http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/Neuro-Ophthalmology/Article/list/573 Neuro-ophthalmology including ocular motor disorders, nystagmus, pupil abnormalities. Also vision loss, neuropathy, and neuritis. 2009-11-21T17:45:04Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/Clinical+News/Ptosis-A-sign-of-myasthenia-gravis/ArticleStandard/Article/detail/565082?contextCategoryId=573&ref=25 Ptosis is a sign of a number of diseases, most of which are benign. Julie Falardeau, MD, of the Casey Eye Institute, Portland, OR, described how ophthalmologists can avoid overlooking myasthenia gravis, which can be associated with serious morbidity and mortality. 2008-11-10T05:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/462008/565082null HTML http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/Modern+Medicine+Now/Giant-cell-arteritis-focus-of-regional-study/ArticleStandard/Article/detail/603264?contextCategoryId=573&ref=25 The electronic database of a large health-maintenance organization was used to identify patients who had a positive temporal artery biopsy indicating a diagnosis of giant cell arteritis (GCA). The calculated incidence of GCA was significantly less than previously reported and is thought to reflect, in part, differences in population demographics between studies. 2009-06-01T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/242009/603264null XML http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/Modern+Medicine+Now/Giant-cell-arteritis-An-updated-review/ArticleStandard/Article/detail/603263?contextCategoryId=573&ref=25 This article summarizes the recent elucidations on the immunopathogenic process that leads to giant cell arteritis (GCA) and reviews both the well-known and newly recognized clinical subtypes and manifestations of the disease. The role of various noninvasive imaging techniques that are increasingly used to corroborate a clinical diagnosis of GCA as well as traditional and new treatment strategies are discussed. 2009-06-01T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/242009/603263null XML http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/Modern+Medicine+Now/Neuro-ophthalmic-evaluation-vital-for-head-neck-ca/ArticleStandard/Article/detail/599621?contextCategoryId=573&ref=25 A study of patients with head and neck cancers showed a high rate of oculo-orbital complications associated with the malignancy or its treatment and underscores the importance of a neuro-ophthalmic evaluation. 2009-05-15T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/222009/599621null XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Cell-loss-retinal-thinning-found-after-excitotoxic/ArticleStandard/Article/detail/559873?contextCategoryId=573&ref=25 A study in a rat model found retinal ganglion cell loss and retinal thinning following excitotoxic damage. This finding has led researchers to speculate that axonal damage and excitotoxicity are related, and that the connection may be through the Wallerian degeneration gene. Future research into this pathway could lead to new forms of treatment for glaucoma and other neurologic diseases. 2008-10-15T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/432008/559873null XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Genomic-rearrangements-in-OPA1-gene-frequent-in-ad/ArticleStandard/Article/detail/556865?contextCategoryId=573&ref=25 Multiplex ligation probe amplification (MLPA), a relatively new technique for detecting copy number variations in genomic sequences, has been used to study the pathomechanism of autosomal dominant optic neuropathy. 2008-10-01T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/412008/556865null XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Studies-suggest-neurodegenerative-injury-in-Charco/ArticleStandard/Article/detail/556864?contextCategoryId=573&ref=25 Research using a conditional knockout mouse model of the mitofusin 2 gene are providing insights into the optic nerve damage sometimes associated with Charcot-Marie-Tooth disease. Results to date show degenerative changes in the retrobulbar optic nerve suggesting a response to a neurodegenerative injury. 2008-10-01T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/412008/556864null XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Supranuclear-gaze-disturbances-can-be-confusing/ArticleStandard/Article/detail/465542?contextCategoryId=573&ref=25 Supranuclear gaze palsy should be suspected in patients with bilateral and symmetric vertical or horizontal gaze difficulty. Use of specific maneuvers to bypass the supranuclear input to the ocular motor nuclei can help to establish a supranuclear localization to the problem and direct neuroimaging to the supranuclear pathways in the brain and brainstem. 2007-10-01T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/422007/465542null XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Look-for-clues-that-indicate-cause-of-transient-vi/ArticleStandard/Article/detail/456134?contextCategoryId=573&ref=25 Determining the cause of transient monocular visual loss can be tricky. Following simple steps may help sort out the diagnosis. 