Toggle navigation

#neuroophthalmology509 POSTS

Post Content
User Image ophthalmologydoc Posted: Dec 9, 2017 8:11 AM (UTC)

128
3 Normal
A 70 year old referred for glaucomatous discs and a visual field defect. When fields respect midlines be wary!

This one is a good demonstration of neuroanatomy at work. This massive ICA aneurysm is abutting the optic chiasm. You can also see from the first and second videos how contrast really adds to the scan.

The patient was in a very precarious situation...observing this could lead to death from rupture or worse...visual loss 🤔. The risk of operating would be death, stroke and loss of vision. The patient opted for intervention ultimately.
Not sure what I would do. The statistics of aneurysmal rupture vary depending on size and position of the aneurysm. There is a 50% mortality risk from rupture but the average risk of rupture is 1% albeit for smaller lesions. Downstream occlusion from coiling can be around 20%. What would you do?

#ophthalmologydoctor #ophthalmology #eyes #opticnerve #neurosurgery #aneurysm #radiology #eyedoc #eye #neuroophthalmology #neurology #eyedoctor #optometrist #optometry #medicine #neuro #surgery #doctor #stroke #casestudy #resident #medicalstudent
User Image neuroftalmo1minuto Posted: Dec 8, 2017 11:45 AM (UTC)

121
0 Normal
🇧🇷🇧🇷🇧🇷Uma das manobras semiológicas usadas para para diferenciar oftalmoplegia internuclear (OIN) da paralisia do III nervo craniano é pedir para o paciente olhar para perto. Isto levará à convergência dos olhos. A adução relacionada à convergência está preservada na OIN, enquanto na paralisia do III está prejudicada. 🇺🇸🇺🇸🇺🇸One of the objective methods used for differentiate internuclear ophthalmoplegia (INO) from III nerve palsy is to ask the patient to look near. This will result to convergence of eyes. Adduction related to convergence is preserved in INO, whereas in III palsy is impaired.
#neuroftalmologia #neuroftalmología #neuroophthalmology #neurologia #neurology #paralisiaocular #ocularpalsy #oftalmoplegiainternuclear #internuclearophthalmoplegia
User Image cerofufg Posted: Dec 7, 2017 12:30 AM (UTC)

125
4 Normal
☇ Pupila Tônica de Adie
☇ Adie's Tonic Pupil
1- Anisocoria
2- Após Teste da pilocarpina 0,125% / After pilocarpine 0.125% Test
#cerof #ophthalmology #oftalmocerof #oftalmologia #neuro #neuroophthalmology
#Bellspalsy is a unilateral facial nerve #paralysis, usually self-limiting, resulting in inability to control facial muscles on the affected side. Symptoms include a rapid onset of partial or complete palsy, usually in a single day. Named after Scottish anatomist #CharlesBell, who first described it, Bell’s palsy is the most common #acute #disease involving only one #nerve, and is the most common cause of acute #facial nerve paralysis. There are published reports that #angelinajolie had a bout of this. At #schlessingereyeandface we see patients with this #syndrome. The good news is that it’s usually not #permanent. There are a variety of #treatment options! #SEF #information #boardcertified #experience #trust ☎️516-496-2122 #friyay #neuroOphthalmology
User Image neuroftalmo1minuto Posted: Nov 30, 2017 9:41 PM (UTC)

112
5 Normal
🇧🇷🇧🇷🇧🇷Oftalmoplegia internuclear (OIN) se manifesta com deficit da adução no olhar conjugado horizontal causado por acometimento do fascículo longitudinal medial. Nos casos leves,
o olho consegue aduzir mas lentamente (lag de adução). Outro sinal clinico é o nistagmo do olho contralateral quando ele esta abduzido. Esclerose múltipla e infartos são as causas mais comuns. No video, o paciente tem OIN a direita com lag de adução do olho direito e nistagmo na abdução do olho esquerdo. 🇺🇸🇺🇸🇺🇸Internuclear ophthalmoplegia (INO) is characterized by deficit of adduction in the horizontal conjugate gaze caused by involvement of the medial longitudinal fasciculus. In mild cases, the eye shows adduction lag. Another clinical sign is the nystagmus of the contralateral eye when it is abducted. Multiple sclerosis and brainstem infarction are the most common causes. In the video, the patient has right INO with right eye adduction lag and nystagmus in the abduction of the left eye.#neuroftalmologia#neuroftalmología #neuroophthalmology #oftalmoplegiainternuclear #internuclearophthalmoplegia #neurology
User Image neuroftalmo1minuto Posted: Nov 29, 2017 5:08 PM (UTC)

