Course name | Date

Alstrom Syndrome

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Julia L. Hudson, MD
Faculty Discussant(s): Byron L. Lam, MD; Craig A. McKeown, MD
Presenter/Faculty: Hudson, Lam, McKeown
Alstrom Syndrome A 5-year-old male referred to the BPEI pediatric ophthalmology clinic for second opinion regarding bilateral progressive vision loss since infancy. VA was 20/200 OU and the patient had nystagmus. He was 99% percentile for weight but had no hearing loss or polydactyl. He underwent s…

Amalric Triangular Choroidal Infarction in Giant Cell Arteritis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD
Presenter/Faculty: Patel
The patient presented with ocular ischemic syndrome and corneal edema in the fellow eye. In the right eye on angiography there is temporal non-perfusion as well as choroidal hyperfluorescent infarcts in the late phases. ESR and CRP were elevated. Diagnosis of GCA was made. The patient retained 20/3…

Bilateral Ischemic Optic Neuropathy Following Buttock Augmentation in an IIH Suspect

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Patrick Staropoli, MD
Faculty Discussant(s): Byron L. Lam, MD
Presenter/Faculty: Lam, Staropoli
Bilateral Ischemic Optic Neuropathy Following Buttock Augmentation in an IIH Suspect A 51-year-old female was transferred from an outside facility 5 days after buttock augmentation surgery in the prone position. On examination, there was no light perception in the right eye and hand motion vision i…

Bilateral Optic Neuritis

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Fawzi D. Abukhalil, MD, MB
Faculty Discussant(s): Byron L. Lam, MD; Hong Jiang, MD, PhD
Presenter/Faculty: Abukhalil, Lam, Jiang
Bilateral Optic Neuritis A 36-year-old male presented to ER with sudden loss of vision in both eyes, associated with sever periorbital pain, photophobia and pain with eye movement. Vision was NLP right eye and 20/70 left eye with a right afferent pupillary defect in the right eye. Eye movements wer…

Bilateral Papillitis

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Jesse D. Sengillo, MD
Faculty Discussant(s): Carlos E. Mendoza Santiesteban, MD
Presenter/Faculty: Mendoza Santiesteban, Sengillo
Bilateral Papillitis A 66-year-old man presented to Bascom Palmer with complaints of blurry vision in both eyes for three days which he described as painless. Vision was 20/350 in the right and 20/200 in the left eye with evident papillitis in both eyes on exam. An MRI revealed no retrobulbar optic…

Bosch-Boonstra-Schaaf Syndrome

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Apostolos Anagnostopoulos, MD
Faculty Discussant(s): Carlos E. Mendoza Santiesteban, MD; Carla J. Osigian Probst, MD
Presenter/Faculty: Anagnostopoulos, Mendoza Santiesteban, Osigian
Bosch-Boonstra-Schaaf Syndrome The following case review presents a 3-year-old, born full term, with developmental delay which was referred by an outside physician for further evaluation. Further testing was required for a final diagnosis which included an MRI of the brain and genetic testing. Resu…

Carotid Cavernous Fistula with Ocular Ischemic Syndrome

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong
Slit lamp photo with dilated epi-scleral veins. Fundus photo with retinal hemorrhages. FA with severe non perfusion, leakage from the disc, and laser scars. MRI/MRA demonstrates left distal precavernous/proximal cavernous ICA fistula into the cavernous sinus with arterialized flow. There is resulta…

Cranial Nerve 6 Palsy from Metastatic Cholangiocarcinoma

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Benjamin J. Fowler, MD, PhD
Faculty Discussant(s): Byron L. Lam, MD
Presenter/Faculty: Fowler, Lam
Cranial Nerve 6 Palsy from Metastatic Cholangiocarcinoma A 34-year-old woman presented with 2 weeks of diplopia. The patient had binocular horizontal diplopia with a right cranial nerve 6 palsy and moderate-to-severe headache of 1-week duration. Magnetic resonance imaging (MRI) of the brain and orb…

Grade 5 Papilledema From Idiopathic Intracranial Hypertension

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong

Increased intracranial pressure leading to bilateral optic nerve edema. Grade 5 is considered when all vessels are partially obscured by edema.