2007-09-01T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/372007/456134null XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Optic-neuropathy-may-be-drug-related-physician-say/ArticleStandard/Article/detail/456136?contextCategoryId=573&ref=25 Ophthalmologists need to warn patients that the use of a phophodiesterase-5 inhibitor may increase the risk of the development of ischemic optic neuropathy. 2007-09-01T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/372007/456136null XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Pros-cons-of-pharmacologic-testing-for-Horners-syn/ArticleStandard/Article/detail/453255?contextCategoryId=573&ref=25 Pharmacologic testing can help target subsequent imaging for Horner's syndrome, but can it delay a full evaluation? Two ophthalmologists engage in a friendly debate. 2007-08-15T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/352007/453255null XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Untangling-neuroimaging-modalities-key-for-surgeon/ArticleStandard/Article/detail/453254?contextCategoryId=573&ref=25 Computed tomography and magnetic resonance imaging are extremely important imaging modalities with different capabilities that the ophthalmic surgeon should understand to use to the best advantage, according to Neil R. Miller, MD. 2007-08-15T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/352007/453254null XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Traumatic-optic-neuropathy-Do-two-wrongs-make-a-ri/ArticleStandard/Article/detail/392915?contextCategoryId=573&ref=25 It is clear that there is insufficient evidence to recommend corticosteroids as a 'standard of care' for TON. 2006-12-01T05:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/502006/392915/346085_thumbnail.jpg http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/502006/392915null XML http://www.modernmedicine.com/modernmedicine/Surgery/Typical-microvascular-third-nerve-palsy-requires-c/ArticleStandard/Article/detail/339812?contextCategoryId=573&ref=25 La Jolla, CA—When diagnosing a cranial third-nerve palsy, there are a number of factors to consider that let the ophthalmologist decide whether a patient's third-nerve palsy is microvascular, or whether the cause is a more serious one. Leah Levi, MBBS, described the checklist that she uses to arrive at the diagnosis of microvascular third-nerve palsy. 2006-06-15T04:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/262006/339812null XML http://www.modernmedicine.com/modernmedicine/ModernMedicine+Now/Differentiating-between-divergence-convergence-dis/ArticleStandard/Article/detail/327074?contextCategoryId=573&ref=25 Baltimore—Divergence and convergence abnormalities are similar in nature and can be difficult to differentiate. Michael Repka, MD, described the subtleties as well as what works best for these patients. 2006-05-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Determining-cause-of-diplopia-can-be-difficult/ArticleStandard/Article/detail/327073?contextCategoryId=573&ref=25 Oklahoma City, OK—Ferreting out the causes of diplopia can be tricky. To make the task easier, R. Michael Siatkowski, MD, outlined his four steps to finding the causes of diplopia and seven rules that all cases should follow. 2006-05-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Erectile-dysfunction-agents-NAION-causal-or-coinci/ArticleStandard/Article/detail/310124?contextCategoryId=573&ref=25 It might be wise to counsel patients regarding the possible but likely low risk of NAION, especially for individuals with a higher risk for NAION. 2006-03-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Primary+Care+Medicine/High-degree-of-suspicion-needed-for-diagnosis-of-a/ArticleStandard/Article/detail/279334?contextCategoryId=573&ref=25 Chicago—"When is a lid laceration not just a lid laceration?" When it is occult penetrating orbito-cranial trauma, explained Roger E. Turbin, MD, assistant professor of ophthalmology and associate director of neuro-ophthalmology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School. 2006-01-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neurology/Clinician-plays-critical-role-in-diagnosis-treatme/ArticleStandard/Article/detail/279336?contextCategoryId=573&ref=25 Chicago—Painful ophthalmoplegia may be a benign condition, such as microvascular ocular motor neuropathy, most commonly seen in the elderly with head and/or face pain, not requiring neuroimaging. On the other hand, it may be more serious with a combination of signs/symptoms that indicate a problem originating in the brain stem, cavernous sinus, or elsewhere, requiring a complete work-up, explained Gregory P. Van Stavern, MD. 2006-01-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neurology/Cause-of-transient-monocular-visual-loss-may-be-di/ArticleStandard/Article/detail/279335?contextCategoryId=573&ref=25 With the widespread availability of OCT, clinical can easily examine the vitreous interface. 