131
4 Normal
🇧🇷🇧🇷🇧🇷Geralmente, a progressão da neuropatia óptica associada ao Pseudotumor cerebral idiopatico é lenta o que permite tratamento clinico com acetazolamida e perda de peso. Entretanto, se o paciente apresenta perda visual grave no momento do diagnóstico, cirurgia é mais apropriada para o controle da neuropatia optica. No post (deslize para esquerda), voce vê o campo visual de uma paciente com pseudotumor cerebral idiopatico. Acuidade visual 20/400(OD) e. 20/20 (OE). Fenestração da bainha do nervo óptico foi realizada em ambos os olhos. 🇺🇸🇺🇸🇺🇸Usually, the progression of optic neuropathy associated with idiopathic pseudotumor cerebri is slow which allows medical treatment with acetazolamide and weight loss. However, if the patient presents severe visual loss at the time of diagnosis, surgery is more appropriate for the control of optic neuropathy. In the post (slide to the left), you see the visual field of a patient with idiopathic pseudotumor cerebri. Visual acuity 20/400 (OD) e. 20/20 (OS). Fenestration of the optic nerve sheath was performed in both eyes. #neuroftalmologia #neuroftalmología #neuroophthalmology #neurology #pseudotumorcerebri #fenestração #opticnervesheathfenestration
#happiness comes from within. Today at #SEF is all about our #NeuroOphthalmology patients, some of whom have been through some #trauma. Did you know that @dschlessinger is one of just a few #NeuroOphthalmologist in the area and treats some very hard to #diagnose patients that are referred by other #physicians in our #community and beyond? #Neurologists commonly co-manage or #refer their patients to our office for their care. It’s not all about a #prettyface around here. No two days are alike which keeps our staff and #Doctors on our toes! Feel #grateful for those #cosmetic #fillers and other #fun treatments that may keep bringing you back to see our #boardcertified #topdocs and remember that #happiness is truly the best cosmetic we have!! #happyhumpday #Wednesday vibe
User Image neuroftalmo1minuto Posted: Nov 27, 2017 10:03 PM (UTC)

147
2 Normal
🇧🇷🇧🇷🇧🇷Atrofia óptica dominante (AOD) está associada a aumento da escavação que confunde com glaucoma de pressão normal (GPN). Palidez temporal e defeito de campo central são característicos da AOD e ajudam a diferenciar do GPN. As fotos mostram estes dois sinais clínicos. 🇺🇸🇺🇸🇺🇸Dominant optic atrophy (DOA) is associated with optic cup enlargment that confuses normal-tension glaucoma (NTG). Temporal pallor and central visual field defect are characteristic of DOA and help to differentiate from GPN. The photos show these two clinical signs.#neuroftalmologia #neuroftalmología #neuroophthalmology #glaucoma #opticcup#opticnerve#cupping
User Image johngmchenrymd Posted: Nov 26, 2017 6:54 PM (UTC)
23
3 Reyes
Our annual Thanksgiving lunch party with the John G McHenry MD Family!
User Image neurologiabr Posted: Nov 24, 2017 12:13 PM (UTC)

77
1 Normal
Compartilhando o post sensacional do meu amigo @neuroftalmo1minuto

#Repost @neuroftalmo1minuto (@get_repost)
・・・
🇧🇷🇧🇷🇧🇷Nistagmo convergência retração é um dos sinais caracteristico da síndrome de Parinaud (ou sindrome do mesencéfalo dorsal). É desencadeado na tentativa de olhar para cima. A retração ocular (olhos são puxados para dentro da órbita) ocorre devido à co-contração dos músculos horizontais. A contração do músculo reto medial é mais forte do que a do reto lateral e causa o movimento de convergência. 🇺🇸🇺🇸🇺🇸 Convergence-retraction nystagmus is one of the hallmarks of Parinaud's syndrome (or dorsal midbrain syndrome). It is triggered on attempted upward gaze. Ocular retraction (eyes are pulled into the orbit) occurs due to the co-contraction of the horizontal extraocular muscles. The contraction of the medial rectus muscle is stronger than lateral rectus and causes the movement of convergence.#neuroftalmologia #neuroftalmología #neuroophthalmology #parinaud #sindromedeparinaud#mesencefalodorsal#dorsalmidbrain
User Image liang.md Posted: Nov 24, 2017 11:45 AM (UTC)

98
2 Normal
Repost @neuroftalmo1minuto 🇧🇷🇧🇷🇧🇷Nistagmo convergência retração é um dos sinais caracteristico da síndrome de Parinaud (ou sindrome do mesencéfalo dorsal). É desencadeado na tentativa de olhar para cima. A retração ocular (olhos são puxados para dentro da órbita) ocorre devido à co-contração dos músculos horizontais. A contração do músculo reto medial é mais forte do que a do reto lateral e causa o movimento de convergência.
Sigam @neuroftalmo1minuto 🇺🇸🇺🇸🇺🇸 Convergence-retraction nystagmus is one of the hallmarks of Parinaud's syndrome (or dorsal midbrain syndrome). It is triggered on attempted upward gaze. Ocular retraction (eyes are pulled into the orbit) occurs due to the co-contraction of the horizontal extraocular muscles. The contraction of the medial rectus muscle is stronger than lateral rectus and causes the movement of convergence.
Follow @neuroftalmo1minuto

