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Wernicke Encephalopathy A patient with past history of bariatric surgery presenting with blurred vision, oscillopsia and decreased hearing of few days. Her exam was remarkable for up-beating nystagmus in all gazes. Vision was 20/20 in each eye, pupils equal and reaction. She had full ocular motilit…

Vitreopapillary Traction Syndrome The patient presented to the emergency room (ER) with recent-onset photopsia and blurred vision in the left eye, ocular discomfort, and headache. Examination revealed 20/25 vision in the left eye, blurred disc margin, and inferior disc hemorrhage. MRI orbit was unr…

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…

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…

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…

Traumatic Optic Neuropathy A patient presented with no light perception four days following being hit in the eye with a curling iron. Besides decreased vision, an afferent pupillary defect, and periorbital edema/ecchymosis, clinical exam including of the optic nerve was otherwise unremarkable. Init…

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…

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 …

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…

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…

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

Radiation Optic Neuropathy A patient with a history of skull base meningioma status-post gamma knife radiation presented with three weeks of decreased vision in both eyes. She had no light perception in the right eye and a visual acuity of 20/50 in the left. Magnetic resonance imaging of the brain …

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…

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 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…

POEMS Syndrome A patient presented for evaluation of grade 4 optic disc swelling in both eyes. The patient has a history of polyneuropathy both sensory and motor involving the upper limbs more than lower limbs consistent with a diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) a…

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.

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…

Optic Nerve Pit Optic nerve anomalies are rare entities with a variety of clinical presentations. They can be classified according to anomalies of disc size, disc conformation, or by the presence of abnormal tissue on the optic nerve head, or pseudoswelling. Here, we present a child with an inciden…