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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 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…

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. …

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…

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…

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…

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 …

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…

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…

Leukemic Optic Neuropathy Leukemic optic neuropathy is a rare entity that is characterized as optic nerve dysfunction resulting from direct infiltration of neoplastic leukocytes. It is an indicator of central nervous system involvement, and it is a neuro-ophthalmic and oncologic emergency that warr…

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…

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…

Bartonella Henselae Neuroretinitis and Branch Retinal Artery Occlusion A patient with past ocular history of viral conjunctivitis presented with 2 weeks of decreased vision in the right eye. His exam was notable for visual acuity of 20/80+1 in the right eye and 20/20 in the left eye. Intraocular pr…

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 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…