#neuroftalmologia #neuroftalmología #neuroophthalmology #parinaud #sindromedeparinaud#mesencefalodorsal#dorsalmidbrain
User Image neuroftalmo1minuto Posted: Nov 24, 2017 11:42 AM (UTC)

91
0 Rise
🇧🇷🇧🇷🇧🇷Nistagmo convergência retração é um dos sinais caracteristico da síndrome de Parinaud (ou sindrome do mesencéfalo dorsal). É desencadeado na tentativa de olhar para cima. A retração ocular (olhos são puxados para dentro da órbita) ocorre devido à co-contração dos músculos horizontais. A contração do músculo reto medial é mais forte do que a do reto lateral e causa o movimento de convergência. 🇺🇸🇺🇸🇺🇸 Convergence-retraction nystagmus is one of the hallmarks of Parinaud's syndrome (or dorsal midbrain syndrome). It is triggered on attempted upward gaze. Ocular retraction (eyes are pulled into the orbit) occurs due to the co-contraction of the horizontal extraocular muscles. The contraction of the medial rectus muscle is stronger than lateral rectus and causes the movement of convergence.#neuroftalmologia #neuroftalmología #neuroophthalmology #parinaud #sindromedeparinaud#mesencefalodorsal#dorsalmidbrain
User Image wonderer_me Posted: Nov 23, 2017 6:42 AM (UTC)
201
6 Clarendon
งานตำราก็มา 😄✌🏻 #happylife #neuroophthalmology
User Image liang.md Posted: Nov 21, 2017 9:03 PM (UTC)

52
0 Normal
#Repost com o consentimento de @neuroftalmo1minuto ・・・
Sigam a página @neuroftalmo1minuto 🇧🇷🇧🇷🇧🇷Defeito pupilar aferente relativo (DAR) é o sinal objetivo mais importante no diagnostico da neuropatia optica unilateral (ou bilateral assimetrica). Sua presença independe da acuidade visual. Neuropatia optica com acuidade visual 20/20 tem DAR (veja post dia 08fevereiro2017); assim como opacidade total de meio com perda visual grave não tem DAR. No video, voce vê um paciente com catarata total, percepção de luz e ausência de DAR. 🇺🇸🇺🇸🇺🇸
Repost with @neuroftalmo1minuto 's consent.
::: follow @neuroftalmo1minuto

Relative afferent pupillary defect (RAPD) is the most important objective signal in the diagnosis of unilateral (or asymmetric bilateral) optic neuropathy. Its presence does not depend of visual acuity. Optic neuropathy with 20/20 visual acuity may have RAPD (see post 08February2017); as well as total media opacity with severe visual loss does not have RAPD. In the video, you see a patient with total cataract, light perception and absence of RAPD. #neuroftalmologia #neuroftalmología #neuroophthalmology #defeitoaferenterelativo #dar #rapd #relativeafferentpupillarydefect
User Image neuroftalmo1minuto Posted: Nov 21, 2017 3:14 PM (UTC)

61
3 Normal
🇧🇷🇧🇷🇧🇷Defeito pupilar aferente relativo (DAR) é o sinal objetivo mais importante no diagnostico da neuropatia optica unilateral (ou bilateral assimetrica). Sua presença independe da acuidade visual. Neuropatia optica com acuidade visual 20/20 tem DAR (veja post dia 08fevereiro2017); assim como opacidade total de meio com perda visual grave não tem DAR. No video, voce vê um paciente com catarata total, percepção de luz e ausência de DAR. 🇺🇸🇺🇸🇺🇸
Relative afferent pupillary defect (RAPD) is the most important objective signal in the diagnosis of unilateral (or asymmetric bilateral) optic neuropathy. Its presence does not depend of visual acuity. Optic neuropathy with 20/20 visual acuity may have RAPD (see post 08February2017); as well as total media opacity with severe visual loss does not have RAPD. In the video, you see a patient with total cataract, light perception and absence of RAPD. #neuroftalmologia #neuroftalmología #neuroophthalmology #defeitoaferenterelativo #dar #rapd #relativeafferentpupillarydefect
User Image ophthalmologydoc Posted: Nov 21, 2017 7:13 AM (UTC)

131
4 Normal
40 year old who had a nasty headache and couldn't even stand up due to the pain. Vision is RE 6/9 and LE 6/12. No RAPD. Previous treated profilerative diabetic retinopathy and poor current diabetic control.
The immediate concern was papilloedema, however this patient had a normal CT angiogram and opening pressure of 22mmHg. Also the other disc is not swollen. Normal inflammatory markers.

It seems to fit with an impending CRVO. The next step is an FFA to prove it. If it doesn't then we go down the rabbit hole of vasculitides and other weird and wonderful causes.

#ophthalmologydoctor #ophthalmology #eyes #opticnerve #diabetes #retinopathy #diabeticretinopathy #eyedoc #eye #neuroophthalmology #neurology #eyedoctor #optometrist #optometry #medicine #retina #surgery #doctor #haemorrhage #crvo #casestudy #resident

Hashtags found on this page