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A patient with ocular Bartonella henselae infection manifesting as neuroretinitis and branch retinal artery occlusion.

Spontaneous Intracranial Hypotension A patient presented with sudden onset of postural headaches that improved with recumbency associated with nausea, vomit, photophobia and phonophobia of 5 days of evolution followed by binocular horizontal diplopia at distance and in left gaze. Patient denied rec…

Intracanalicular Optic Nerve Sheath Meningioma A middle-aged patient with a PMH of breast cancer, migraines, and hyperlipidemia presents to the Bascom Palmer ER with a chief complaint of headache and left eye blurry vision for the past month. Recent work-up outside is remarkable for normal laborato…

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 …

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

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…

In this module, we will look at:




Anatomy / Pathways / Light Reflex


Optic Neuritis


Papilledema


NAION


Giant Cell Arteritis


Inherited Optic Neuropathies


Other Optic Neuropathies

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…

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…

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…

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

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.