3rd Edition
Consultations in Neuro-Ophthalmology 50 Clinical Questions
Editor Biographies
Acknowledgements
List of Contributors
Preface
Question 1 How Should a Childhood Optic Nerve Glioma Be Worked Up?
Grace Forbes, BA and Robert A. Avery, DO
Question 2 How Should a Optic Nerve Sheath Meningioma Be Managed?
Neil R. Miller, MD
Question 3 When Should You Consider the Diagnosis of Neuromyelitis Optica Spectrum Disease with Positive Aquaporin 4-IgG (AQP4+ NMOSD)?
Fiona Costello, MD, and Jodie M. Burton, MD
Question 4 How Should I Evaluate and Manage Suspected Optic Neuritis?
Eric Eggenberger, DO
Question 5 What Is the Treatment of Optic Neuritis?
Nicholas R. Levergood, MD, and Melissa W. Ko, MD, MBA
Question 6 What is the Workup and Treatment for Neuroretinitis?
Kenneth Han, BS, Jay Patel, MD, and Karl Golnik, MD
Question 7 How Do You Evaluate and Treat Nonarteritic Anterior Ischemic Optic Neuropathy?
M. Tariq Bhatti, MD
Question 8 How Do You Differentiate Arteritic from Nonarteritic Anterior Ischemic Optic Neuropathy?
Rod Foroozan, MD
Question 9 How Should I Treat Giant Cell Arteritis?
Sehreen Mumtaz, MBBS, and Kenneth J. Warrington, MD
Question 10 What Is the Evaluation of Traumatic Optic Neuropathy?
Shira Simon, MD, and Nicholas Volpe, MD
Question 11 What Is the Evaluation and Management for Papilledema?
Michael Wall, MD
Question 12 Is There a Difference in the Management of Idiopathic Intracranial Hypertension in Pregnancy?
Rafella Penteado, MD, Srav Vegunta, MD, and Kathleen B. Digre, MD
Question 13 What Is the Acute Idiopathic Blind Spot Enlargement (AIBSE) Syndrome and How Can I Confirm the Diagnosis?
M. Tariq Bhatti, MD
Question 14 How Do I Work Up and Manage an Internuclear Ophthalmoplegia?
Christopher C. Glisson, DO, FAAN, and David I. Kaufman, DO
Question 15 What Is the Workup and Treatment of Myasthenia Gravis?
Prem S. Subramanian, MD, PhD
Question 16 How Do You Manage Visual Loss in Thyroid Eye Disease?
James A. Garrity, MD
Question 17 When Do You Use Radiation, Steroids, or Teprotumumab in Thyroid Eye Disease?
Tracy J. Lu, MD, Steven E. Feldon, MD, and Amina Malik, MD
Question 18 How Do You Manage Diplopia in Thyroid Eye Disease?
Kimberly Cockerham, MD
Question 19 What Are the Evaluations and Treatments for Acquired Nystagmus?
Janet C. Rucker, MD, and Ruben Jauregui, MD
Question 20 What Is the Evaluation for Anisocoria?
Aroucha Vickers, DO
Question 21 How and When Should I Work Up Horner Syndrome?
Sachin Kedar, MD, and Valérie Biousse, MD
Question 22 What Should I Do with a Dilated Pupil?
Randy Kardon, MD, PhD
Question 23 What Is the Evaluation for Episodic Anisocoria?
Aki Kawasaki, MD, PhD
Question 24 How Do You Diagnose and Manage Toxic and Nutritional Optic Neuropathies?
Alfredo A. Sadun, MD, PhD, Maryam Golmohammadi, MD, and Michelle Y. Wang, MD
Question 25 What Are Visual Processing Defects and How Can I Recognize Them?
Swaraj Bose, MD
Question 26 How Do I Manage Patients With Headache Syndromes Who Come to Me as an Ophthalmologist?
Deborah I. Friedman, MD
Question 27 What Is the Evaluation of Optic Atrophy?
Julie Falardeau, MD
Question 28 How Do I Treat a Child with Asymmetric Nystagmus?
Madhura A. Tamhankar, MD, and Grant T. Liu, MD
Question 29 What Is Opsoclonus and How Do I Manage It?
