• By Michael S. Lee, MD
    Spontaneous improvement can occur after homonymous hemianopia,1 although most patients do not enjoy complete resolution. This article describes three suggested strategies for ophthalmologists to try with such patients: the use of spectacle-mounted prisms that shift images fr…
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    By Ronald A. Braswell, MD; Courtney Flanagan, MD
    Postherpetic neuralgia (PHN) is defined as neuropathic pain, which may be lancinating or burning, with associated itching or allodynia (a painful response to a usually nonpainful stimulus) following resolution of the herpes zoster rash. The pain often lasts years and is not…
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    By Gregory Van Stavern, MD
    IntroductionOptical coherence tomography (OCT) is a noninvasive, high-resolution technique that uses near-infrared light to measure the thickness of intraocular structures, such as retinal nerve fiber layer (rNFL). Ophthalmic applications have included accurate assessment of…
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    By Michael Vaphiades, DO
    Pituitary apoplexy is characterized by sudden onset of headache, visual symptoms, altered mental status, and hormonal dysfunction. It may be hemorrhagic or nonhemorrhagic. It may involve a pre-existing pituitary adenoma or a nonadenomatous gland, as in Sheehan syndrome, whic…
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    By Julie Falardeau, MD, FRCSC
    IntroductionOptic nerve sheath meningiomas (ONSMs) represent the most common tumors of the optic nerve sheath and account for one-third of primary optic nerve tumors.1 The diagnosis is usually made by a combination of clinical and neuroimaging findings and is rarely confirme…
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    By Roger E. Turbin, MD, FACS
    Compelling evidence based on populations exposed to low-dose radiation in Hiroshima and Nagasaki suggests that radiation exposure similar to that generated by even a single head, orbit, abdominal, or chest computed tomography (CT) presents a significant risk for the developm…
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    By Jane C. Edmond, MD
    Many diseases mimic the ocular manifestations of ocular and generalized myasthenia gravis. The clinical history and examination provide the most important data for making the diagnosis of myasthenia. Patients with ocular myasthenia often have negative serum tests for acetylc…
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    By Chris Thiagarajah, MD; Karl C. Golnik, MD
    Patients who present with isolated optic atrophy can be a diagnostic dilemma for the ophthalmologist. Although the etiology of optic atrophy may be elucidated by a thorough history and examination, a definite cause is not always apparent. Recent studies have evaluated the di…
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    By Andrew G. Lee, MD; Karl C. Golnik, MD
    A multidisciplinary task force consisting of anesthesiologists, orthopedic surgeons, neurosurgeons, and neuro-ophthalmologists from the American Society of Anesthesiologists (ASA) has been unable to define any specific ophthalmic or neuro-ophthalmic evaluations that might id…
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    By Fiona E. Costello, MD, FRCP
    Optical coherence tomography (OCT) is part of the recent wave of advances in ocular imaging that has introduced new opportunities to visualize ocular anatomy and quantify the effects of retinal nerve fiber layer (RNFL) damage. The RNFL represents the most proximal region of…
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    By Howard D. Pomeranz, MD, PhD
    The erectile dysfunction drugs sildenafil, vardenafil, and tadalafil have recently been associated with non-arteritic anterior ischemic optic neuropathy (NAION). As inhibitors of phosphodiesterase (PDE) type 5, which regulates cGMP levels in vascular smooth muscles located i…
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    By Michael Vaphiades, DO
    Nonarteritic anterior ischemic optic neuropathy (NAION) has garnered attention of late in the popular media and in the ophthalmology community primarily because of its association with Sildenafil (Viagra). NAION’s relationship to diabetic papillopathy and amiodarone are als…
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    By Karl C. Golnik, MD
    New research by the Optic Neuritis Study Group has found that if magnetic resonance imaging (MRI) shows the presence of 1 or more white matter abnormalities (plaques) in patients with optic neuritis (ON), it is much more likely that those patients will develop multiple scler…
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