The ligamentous cervical instability etiology of human disease from the forward head-facedown lifestyle: emphasis on obstruction of fluid flow into and out of the brain.

Ligamentous cervical instability, especially ligamentous upper cervical instability, can be the missing structural cause and/or co-morbidity for many chronic disabling brain and systemic body symptoms and diagnoses. Due to the forward head-facedown lifestyle from excessive computer and cell phone usage, the posterior ligament complex of the cervical spine undergoes a slow stretch termed "creep" which can, over time, lead to cervical instability and a breakdown of the cervical curve. As this degenerative process continues, the cervical curve straightens and ultimately becomes kyphotic, a process called cervical dysstructure; simultaneously, the atlas (C1) moves forward, both of which can lead to encroachment of the structures in the carotid sheath, especially the internal jugular veins and vagus nerves.

A Case of Saturday Night Retinopathy Following Postoperative Orbital Compression Bandaging: Diagnosis and Evaluation Using Multimodal Imaging.

We report a rare case of Saturday Night Retinopathy (SNR) following postoperative orbital compression bandaging, highlighting the value of multimodal imaging in diagnosis and management. A 24-year-old male underwent surgical repair of an inferior orbital wall fracture with an absorbable implant, followed by compression bandaging of the right eye for three days. Upon bandage removal, the patient experienced a significant drop in visual acuity (VA) from 20/20 to 20/200.

Asymmetric, Bilateral Nontraumatic Subperiosteal Orbital Hematomas in an Anticoagulated Patient Following Anesthesia in Prone Positioning.

The authors report a case of nontraumatic orbital subperiosteal hematoma after general anesthesia with patient in the prone position. The patient, who was on aspirin, clopidogrel, and subcutaneous heparin, presented immediately after sacral ulcer debridement with acute bilateral vision loss and periorbital edema. While the OD improved with conservative management, the OS continued to have 20/200 vision, decreased color vision, afferent pupillary defect, and extraocular movement limitation after lateral canthotomy and cantholysis.

An Atypical Case of Orbital Wall Infarction Secondary to Sickle Cell Disease in an Adult and Review of Literature.

Sickle cell disease is known to cause painful vaso-occlusive crises in long bones with large marrows. Orbital infarction is a rare complication of sickle cell disease and usually presents in children and adolescents with acute onset periocular swelling mimicking orbital cellulitis. We describe an atypical case of a 38-year-old man with homozygous sickle cell disease who presented with isolated, complete ptosis of his OD with minimal swelling.

Is endoscopic optic nerve decompression useful in cases of optic neuropathy secondary to pachymeningitis?

This case reports the outcome of endoscopic optic nerve decompression in a rare case of idiopathic pachymeningitis in a patient solely reliant on the affected eye. A 70 year old man with complete blindness in his left eye presented with deterioration of vision in his right eye. An MRI head and orbits was suggestive of idiopathic pachymeningitis extending into the right orbital apex, causing a compressive optic neuropathy.

Sphenoidal pneumosinus dilatans associated compressive optic neuropathy: A case series of four adolescent patients.

Visual impairment caused by pneumosinus dilatans (PSD) among adolescents is a rare condition, which is associated with a high blinding rate due to the lack of clinical manifestations and effective treatment. The use of magnetic resonance imaging (MRI) and computed tomography (CT) may be helpful in diagnosis of PSD, and the endoscopic transnasal optic nerve decompression (ETOND) can improve the vision of PSD patients with visual impairments. This case series report detailing the diagnosis and treatment of visual impairments caused by PSD has improved clinicians' understanding of this disease and helped reduce misdiagnoses and missed diagnoses.

Intravitreal bevacizumab causes rapid regression of disc neovascularization associated with large optic disk melanocytoma: a case report.

Optic disk melanocytoma (ODM) is a rare ophthalmic tumor that can present with local compressive effects such as retinal vascular occlusion (RVO) that results in neovascularization of the disk (NVD) and is reportedly challenging to treat. We report the case of a 37-year-old Black African male with a two-year history of painless nonprogressive blur in his right eye vision. Findings on ocular examination include best corrected visual acuity right eye 6/18 and left eye 6/6, right eye relative afferent pupillary defect, and a large dark brown pigmented mass covering the optic disc measuring 4.

Orbital Abscess With Vision Threatening Optic Neuropathy Due to Odontogenic Sinusitis in Adolescence: A Case Report and Literature Review.

Orbital abscesses secondary to odontogenic infections are rare but can lead to serious complications, including compressive optic neuropathy and permanent vision loss, if not diagnosed and treated promptly. We present the case of a 13-year-old child with a radiologically confirmed orbital abscess associated with a recent odontogenic infection. The patient initially presented with a one-week history of right eyelid swelling and fever.

How I do it - endoscopic endonasal optic nerve decompression for traumatic optic nerve neuropathy.

Traumatic optic neuropathy (TON) consists of damage to the optic nerve following head injury and affects about 0.5-5% of patients with closed head injuries. It is characterized by a sudden decrease in visual acuity and/or visual field loss.

Growth Hormone Neuroprotective Effects After an Optic Nerve Crush in the Male Rat.

Purpose: Growth hormone (GH) has neuroprotective effects that have not been evaluated in the mammalian visual system. This study tested the hypothesis that GH administration can promote retinal neuroprotection in an optic nerve crush (ONC) model in male rats.

Methods: The ON was compressed for 10 seconds, and bovine GH was injected concomitantly to injury for 14 days (0.

A Descriptive, Cross-sectional Study on the Ophthalmic Symptoms and Signs in Patients with Nasopharyngeal Carcinoma.