Lea Saab, MD, and Janet C. Rucker, MD
Question 30 What Is Wernicke Syndrome and How Does It Affect the Eye?
Gregory P. Van Stavern, MD
Question 31 How Do I Manage Postoperative Visual Loss After Nonocular Surgery?
M. Tariq Bhatti, MD
Question 32 How Do I Manage Transient Monocular Visual Loss in a Young, Otherwise Healthy Patient?
Rosa Ana Tang, MD, MPH, MBA, Roberto Alejandro Cruz, MD, and Daniel Uribe Padilla, MD
Question 33 What Is the Evaluation for Transient Monocular Visual Loss in an Older Adult?
Byron L. Lam, MD
Question 34 What Is the Evaluation for a Homonymous Hemianopia?
Jonathan C. Horton, MD, PhD
Question 35 What Is the Evaluation for a Painful Third Nerve Palsy Without a Fixed and Dilated Pupil but With Anisocoria (Partial Pupillary Involvement)?
Michael S. Vaphiades, DO
Question 36 How Do You Manage an Isolated and Presumed Vasculopathic, Pupil-Sparing Third Nerve Palsy?
Catherine R. Garcia, MD, and Nagham Al-Zubidi, MD
Question 37 What Is the Appropriate Evaluation of a Fourth Nerve Palsy?
Robert L. Tomsak, MD, and Matthew J. Thurtell, MBBS
Question 38 What Is the Appropriate Evaluation in a Patient Suspected of Having a Sixth Nerve Palsy?
Steven R. Hamilton, MD
Question 39 How Do You Evaluate a Patient with Multiple Ocular Cranial Nerve Palsies?
Marc Dinkin, MD, and Gregory S. Kosmorsky, DO
Question 40 What Is Blepharospasm?
Mena M. Kozman, MD, and Timothy J. McCulley, MD
Question 41 What Is Hemifacial Spasm?
Andrew R. Harrison, MD, and Michael S. Lee, MD
Question 42 How Do You Deal with a Patient Who Has Functional Visual Loss?
Danielle S. Rudich, MD, and Robert L. Lesser, MD
Question 43 How Do You Diagnose and Manage Migraine Visual Aura?
Benjamin Frishberg, MD
Question 44 How Do I Recognize Leber Hereditary Optic Neuropathy?
Nancy J. Newman, MD
Question 45 How Do I Manage an Orbital Apex Syndrome?
Roger E. Turbin, MD
Question 46 How Do I Evaluate and Manage Nonspecific Orbital Inflammation?
Mena M. Kozman, MD, and Timothy J. McCulley, MD
Question 47 How Should I Evaluate and Manage a Carotid-Cavernous Fistula?
Zoë R. Williams, MD
Question 48 How Do I Evaluate and Treat Radiation-Induced Optic Neuropathy?
Anne S. Abel, MD, and Michael S. Lee, MD
Question 49 What Should I Do with a Seventh Nerve Palsy?
Matthew J. Thurtell, MBBS
Question 50 How Do You Diagnose and Treat Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease?
Sabrina Poonja, MD, and John J. Chen, MD, PhD
Index
Biography
Andrew G Lee, M.D. is the Herb and Jean Lyman Centennial Chair in Ophthalmology and is the Founding Chairman of the Blanton Eye Institute, Department of Ophthalmology at Houston Methodist Hospital in Houston, Texas. He is Professor of Ophthalmology, Neurology, and Neurosurgery at Weill Cornell Medicine and an adjunct professor of Ophthalmology at Baylor College of Medicine; Texas A and M College of Medicine; University of Iowa and the University of Buffalo; and Clinical Professor at the University of Texas Medical Branch (UTMB) in Galveston, Texas and the UT MD Anderson Cancer Center.
He is a graduate of the University of Virginia (UVA) undergraduate and UVA School of Medicine. He was an ophthalmology resident and chief resident at Baylor College of Medicine and a clinical neuro-ophthalmology fellow and Fight for Sight postdoctoral research fellow at the Wilmer Eye Institute, the Johns Hopkins Hospital.