2006-01-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Modern+Medicine+Feature+Articles/Optic-nerve-sheath-advances-detailed/ArticleStandard/Article/detail/201235?contextCategoryId=573&ref=25 Chicago—A number of advances have been made in the ability to diagnose and manage optic nerve sheath meningiomas. Neil R. Miller, MD, described how best to handle these tumors during the William F. Hoyt Lecture at the American Academy of Ophthalmology annual meeting. 2005-11-15T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Chance-of-visual-field-loss-relatively-small-with-/ArticleStandard/Article/detail/186748?contextCategoryId=573&ref=25 Iowa City—The rate of visual field loss in patients who had optic nerve head drusen (ONHD) was about 1.6% per year, approximately what would be expected for this condition, said Andrew G. Lee, MD, professor of ophthalmology, neurology, and neurosurgery at the University of Iowa Hospitals and Clinics, Iowa City. 2005-10-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/With-new-onset-nystagmus-in-adult-consider-MS/ArticleStandard/Article/detail/186749?contextCategoryId=573&ref=25 Iowa City—Multiple sclerosis (MS) is associated with the development of various forms of nystagmus. The association is so strong that new-onset nystagmus in an adult should be considered MS until proven otherwise. 2005-10-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Sildenafil-use-may-be-linked-to-NAION-in-men/ArticleStandard/Article/detail/184649?contextCategoryId=573&ref=25 Editor's Note: Howard Pomeranz, MD, describes a possible association of sildenafil and non-arteritic anterior ischemic optic neuropathy (NAION). There are several compelling parts of the argument, including temporal relationship of symptoms to drug delivery, a suggestive rechallenge history, a biologically plausible mechanism of effect, and analogy from other cases. 2005-10-12T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Cerebellar-disease-implicated-in-abnormal-eye-move/ArticleStandard/Article/detail/176077?contextCategoryId=573&ref=25 Baltimore—A number of eye movement disturbances are characterized by cerebellar disease and saccadic intrusions. Michael X. Repka, MD, detailed these abnormalities and how to distinguish among them. 2005-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/ARVO/LHON-can-lead-to-devastating-vision-loss-in-carrie/ArticleStandard/Article/detail/175955?contextCategoryId=573&ref=25 Fort Lauderdale, FL—A study of a large pedigree of Leber's hereditary optic neuropathy (LHON) revealed two family members who were asymptomatic carriers but nevertheless had subclinical fundus and psychophysical impairments. After being followed for years, status in both patients converted from carrier to affected. 2005-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Ophthalmic+News/Improvements-in-arterial-imaging-aid-stroke-diagno/ArticleStandard/Article/detail/157085?contextCategoryId=573&ref=25 East Lansing, MI—New techniques are available to image the arteries, including new methods of noninvasive imaging and diffusion-weighted imaging to visualize acute strokes. Eric Eggenberger, DO, discussed these as well as the importance of consulting with a neuroradiologist to help make the best decisions for patients. 2005-05-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/lead+item/Amiodarone-related-vision-loss-a-new-entity-or-NAI/ArticleStandard/Article/detail/153486?contextCategoryId=573&ref=25 Amiodarone was introduced in 1961 as an anti-anginal agent and was also found to be helpful in several cardiac arrhythmias. 2005-04-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/How-to-screen-asymptomatic-patients-taking-HCQ/ArticleStandard/Article/detail/153473?contextCategoryId=573&ref=25 A 65-year-old obese man with systemic lupus erythematosus presents to the ophthalmology clinic, referred from rheumatology for "toxicity screening" after starting therapy with hydroxychloroquine sulfate (HCQ) 400 mg per day (Plaquenil Sulfate). He had prior lupus-related glomerulonephritis but has a stable serum creatinine level. There was no liver dysfunction. 2005-04-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Isolated-optic-atrophy-best-evaluated-by-imaging/ArticleStandard/Article/detail/150416?contextCategoryId=573&ref=25 New Orleans—Neuroimaging tests such as MRI appear to have the highest diagnostic value in evaluation of cases of unexplained optic atrophy, while laboratory testing has a low yield, according to Karl C. Golnik, MD. 2005-03-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/How-to-choose-the-best-visual-field-testing-strate/ArticleStandard/Article/detail/150415?contextCategoryId=573&ref=25 Every patient should undergo at least screening confrontation visual field testing. 