Objective: This study described the ophthalmic symptoms and signs in patients with nasopharyngeal carcinoma (NPCA).

Methods: This was a retrospective, cross-sectional, descriptive study involving patients with histologically-confirmed NPCA seen in two subspecialty eye clinics in a single referral hospital from January 2014 to December 2018. Chart review obtained data on symptoms and ophthalmic findings of patients with NPCA on the first visit.

Trastuzumab-Induced Early Corneal Melt in HER2-Positive Breast Cancer: A Case Report and Review.

BACKGROUND Trastuzumab (Herceptin) is a recombinant DNA-derived humanized monoclonal antibody that the US Food and Drug Administration (FDA) approved in 1998 for metastatic human epidermal growth factor receptor 2 (HER2)-positive breast cancer therapy. It selectively binds to the extracellular domain of HER2 and mediates an antibody-dependent cellular toxicity in various tissues. Trastuzumab use alone does not typically cause aggressive ocular complications.

Recovery of Homonymous Hemianopsia Following the Clipping of a Large Thrombosed Anterior Cerebral Artery Aneurysm Compressing the Optic Tract: A Case Report.

Unruptured cerebral aneurysms can cause visual dysfunction by compressing the optic pathways. However, there are no reports of an aneurysm at the A1 segment of the anterior cerebral artery compressing the optic tract. A 69-year-old male presented with progressive right homonymous hemianopsia, and radiological examinations revealed a large, partially thrombosed left A1 aneurysm compressing the left optic tract.

Cranial nerve palsies following neuraxial blocks.

Spinal anesthesia is one of the most frequently performed regional anesthesia techniques for a variety of surgeries world-wide. Cranial nerve palsy is a rarely reported complication of central neuraxial block. The etiology varies; however, it is most often associated with nerve compression or traction due to intracranial hypotension.

Dysthyroid Optic Neuropathy Dramatically Improved by Sheath-Guided Triamcinolone Orbital Injection: A Case Report.

Thyroid eye disease is an autoimmune disorder caused by thyroid-stimulating hormone receptor autoantibodies stimulating the thyroid-stimulating hormone receptor, resulting in proptosis, extraocular muscle dysfunction, diplopia, retro-orbital pain, optic nerve compression, and visual impairment. Dysthyroid optic neuropathy (DON), believed to result from direct compression by enlarged extraocular muscles, represents a severe complication with the potential for irreversible vision loss. Currently, the treatment options for DON are limited to highly invasive procedures, such as orbital decompression surgery and systemic steroid pulse therapy.

Delayed Surgical Reversal of Optic Nerve Compression Leads to Exponential Degeneration of Optic Nerve Fibers and Selective Sparing of the Small Fibers.

Purpose: To evaluate the effectiveness of surgical reversal of experimental optic nerve compression in treating persistent compressive optic neuropathy and to explore the relationship between surgical outcomes and the timing of the procedure.

Methods: Surgical reversal procedures (decompression surgery) were conducted at five time intervals: 1, 3, and 7 days and 2 and 3 weeks following optic nerve compression in a rabbit model. The groups were labeled as DC-1d, DC-3d, DC-7d, DC-2w, and DC-3w, respectively.

Transition from hypothyroidism to Graves' disease, development of thyroid eye disease, progression to optic neuropathy after inpatient pulse therapy, and long-term administration of outpatient pulse therapy: a case report with review of literature.

A 55-year-old woman transitioned from hypothyroidism to Graves' disease (GD) and then developed thyroid eye disease (TED) with proptosis and diplopia. After three cycles of daily methylprednisolone pulse therapy, her condition progressed to dysthyroid optic neuropathy with decreased visual acuity in both eyes. Her clinical activity score (CAS) was 7 points.

Optic Nerve Microvascular Decompression for Carotid Dolichoectasia.

Vascular compression of the optic nerve in a patient with rapid monocular vision loss with otherwise negative diagnostic workup is a rare, but controversial dilemma. The literature is conflicted, advocating for either timely surgical decompression to preserve vision or observation only given the prevalence of asymptomatic vascular compression and observed arrest of visual decline. The most frequently reported sources of symptomatic compression are unruptured aneurysms and dolichoectatic vasculature, with recent consensus reached over a need for extensive perioperative ophthalmologic evaluations and follow-up.

Are Peripapillary Hyperreflective Ovoid Mass-like Structures with an Elevated Optic Disc Still a Diagnosis Dilemma?

Purpose: To identify clinical characteristics that would help make or rule out the diagnosis of idiopathic intracranial hypertension (IIH) in patients referred for papilledema (PE) with peripapillary hyperreflective ovoid mass-like structures (PHOMS).

Design: A retrospective cohort study.

Participants: All patients referred for PE excluding PE with Frisén grade ≥ 3, optic neuritis, ischemic optic neuropathy, and compressive optic neuropathy.

Etiologies and Outcomes of Granulomatosis With Polyangiitis-Associated Optic Neuropathy: A Case Series and Review of the Literature.

Background: Granulomatosis with polyangiitis (GPA), formerly known as Wegener granulomatosis, is a rare autoimmune disease characterized by inflammation of small- to medium-sized blood vessels (vasculitis). We described the 3 causes of GPA-associated optic neuropathy (compressive, inflammatory, or ischemic) and analyzed initial and final visual acuities (VAs) in each group, which could potentially help prognosticate visual outcomes depending on the etiology of optic neuropathy.

Methods: This was a retrospective chart review of patients who were diagnosed with GPA-associated optic neuropathy and were seen in the Department of Ophthalmology at Mayo Clinic in Rochester, Minnesota.