Bascom Palmer Learn

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…

Myotonic Dystrophy Associated Cataracts We present a case series of two siblings with myotonic dystrophy and cataract with different degrees of zonulopathies. Myotonic dystrophy usually presents with early onset cataracts. We showcase the challenges of doing surgery on patients with advanced myopat…

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…

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…

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.

Idiopathic Intracranial Hypertension with Secondary Choroidal Neovascular Membrane A patient with no past ocular history presented to the emergency department complaining of floaters in the left eye for 4 days. Exam was notable for visual acuity of 20/20 in the right eye and 20/25 in the left eye. …

Miller Fisher Syndrome A patient presented with binocular diplopia of 2 weeks duration after COVID-19 infection. Additionally, she had neurological symptoms, weakness, tingling, numbness of extremities. She had been fully vaccinated against COVID-19. On exam her BCVA was 20/20 OU, she was noted to …

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…

Leber Hereditary Optic Neuropathy (LHON) A previously healthy patient presented to the emergency department (ED) with a 2-week history of bilateral blurry vision associated with painful eye movement. The patient denied eye redness, eye discharge, photophobia, double vision, or headache. The ophthal…

Nyctalopia Due to Vitamin A Deficiency A patient with a past medical history of liver cirrhosis, presented to the neuro-ophthalmology clinic with blurry vision in both eyes and nyctalopia that started around a year ago. Ophthalmological exam was notable for a visual acuity of 20/40 in both eyes, re…

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 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…

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 – 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…

Leber Hereditary Optic Neuropathy An 18-year-old male presented to the ER with bilateral decreased vision and eye pain for 10 days. His visual acuity was HM OD, 20/300 OS. He was noted to have disc pallor OD and temporal pallor with slight nasal elevation OS on fundus exam. His MRI showed T2 hyper …

Neuromyelitis Optica Spectrum Disorder (NMOSD) A patient presented to the emergency room with acute vision loss in the left eye for two weeks. Examination revealed 20/400 vision, crowded nerve with blurred margin, and afferent pupillary defect in the left eye. MRI orbit with and without contrast re…

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…

Hermansky-Pudlak Syndrome An infant was brought to the emergency department by his mother referred from his pediatrician after a routine well-child visit. Parents had noticed severe light sensitivity, but patient was otherwise developing well. Patient grimaced to light in both eyes but had poor fix…

Coloboma associated with a systemic syndrome.