2005-03-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Seven-easy-steps-in-evaluation-of-fourth-nerve-pal/ArticleStandard/Article/detail/131220?contextCategoryId=573&ref=25 A fourth-nerve palsy is a common cause of acquired vertical diplopia in the adult. These patients typically complain of vertical diplopia and tilting (torsion) of objects. The history and exam should focus on any other neurologic signs or symptoms, recent head trauma, vasculopathic risk factors, and prior symptoms suggestive of a congenital or long-standing palsy. 2004-11-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Editorial/Is-neuro-ophthalmology-in-jeopardy/ArticleStandard/Article/detail/157461?contextCategoryId=573&ref=25 Unless action is taken, resident training and patient care may suffer 2004-11-01T05:00:00Z HTML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/MfERG-mfVEP-helps-in-neuro-ophthalmology/ArticleStandard/Article/detail/129361?contextCategoryId=573&ref=25 New York—Multifocal electroretinograms (mfERGs) and multifocal visual evoked potentials (mfVEPs) are relatively new techniques that are starting to be used in a clinical setting. Jeffrey G. Odel, MD, discussed the usefulness of these diagnostic tests in patients with neuro-ophthalmic pathology. 2004-10-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Differential-diagnosis-key-to-treatment-of-pale-op/ArticleStandard/Article/detail/129360?contextCategoryId=573&ref=25 Buffalo, NY—In the absence of optic nerve swelling, the clinician may be faced with a difficult diagnosis in a patient with a pale optic nerve, according to Norah S. Lincoff-Cohen, MD. A comprehensive differential diagnosis needs to be made to rule out disorders that may require immediate treatment. 2004-10-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Note-differences-between-optic-nerve-diseases/ArticleStandard/Article/detail/126316?contextCategoryId=573&ref=25 Los Angeles—Chronic progressive optic neuritis or optic nerve sheath meningioma? Until fairly recently, differentiating these two clinical entities would not have affected the clinical outcome because of the lack of an established safe, efficacious treatment for either condition. However, things have changed, said Howard R. Krauss, MD. 2004-09-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Coronado-receives-patents-for-PNT-treatment-techno/ArticleStandard/Article/detail/126309?contextCategoryId=573&ref=25 Fountain Hills, AZ—Coronado Industries Inc. announced that it has received patents for its pneumatic trabeculoplasty (PNT) treatment device and procedure in China. 2004-09-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Differentiating-diseases-Rules-to-live-by/ArticleStandard/Article/detail/126317?contextCategoryId=573&ref=25 Howard R. Krauss, MD, shared these "10 Golden Rules for differentiating optic neuritis from optic nerve sheath meningioma." 2004-09-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Clues-differentiate-ischemic-optic-neuropathy-opti/ArticleStandard/Article/detail/120493?contextCategoryId=573&ref=25 Minneapolis—Differentiating ischemic optic neuropathy from optic neuritis can be problematic. The type of visual field defect, the presence or absence of pain, radiologic differences distinguishing between the two, and the degree of visual recovery, among others, may be helpful clues, Howard D. Pomeranz, MD, PhD, suggested. 2004-09-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Digital-subtraction-anglography-still-the-gold-sta/ArticleStandard/Article/detail/120491?contextCategoryId=573&ref=25 Birmingham, AL— Advances in diagnostic testing are aiding in the diagnoses of neuro-ophthalmic disorders. Michael S. Vaphiades, DO, described the pros and cons of digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and com-puted tomographic angiography (CTA). 2004-09-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Pattern-location-top-factors-to-evaluate-in-horizo/ArticleStandard/Article/detail/120492?contextCategoryId=573&ref=25 Ann Arbor, MI—When considering horizontal diplopia, two important factors are the pattern of the diplopia and the location. Wayne T. Cornblath, MD, described the clinical plan he follows when patients present with horizontal diplopia. 2004-09-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Start-steroids-immediately-if-temporal-arteritis-i/ArticleStandard/Article/detail/120490?contextCategoryId=573&ref=25 Lausanne, Switzerland—The presentation of temporal arteritis can vary, so ophthalmologists sometimes fail to diagnose this vision-threatening disease in a timely fashion. 2004-09-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Sleep-apnea-linked-to-some-ischemic-optic-neuropat/ArticleStandard/Article/detail/119643?contextCategoryId=573&ref=25 Dallas—A sleep study should be performed in patients who have an elevated C-reactive protein (CRP) level and biopsy-negative ischemic optic neuropathy. Elevated CRP may be a marker for sleep apnea-associated optic neuropathy, according to John G. McHenry, MD. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Ocular-motility-testing-an-important-part-of-exami/ArticleStandard/Article/detail/119648?contextCategoryId=573&ref=25 Los Angeles—"An assessment of ocular motility is a component of a comprehensive ophthalmologic examination. Therefore, it should be carried out even in the absence of complaints referable to the ocular motor system," said Howard R. Krauss, MD, clinical professor of ophthalmology, Jules Stein Eye Institute, and clinical professor of neurosurgery, UCLA, Los Angeles. "More detailed ocular motor tests can be performed when clinically indicated." 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Consider-hypertension-as-cause-of-bilateral-disc-e/ArticleStandard/Article/detail/119645?contextCategoryId=573&ref=25 Los Angeles—Hypertension in a patient should raise a red flag for ophthalmologists because it may be associated with optic neuropathy. Anthony C. Arnold, MD, provided his pearls for the safe management of these patients. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Be-careful-to-order-proper-imaging-with-vertical-f/ArticleStandard/Article/detail/119641?contextCategoryId=573&ref=25 New York—When evaluating patients with a visual field cut that respects the vertical meridian, there are a few golden rules to follow. Jeffrey G. Odel, MD, described the steps neuro-ophthalmologists should follow. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Glaucoma/Glaucoma-drug-may-be-useful-approach-for-blepharos/ArticleStandard/Article/detail/119640?contextCategoryId=573&ref=25 Monterey Park, CA—Latanoprost (Xalatan, Pfizer) may be an alternative treatment for blepharospasm. Ted C. Wei Jr., MD, reported that 75% of his patients had moderate to complete resolution of symptoms after latanoprost was prescribed. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Visual-loss-of-amaruosis-fugax-can-be-diagnosed-in/ArticleStandard/Article/detail/119646?contextCategoryId=573&ref=25 New York—Differentiating the classic embolic visual loss of amaurosis fugax from the numerous other causes of transient visual loss involves careful evaluation. Mark J. Kupersmith, MD, described how to differentiate among the various causes of transient visual disturbance and target the necessary diagnostic procedures. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Disorders-of-accomoation-can-be-perplexing/ArticleStandard/Article/detail/119647?contextCategoryId=573&ref=25 Lausanne, Switzerland—Disorders of accommodation can be caused by disruption of neuroregulation. While many patients present with an insidious and mild accommodative insufficiency, often accompanying a systemic illness, the acute onset of severe and bilateral loss of accommodation is a more serious condition and may indicate the presence of a midbrain lesion. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/New-procedure-for-NAION-appears-promising/ArticleStandard/Article/detail/119650?contextCategoryId=573&ref=25 New Orleans—Transvitreal optic neurotomy, a space-creating procedure, may be a beneficial treatment for patients with nonarteritic anterior ischemic optic neuropathy (NAION) because it reduces constriction of ocular tissue and prevents necrosis of functioning nerve fibers. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Rule-of-pupil-still-applies-to-complete-third-nerv/ArticleStandard/Article/detail/119639?contextCategoryId=573&ref=25 St. Louis—When the rule of the pupil was first described in 1958 by Wilbur Rucker, MD, there were specific guidelines to follow if the pupillary reaction was normal and if it was not; in the first case, paralysis is likely due to occlusive vascular disease and in the second case to aneurysm. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/OCT-offers-promising-new-uses-for-neuro-ophthalmol/ArticleStandard/Article/detail/119649?contextCategoryId=573&ref=25 Boston—Optical coherence tomography (OCT), a relatively new technology introduced in 1995, has been getting increasingly greater attention as its usefulness is better appreciated in the areas of retina and glaucoma. Joseph F. Rizzo III, MD, discussed the technology as it applies to neuro-ophthalmic practice. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Early-diagnosis-essential-in-cerebrovascular-disse/ArticleStandard/Article/detail/119644?contextCategoryId=573&ref=25 Philadelphia—Cerebrovascular dissection represents a life-and-death situation for the patient. Ophthalmologists should be able to recognize this potentially catastrophic diagnosis and initiate emergent treatment, said Nicholas Volpe, MD. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Acute-palsies-may-require-assessing-ischemic-risk-/ArticleStandard/Article/detail/119642?contextCategoryId=573&ref=25 Montreal—Acute third-, fourth-, or sixth-nerve palsies do not seem to be associated with myocardial infarctions (MI) and cerebrovascular accidents (CVA), but the development of one of these palsies is an indi- cation for an assessment of ischemic risk factors, according to Kashif Baig, MD, MBA. 2004-08-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Key-factors-help-clinician-assess-strabismus-diplo/ArticleStandard/Article/detail/112707?contextCategoryId=573&ref=25 Oklahoma City-When patients with strabismus or diplopia present, ophthalmologists question if the condition is a congenital or an acquired neurologic disease and if imaging or any other tests are needed. R. Michael Siatkowski, MD, differentiated among the various possibilities. 2004-08-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Vertical-diplopia-requires-detailed-history-comple/ArticleStandard/Article/detail/112709?contextCategoryId=573&ref=25 Nashville-Vertical diplopia has an extensive differential diagnosis. However, it is im-portant to realize that if the ophthalmologist does an appropriate history and looks for a few key clues, there is rarely a case for which it is necessary to order imaging studies, according to Sean P. Donahue, MD, PhD, associate professor of ophthalmology, Vanderbilt University Medical Center, Nashville. 2004-08-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Constricted-pupil-may-indicate-physiologic-anisoco/ArticleStandard/Article/detail/112702?contextCategoryId=573&ref=25 Iowa City, IA-The constricted pupil is both easy and hard to diagnose. As with the dilated pupil, there are easy-to-diagnose conditions in the patient with a small pupil-such as physiologic anisocoria, Horner's syndrome, and iris abnormalities-and these occur commonly. Pharmacologic miosis, Adie's pupil, and aberrant regeneration of the third nerve, however, are a bit harder to pinpoint, according to Andrew G. Lee, MD, who outlined his practical approach to diagnosing the constricted pupil. 2004-08-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Five-main-causes-of-light-near-dissociation-covere/ArticleStandard/Article/detail/112706?contextCategoryId=573&ref=25 Philadelphia-The five most important causes of light-near dissociation are deafferented pupils, midbrain lesions, Argyll-Robertson pupils, aberrant regeneration of the third nerve, and tonic pupils. 2004-08-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Use-term-papilledema-with-caution-to-avoid-unneces/ArticleStandard/Article/detail/112704?contextCategoryId=573&ref=25 Papilledema is a term that is best reserved for optic disc edema that is due to increased intracranial pressure. All other forms of optic disc swelling should probably be referred to as optic disc edema to avoid clinical confusion with the more specific term, papilledema. Ophthalmologists should therefore be cautious about using the term papilledema when they really mean ischemic optic neuropathy or optic neuritis. This is especially important when referring patients to other consultants (for example, neurology) because these patients may end up with inappropriate, expensive, or unnecessary testing. 2004-08-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Atypical-optic-neuritis-challenging-to-diagnose/ArticleStandard/Article/detail/112705?contextCategoryId=573&ref=25 Certain systemic infections such as syphilis, Lyme disease, cat-scratch disease, tuberculosis, or post-viral optic neuritis can mimic the appearance of typical optic neuritis. 2004-08-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Connection/Third-nerve-palsy-an-uncommon-occurrence-in-childr/ArticleStandard/Article/detail/106552?contextCategoryId=573&ref=25 As opposed to adults, in whom ischemic palsies are common, ischemia is a rare cause for a third-nerve palsy in children. 2004-07-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Connection/Intracranial-shunts-101-for-the-ophthalmologist/ArticleStandard/Article/detail/99603?contextCategoryId=573&ref=25 The typical signs and symptoms of shunt malfunction include headache, neck pain, malaise, nausea and vomiting, mental status changes, increased blood pressure, or seizure. 2004-06-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Questioning-can-help-differentiate-worrisome-migra/ArticleStandard/Article/detail/99604?contextCategoryId=573&ref=25 Patients with atypical or stereotypical symptoms present more cause for concern. 2004-06-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/MRI-lumbar-puncture-key-to-pseudotumor-cerebri-dia/ArticleStandard/Article/detail/99605?contextCategoryId=573&ref=25 Visual field testing, fundus photography help to document condition of optic nerve over time 2004-06-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Evaluation-of-anisocoria-a-straightforward-process/ArticleStandard/Article/detail/93125?contextCategoryId=573&ref=25 Los Angeles-Examination of patients with anisocoria is a straightforward procedure, according to Lynn K. Gordon, MD, PhD, who highlighted a number of practical considerations that might cause the disease process. 