Idiopathic Intracranial Hypertension

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Michelle M. Maeng, MD
Faculty Discussant(s): David T. Tse, MD
Presenter/Faculty: Maeng, Tse
Idiopathic Intracranial Hypertension A 39-year-old male presented to the BPEI ER with blurry vision in his right eye for 2 weeks. Examination revealed CF OD, 20/60 OS vision, right APD, and bilateral disc edema. OCT showed diffusely elevated RNFL thickness and HVF 30-2 was not able to be performed …

Indirect Carotid Cavernous Fistula

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Julia L. Hudson, MD
Faculty Discussant(s): Joshua Pasol, MD; Robert M. Starke, MD
Presenter/Faculty: Hudson, Pasol, Starke
Indirect Carotid Cavernous Fistula A 72-year-old female referred to Bascom Palmer Emergency room with 4 months of progressive painless diplopia and eye redness after dental procedure. Exam revealed VA 20/25 OU with bilateral abducens palsy, and arterialization of the conjunctival vessels. Review of…

Juvenile Psammomatous Ossifying Fibroma

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Somya Chowdhary, MD
Faculty Discussant(s): Sander R. Dubovy, MD; Nickalus Khan, MD; Carlos E. Mendoza Santiesteban, MD
Presenter/Faculty: Chowdhary, Dubovy, Khan, Mendoza Santiesteban
Juvenile Psammomatous Ossifying Fibroma An 18-year-old female presented with blurry vision, headaches for 4 months. She was diagnosed to have papilledema on an outside eye exam and referred to BPEI. Her visual acuity was 20/20 OD, 20/100 OS. Additionally, she was noted to have junctional scotoma on…

Leber Hereditary Optic Neuropathy

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Maja Kostic, MD, PhD
Faculty Discussant(s): Byron L. Lam, MD; Craig A. McKeown, MD; Carlos E. Mendoza Santiesteban, MD
Presenter/Faculty: Kostic, Lam, McKeown, Mendoza Santiesteban
Leber Hereditary Optic Neuropathy – LHON An 18-year-old healthy man was evaluated in the eye emergency room for acute progressive painless vision loss in both eyes. First was affected a right eye and a six days later, left eye was affected too. Best-corrected visual acuity was 20/800 right eye an…

Neuro-Ophthalmology

Type: Medical Student Education
Include in Catalogue?: Yes
Presenter(s): Chris R. Alabiad, MD
Presenter/Faculty: Alabiad

In this module, we will look at:




Anatomy / Pathways / Light Reflex


Optic Neuritis


Papilledema


NAION


Giant Cell Arteritis


Inherited Optic Neuropathies


Other Optic Neuropathies


Non-Arteritic Ischemic Optic Neuropathy

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Ying Chen, MD
Faculty Discussant(s): Byron L. Lam, MD
Presenter/Faculty: Chen, Lam
Non-Arteritic Ischemic Optic Neuropathy We report a case of a 32-year-old male who presents with a four days blurry vision in the left eye. Patient denied any associated pain or systemic symptoms. His review of system includes mild gastrointestinal discomfort 2 years prior that led to eventual remo…

Ocular Ischemic Syndrome

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Ann V. Quan, MD
Faculty Discussant(s): Norman Schatz, MD; Jayanth Sridhar, MD
Presenter/Faculty: Quan, Schatz, Sridhar
Ocular Ischemic Syndrome Ocular ischemic syndrome (OIS) is a rare condition associated with severe carotid artery occlusive disease leading to ocular hypoperfusion. It typically presents at mean age of 65, there is no racial predilection, and is two times more common in men than women. It is typica…

Pediatric Leber's Hereditary Optic Neuropathy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Maja Kostic, MD, PhD; Byron L. Lam, MD; Nimesh A. Patel, MD
Presenter/Faculty: Kostic, Lam, Patel

A 7-year-old patient with fundus photos showing temporal optic nerve pallor OU. Vision was 20/400 and 20/800. Ganglion cell layer of the patients male first cousin reveals diffuse thinning.

Retinitis Pigmentosa

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD
Presenter/Faculty: Patel

Fundus photo with peripheral hyperpigmentation and bone spicules. Angiogram demonstrating peripheral atrophy and mild vessel leakage. OCT with cystoid macula edema.

Vitamin A Deficiency

Type: Grand Rounds
Include in Catalogue?: Yes
Presenter(s): Nicole J. Topilow, MD
Faculty Discussant(s): Byron L. Lam, MD
Presenter/Faculty: Lam, Topilow
Vitamin A Deficiency A 73-year-old woman with a past medical history significant for Crohn’s disease and recently diagnosed colon cancer with recent sigmoid colon resection, presented with ten days of blurry vision in both eyes and nyctalopia. Onset of her symptoms was during a hospitalization fo…