The 12 neuro-ophthalmological diagnoses you would hate to miss
Joint Event on 7th European Clinical Microbiology Congress & 4th International Conference on Ophthalmology and Eye Disorder
November 01-02, 2018 | London, UK
Hadassah University, Israel
Keynote : Clinical Microbiology and Eye
The presentation will elaborate on twelve neuroophthalmologic disorders, part of a longer list, which can potentially cause death or blindness if not diagnosed and treated correctly: Aneurysmal third nerve palsy; aneurysm is not the most common compressive lesion causing third nerve palsy, but it has the highest mortality if untreated. Giant cell arteritis is an idiopathic inflammatory vasculitis affecting small– to-medium size arteries, which can cause blindness, but also cerebral infarction and cardiac ischemia. Myasthenia gravis is an autoimmune disease of the neuromuscular junction, which has both an ocular and generalized form. Myasthenic crisis is a neurologic emergency, which causes paralysis of the muscles of breathing. Pituitary apoplexy results from hemorrhagic infarction of the pituitary gland and causes acute endocrine and neurologic symptoms. Pseudotumor cerebri or idiopathic intracranial hypertension is a condition of unknown cause that produces elevated intracranial pressure and papilledema primarily in young obese females. In 24% of cases can cause visual dysfunction. Primary optic nerve sheath meningioma is the most common tumor of the optic nerve sheath, and it typically presents with a slowly progressive optic neuropathy characterized by a variable loss of visual acuity. Pituitary adenomas are the most common cause of chiasmal lesions in adults. The most common symptom of a chiasmal compressive lesion is gradual, painless, progressive and bilateral vision loss. Fungal optic neuropathy may complicate meningitis resulting from a variety of molds and yeasts. The prevalence of these disorders increases in immunocompromised or immunosuppressed patients with diabetes, lymphoreticular disorders or AIDS. Neuromyelitis optica or Devic’s disease is characterized by acute or subacute loss of vision in one or both eyes caused by acute optic neuropathy preceded or followed within days or weeks by a transverse or ascending myelopathy. Horner syndrome is manifested with acute neck pain and a miotic pupil. It may be caused by a lesion along the sympathetic pathway that supplies the head, eye and neck. Toxic/nutritional optic neuropathies usually develop over months with a painless, bilateral, symmetric and progressive loss of central vision, but some cases may present with acute and severe vision loss such as poisoning with methanol or ethylene glycol. Amaurosis fugax lasting minutes in an altitudinal fashion should be considered to be ischemic, due to cardioembolic source or giant cell arteritis, until proven otherwise.
Shlomo Dotan attended medical school at the Hebrew University–Hadassah Hospital in Jerusalem, between the years 1968 and 1974. He completed his internship and residency in ophthalmology and received his license as a specialist in ophthalmology from the Israeli Ministry of Health in 1986. In 1989, he started a clinical fellowship in neuro-ophthalmology at the Kellogg Eye Center in Ann Arbor, MI, USA, under the supervision of Dr. Jonathan Trobe, a world leading neuro-ophthalmologist. For the last 27 years, he was the chief of the neuro-ophthalmology service at the Hadassah- Hebrew University Medical Center in Ein Kerem, Jerusalem. He speaks fluently five languages, is the author of almost forty scientific articles and the organizer and speaker in many ophthalmological and neuro-ophthalmological conferences.