2004-04-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Optic-nerve-sheath-meningioma-a-diagnostic-challen/ArticleStandard/Article/detail/93123?contextCategoryId=573&ref=25 Newark, NJ-Optic nerve sheath meningiomas can present problematic diagnostic dilemmas. 2004-04-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Thorough-exam-history-needed-for-intermittent-dipl/ArticleStandard/Article/detail/93122?contextCategoryId=573&ref=25 Indianapolis-Intermittent diplopia is particularly problematic for physicians. 2004-04-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Be-aware-of-the-big-four-As-you-cannot-afford-to-m/ArticleStandard/Article/detail/92072?contextCategoryId=573&ref=25 The busy general ophthalmologist should be aware of four neuro-ophthalmic emergencies: giant cell arteritis, pituitary apoplexy, amaurosis fugax, and intracranial aneurysm. Specific pertinent pearls for recognizing each disorder are emphasized in this article. 2004-04-01T05:00:00Z http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/data/articlestandard/ophthalmologytimes/162004/92072/main_main.jpg XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/NAION-may-herald-hyperlipidemia-in-young-patients/ArticleStandard/Article/detail/92070?contextCategoryId=573&ref=25 Philadelphia-Nonarteritic anterior ischemic optic neuropathy (NAION) is the second most common optic neuropathy and can be confused with low-tension glaucoma or even multiple sclerosis. 2004-04-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Fixation-instabilities-need-careful-exam-for-diagn/ArticleStandard/Article/detail/90333?contextCategoryId=573&ref=25 Anaheim, CA-Nystagmus and saccadic oscillations, both fixation instabilities, are often important findings diagnostically, said Robert D. Yee, MD, at the American Academy of Ophthalmology annual meeting. 2004-03-15T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Temporal-GCA-needs-immediate-attention/ArticleStandard/Article/detail/90334?contextCategoryId=573&ref=25 Anaheim, CA-Temporal giant cell arteritis (GCA) is potentially devastating if not recognized and treated early. Even early intervention may not reverse or prevent visual loss. Neil R. Miller, MD, provided his approach to recognizing and managing this systemic disease of the elderly during the annual meeting of the American Academy of Ophthalmology. 2004-03-15T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Typical-optic-neuritis-may-signal-multiple-scleros/ArticleStandard/Article/detail/88645?contextCategoryId=573&ref=25 Anaheim, CA-Typical optic neuritis may be the first indication of multiple sclerosis (MS). Recognizing this and the implications for treatment as well as determining the degree of risk of developing MS are critical for ophthalmologists, who are often the first to evaluate these patients. 2004-03-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Irregular-pupil-indicates-damage-to-one-of-three-s/ArticleStandard/Article/detail/88646?contextCategoryId=573&ref=25 Anaheim, CA-Development of an irregular pupil can occur as the result of a number of different factors, that is, problems with the iris tissue itself, nerve innervation to the iris dilator or sphincter muscle, or insults to the central nervous system, according to Randy H. Kardon, MD, PhD, who discussed the three sites of dysfunction here at the American Academy of Ophthalmology annual meeting. 2004-03-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Dilated-pupil-may-be-a-diagnostic-challenge/ArticleStandard/Article/detail/88647?contextCategoryId=573&ref=25 Anaheim, CA-When presented with a patient with a dilated pupil, the physician must determine if it is an isolated occurrence or if there is a more complicated clinical problem, according to Leah Levi, MBBS, who spoke at the American Academy of Ophthalmology annual meeting. 2004-03-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Immunotherapy-may-help-prevent-progression-of-OM-t/ArticleStandard/Article/detail/88643?contextCategoryId=573&ref=25 Myasthenia gravis is a relatively common autoimmune disorder that may present to the general ophthalmologist with unilateral or bilateral ptosis with or without ophthalmoplegia. 2004-03-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Connection/Atypical-features-signal-when-to-image-glaucomatou/ArticleStandard/Article/detail/73386?contextCategoryId=573&ref=25 Imaging studies in typical glaucomatous cupping are usually unnecessary because the diagnosis can normally be made on clinical grounds alone (e.g., elevated IOP, glaucomatous cupping, nerve fiber layer visual field defects). In addition, glaucoma produces a specific and differentiating form of optic atrophy (i.e., cupping). Although most patients with glaucoma have an elevated IOP, some have normal-tension glaucoma.This article reviews the "red flags" for considering imaging in suspected glaucomatous optic atrophy. 