atrophy Variant of Alzheimer's Disease

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Christopher Burrell, MD
Faculty Discussant(s): Carlos E. Mendoza Santiesteban, MD
Presenter/Faculty: Burrell, Mendoza
Posterior Cortical Atrophy Variant of Alzheimer's Disease A patient presented for evaluation of optic nerve atrophy and gradually progressive, painless visual distortions for 3 years. She reported difficulty keeping track of characters while reading, judging the speed of other moving vehicles, calc…

Leber's Hereditary Optic Neuropathy

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Amir Faramarzi, MD
Faculty Discussant(s): Byron L. Lam, MD
Presenter/Faculty: Faramarzi, Lam
Leber's Hereditary Optic Neuropathy A patient came to ED due to subacute decreased vision in his right eye since 1/2023. He had a history of decreased vision in his left eye following phacoemulsification surgery in Oct 2022. BCVA was 20/70 OD and 20/400 OS Past medical history was positive for HTN,…

Tolosa Hunt Syndrome

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Caroline L. Lieux, MD
Faculty Discussant(s): Byron L. Lam, MD
Presenter/Faculty: Lam, Lieux
Tolosa Hunt Syndrome Tolosa Hunt Syndrome is an idiopathic inflammatory process of the cavernous sinus of unknown etiology. There are no known risk factors, but an inciting event, such as a viral illness, vaccination, trauma, or tumors, are known to be preceding events that result in nonspecific in…

Downbeat Nystagmus

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Amir Faramarzi, MD
Faculty Discussant(s): Hong Jiang, MD, PhD
Presenter/Faculty: Faramarzi, Jiang
Downbeat Nystagmus A patient was referred with double vision and oscillopsia. He reported to have nystagmus and oscillopsia for a few years, and recently mild worsening. He denies head trauma, weakness, numbness, changes in his vision, transient visual loss, or headache. Patient has trouble reading…

Subperiosteal Orbital Hematoma

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Benyam Kinde, MD, PhD
Faculty Discussant(s): Brian C. Tse, MD
Presenter/Faculty: Kinde, Tse
Subperiosteal Orbital Hematoma A patient with a history of chronic pansinusitis and absence of midline nasal cavity structures due to chronic inhalational cocaine usage, presents with acute onset left-sided proptosis. She was found to have a non-traumatic, spontaneous subperiosteal orbital hematoma…

Bartonella Neuroretinitis

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Yasman Moshiri, MD
Faculty Discussant(s): Nicolas A. Yannuzzi, MD
Presenter/Faculty: Moshiri, Yannuzzi
Bartonella Neuroretinitis A patient presented with subacute painless decreased vision in the left eye. On examination, she had evidence of stellate macular exudates in the left eye, as well as optic disc edema in the right eye. Imaging including fluorescein angiography and OCT of the macula and ret…

Non-Paraneoplastic Autoimmune Retinopathy (npAIR)

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Jason C. Fan, MD, PhD
Faculty Discussant(s): Stephanie M. Llop, MD
Presenter/Faculty: Fan, Llop
Non-Paraneoplastic Autoimmune Retinopathy (npAIR) A patient presented to the neuro-ophthalmology clinic for progressively decreasing vision in both eyes. He first noticed flashes and a blind spot in both eyes 3 months ago. Best-corrected visual acuity was 20/80 in the right eye and 20/50 in the lef…

Type C Carotid Cavernous Fistula

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Lauren C. Kiryakoza, MD
Faculty Discussant(s): Carlos E. Mendoza Santiesteban, MD
Presenter/Faculty: Kiryakoza, Mendoza
Type C Carotid Cavernous Fistula A patient presented with acute, painless, intermittent double vision. The patient had a past medical history of hypertension, hyperlipidemia, and myocardial infarction. The presenting visual acuity was 20/25 in both eyes with normal pupillary responses and intraocul…

Thyroid Associated Ophthalmopathy with Compressive Optic Neuropathy

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Naomi E. Gutkind, MD
Faculty Discussant(s): Thomas E. Johnson, MD; Byron L. Lam, MD
Presenter/Faculty: Gutkind, Johnson, Lam
Thyroid Associated Ophthalmopathy with Compressive Optic Neuropathy A patient presented for a second opinion after experiencing pain, proptosis, vision loss, and injection of his left eye for 2 years, with intermittent improvement on systemic steroids. Prior to presentation at our institution, the …

Papilledema from Hypervitaminosis A

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Byron L. Lam, MD; Benjamin Meyer, MD
Presenter/Faculty: Lam, Meyer
This patient presented with optic nerve edema. The medical history was significant for acute promyelocytic leukemia being treated with all-trans retinoic acid (ATRA). The picture however worsened in tandem with intracranial hemorrhage from possible intracranial leukemia, raising the concern for leu…

Vitamin A Induced Intracranial Hypertension

Type: Online Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Benjamin Meyer, MD
Faculty Discussant(s): Byron L. Lam, MD
Presenter/Faculty: Lam, Mayer
Vitamin A Induced Intracranial Hypertension A patient was found to have acute promyelocytic leukemia and was started on all-trans-retinoic acid (ATRA). He was also noted to incidentally have bilateral papilledema and MR imaging demonstrated multiple stigmata suggestive of chronically elevated intra…

Idiopathic Intracranial Hypertension Complicated by Peripapillary Choroidal Neovascular Membrane Formation

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Carlos E. Mendoza Santiesteban, MD; Landon J. Rohowetz, MD; Nicolas A. Yannuzzi, MD
Presenter/Faculty: Mendoza, Rohowetz, Yannuzzi

Fundus photo demonstrating grade 1 optic nerve head edema in the right eye and grade 3 optic nerve head edema in the left eye. The left eye also demonstrates retinal folds, subretinal hemorrhage, and leakage on fluorescein angiography consistent with a choroidal neovascular membrane.