Accomodation in Neuro-Ophthalmology

Accommodation is the mechanism by which the eye can adjust to bring near objects into focus. In order to focus on a distant object, accommodation must be relaxed. This system is quite precise and its operation depends on the integrity of both central and peripheral connections. Systemic abnormalities or focal pathologic processes both may result in accommodative dysfunction which may either be excessive or insufficent

Embryology of the Optic Nerve Head

An understanding of the embryology oflhe optic nerve is key to understanding congenital disc anomalies. ldentification of timely embryologic stages allows one to accurately predict the gestational age when an Insult occurs. InJury may result in an isolated optic nerve disorder or one with both nerve and other somatic involvement. initially embryonic development prior to any evidence of eye structure fomnation will be discussed under the section of preoptic development of the eye structures. The next section entitled Optic Nerve Development (Section V) will concentrate mainly on the early development of the optic nerve in an attempt to lay down a framework for understanding theories of selected congenital disc anomalies

Telemedicine Consultation in Neuro-ophthalmology: Extending Your Expertise and Your Practice

The attendee will be able to understand how an electronic medical record can streamline their practice. The attendee will learn about using an electronic medical record along with various other software and hardware to enable an office to become paperless and how an EMR helps make the office a HIPAA-compliant environment

Another ENRON: The Downfall of Downbeat

Diplopia; OscillopsiaA 41-year old male with horizontal and vertical diplopia and oscillopsia. Previous history significant for malaria.VA: 20/15 OU; Normal color vision; RAPD OD and fundus exam was normal. Discs were cupless, + SVP OU, flat with abundant NFL OU. Automated visual fields were full, and a PVER was normal OU. Versions were full; pursuit was interrupted by nystagmus. Saccades were rapid vertically and horizontally. A moderately large amplitude downbeating nystagmus was present in primary position, increased in amplitude on eccentric viewing, and had similar quality in all positions of downgaze. In straight upgaze the nystagmus continued with the same amplitude and direction but significantly lessened in amplitude in gaze to up and right and to up and left. A 3 pd right hypertropia was present in right gaze with a 1 pd LHT in left gaze. Brain MRI (8-8-02) revealed an extensive multilobulated cystic mass lying ventral to and within the 4th ventricle and involving the entire midbrain pretectum and tegmentum.N/AOligodendrocyte-like cells consistent with a low-grade neuroglial lesion.SurgeryAttache

Neuro-Ophthalmic Manifestations of Basilar Meningitis

Despite the advancement in science regarding control programs and powerful antibiotics CNS infections in general are still a management problem for those involved in the care of these patients. In this era of AIDS and other forms of immunosuppression, we also have to recognize symptoms and signs that are not typical for the particular infection in non-AIDS or non-immunosuppressed patients.VBmeningiti

Pourfour du Petit Precipitated by Neosynephrine Drops (.pdf)

Reverse Horners (RHs) or Pourfour du Petit syndrome (PdPs) is a rare.The most common clinical presentations include mydriasis, eyelid retraction, exophthalmos and hyperhidrosis. The pathophysiology of this disorder is not well explained;it is suggested to be secondary to cervical sympathetic chain hyperexcitability, or oculosympathetic spasm

MOG Positive Optic Neuritis with a Phenotype of CRION Disease

CRION is a recurrent, isolated, steroid dependent optic neuritis, without any associated neurological deficits or known systemic autoimmune diseases. MOG is a component of myelin and an antigen target in central nervous system demyelinating disease. There is growing evidence that the MOG antibody is linked to multiple central nervous system diseases such as anti-aquaporin-4 (AQP4)-negative NMO spectrum disorder with several phenotypical expressions. Similarly, cases of CRION, have been found to be positive for the MOG antibody

Quite An Odd Pairing: Miller-Fisher Syndrome and Autoimmune Thyroid Diseases

The concurrence of Miller-Fisher syndrome and autoimmune thyroid diseases (AITD) (Hashimoto's thyroiditis and graves' disease) is scarce with only few reported cases in literature. Immune system dysfunction may underlie this association, and linked by a common immunogenetic susceptibility. Immune system dysfunction was determined by serologic measurements of antibodies to anti-GQ1b antibody, thyroglobulin and thyroid peroxidase. We herein presenting an interesting case with positive antibodies to anti-GQ1b, thyroglobulin and thyroid peroxidase