2003-11-01T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/In+Brief/Neuro-ophthalmology-group-joins-JCAHPO/ArticleBrief/Article/detail/69165?contextCategoryId=573&ref=25 St. Paul, MN-The North American Neuro-Ophthalmology Society (NANOS) has been approved as a regular organizational member of the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO). 2003-09-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Hypothesis-may-explain-clinical-scenarios-in-incre/ArticleLong/Article/detail/65323?contextCategoryId=573&ref=25 Editor's Note: Sherif Amer, MD, proposes a new hypothesis for pressure dissociation in optic disc edema due to increased intracranial pressure (ICP) (i.e., papilledema). This theory provides some insight into some of the clinically controversial scenarios that occur in increased ICP such as pseudotumor cerebri without papilledema, asymmetric or frankly unilateral papilledema, and progressive visual loss due to increased ICP without disc edema. The theory has merit and deserves further study and testing of the hypotheses generated. -- Andrew G. Lee, MD 2003-08-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Craniocervical-arterial-dissection-a-diagnostic-ch/ArticleStandard/Article/detail/55496?contextCategoryId=573&ref=25 A craniocervical arterial dissection usually results from a tear in the intimal arterial layer. This tear allows the formation of a false lumen containing a clot, which can lead to thromboembolic complications (stroke). If the dissection is subintimal, stenosis of the artery is the likely end result. If it is subadventitial, the result is a "pseudo-aneurysm" (Figure 1). 2003-05-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Lessons-from-ONTT-help-in-management-of-optic-neur/ArticleStandard/Article/detail/50658?contextCategoryId=573&ref=25 Baltimore-Ophthalmologists can now use new guidelines on how best to treat optic neuritis based on the results from the Optic Neuritis Treatment Trial (ONTT), which followed long-term outcomes for 10 years, according to Neil R. Miller, MD, who spoke at the Current Concepts in Ophthalmology Meeting. 2003-03-15T05:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/FDT-perimetry-a-better-test-of-ganglion-cell-loss/ArticleBrief/Article/detail/29800?contextCategoryId=573&ref=25 Fort Lauderdale, FL-Frequency doubling technology (FDT) perimetry appears to be a more sensitive visual field test for ganglion cell loss than traditional testing methods, according to Christopher A. Girkin, MD. 2002-09-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Nuclear-genes-other-risk-factors-may-activate-mito/ArticleStandard/Article/detail/26025?contextCategoryId=573&ref=25 Fort Lauderdale, FL-In 1861, an Italian couple emigrated from Verona to rural Brazil. Their 300 descendants spreading over seven generations have given scientists a unique opportunity to study many environmental factors that may have influenced the expression of Leber's hereditary optic neuropathy (LHON). 2002-08-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Capillary-blood-speed-helps-in-NAION-ON-diagnoses/ArticleStandard/Article/detail/26043?contextCategoryId=573&ref=25 Fort Lauderdale, FL-Differences in local capillary blood speed characteristics in patients who have unilateral nonarteritic anterior ischemic optic neuropathy (NAION) and optic neuritis (ON) may help in the differential diagnosis of these two most common nonglaucomatous optic neuropathies, said Nathalie Collignon, MD, at the annual meeting of the Association for Research in Vision and Ophthalmology. 2002-08-01T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Spontaneous-venous-pulses-indicate-normal-intracra/ArticleStandard/Article/detail/18844?contextCategoryId=573&ref=25 Boston-Spontaneous venous pulsations are a common occurrence in normal eyes and indicate that the intracranial pressure is normal, according to Don Bienfang, MD, assistant professor of ophthalmology, department of ophthalmology and neurology, 2002-05-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Cupping-found-frequently-in-AAION-as-well-as-in-gl/ArticleStandard/Article/detail/18880?contextCategoryId=573&ref=25 Philadelphia-Cupping of the optic disc often occurs in association with glaucoma but can also develop after anterior ischemic optic neuropathy (AION), although this is an area of controversy. 2002-05-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Neuroprotection-may-prevent-retinal-ganglion-cell-/ArticleStandard/Article/detail/18881?contextCategoryId=573&ref=25 Madison, WI-There are no immediate effective treatments for most optic neuropathies, which result in the irreversible death of retinal ganglion cells. 2002-05-15T04:00:00Z XML http://www.modernmedicine.com/modernmedicine/Neuro-Ophthalmology/Radiation-preferred-for-optic-nerve-sheath-meningi/ArticleStandard/Article/detail/13264?contextCategoryId=573&ref=25 Baltimore-Radiation therapy is the present standard of care for optic nerve sheath meningiomas, according to Neil R. Miller, MD. 2002-03-15T05:00:00Z XML