Dr. Lee has served in numerous leadership roles at the American Academy of Ophthalmology (AAO) and has received the AAO Achievement Award, Senior Achievement Award, Secretariat Award (three times), and Lifetime Achievement Award. He is a past President, a past Chairman of the Board, and Senior VP for Advocacy of the North American Neuro-ophthalmology Society.
Dr. Lee has received the teaching award 15 times at 7 different academic institutions including the Osler Excellence in Teaching Award, the Baylor College of Medicine Dan B. Jones Teaching Award, University of Iowa Charles Phelps Award, the Texas A and M Mid Career Education award, the HMH Presidential Excellence in Education, and the Houston Methodist Hospital Sherilynn Gordon Memorial Leadership Award.
Dr. Lee has been the invited speaker at over 400 national and international medical meetings; has written over 600 peer-reviewed publications and 14 full textbooks; and has given 15 named lectures. His h-index is 68 and his i-10 is 367 with over 18,000 citations. He has been named one of top 30 ophthalmologists in the United States by Newsweek magazine and is the only neuro-ophthalmologist on the list.
M. Tariq Bhatti, MD, obtained his Doctor of Medicine degree from New York Medical College in Valhalla, New York in 1994. He completed an ophthalmology residency at the University of Florida, Gainesville, Florida followed by a neuro-ophthalmology fellowship at Emory University in Atlanta, Georgia. He also completed a fellowship in orbital disease and surgery at Allegheny General Hospital in Pittsburgh, Pennsylvania. He was one of the principal investigators in the Optic Neuritis Treatment Trial, the Idiopathic Intracranial Hypertension Treatment Trial and the QRK207 trial (a phase2/3 tiral of QPI-1007 for acute nonarteritic anterior ischemic optic neuropathy). Dr. Bhatti has authored or co-authored over 200 peer-reviewed articles, 20 textbook chapters and 2 textbooks. He is an associate examiner for the American Board of Ophthalmology (ABO) and was a member of the ABO examination development committee. He has served as chair of the Neuro-Ophthalmology book (section 5) of the American Academy of Ophthalmology (AAO) Basic and Clinical Science Course (BCSC) from 2016 to 2024. He was awarded teacher of the year award twice during his academic career and was recognized as a US News and World Reports top Ophthalmologist in 2011, 2012 and 2013. He also received the secretariat and senior achievement awards from the AAO. Dr. Bhatti was chief of neuro-ophthalmology and a tenured professor at the Duke Eye Center in Durham, North Carolina as well as professor of ophthalmology and neurology in the Mayo Clinic School of Medicine and Science in Rochester, Minnesota. Currently, he is a senior neuro-ophthalmologist at the Permanente Medical Group in the Department of Ophthalmology at Kaiser Permanente- Northern California
Vivian Paraskevi Douglas, MD, DVM, MBA, MSc is an Ophthalmologist with a background in both human and veterinary medicine. She completed a residency in Ophthalmology at the Athens Naval Hospital, Hellenic Armed Forces, in Athens, Greece and a clinical fellowship in Neuro-Ophthalmology at Massachusetts Eye and Ear, Harvard Medical School. She is currently a clinical Medical Retina fellow at the Beetham Eye Institute/Joslin Diabetes Center, Beth Israel Deaconess Medical Center, and Massachusetts Eye and Ear, Harvard Medical School. Dr. Douglas has published extensively in multiple peer-reviewed journals such as Cell, Radiology, JAMA Ophthalmology, Cephalalgia, and Survey of Ophthalmology; and has served as an ad hoc reviewer for several journals. She is the co-editor of the textbook Pediatric Ocular Surface Disease.
Konstantinos Douglas, MD, DVM, MBA, MSc is an Ophthalmologist with professional experience in both human and animal healthcare. He completed a residency in Ophthalmology at the 1st Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital in Athens, Greece and a clinical fellowship in Neuro-Ophthalmology at Massachusetts Eye and Ear, Harvard Medical School. He is certified in advanced studies in Veterinary Ophthalmology, and currently serves as a consultant. Dr. Douglas has authored or co-authored articles in several prominent peer-reviewed journals such as JAMA Ophthalmology, Radiology, Cephalalgia, Ocular Surface and Survey of Ophthalmology; and has served as an ad hoc reviewer for various journals. He has presented his work at multiple National and International conferences.






