Neuro-Ophthalmology Lectures by Dr. Andrew Lee

Dr. Andrew (Andy) Lee is a highly-accomplished and distinguished neuro-ophthalmologist. He is well-regarded as one of the leading neuro-ophthalmologists in the world, and is also a fantastic educator and lecturer. He has a YouTube channel that I highly encourage everyone to watch, as he distills complex neuro-ophthalmologic concepts into digestible 3-5 minute talks. Some of the videos don’t have great audio, and he keeps things pretty low-tech (the videos are filmed on a cell phone while he draws on a whiteboard), but the information he provides is all high-yield and high-quality - and best of all, free.

I had the privilege of hearing him give a series of neuro-ophthalmology reviews for an OKAP/board review course I took during residency, which significantly helped me understand neuro-ophthalmology in my studies. I think this channel is yet another incredible way he is giving back and providing practical and useful knowledge about neuro-ophthalmology. You’ll probably see me link to his videos where applicable when I’m writing about neuro-ophthalmology. Check it out!

Mini-Atlas

I’m working on some review courses that may be helpful in your studies! One of the things I think is critical for learning and reviewing ophthalmology is having ample amounts of images that can help solidify your pattern-recognition, since ophthalmology is a very visually-oriented specialty (no pun intended).

So as part of my work on creating the course, I am curating as many freely-available images as I can find. While some are completely free to use, other images are free to use for educational purposes (via Creative Commons licenses and the like).

You can find the images here. While it’s not meant to become an atlas like some other great sites out there, hopefully it can serve as yet another resource for finding high-quality images for various diseases you’re trying to look up.

It’s been a very slow process, but I plan to add more links and images as I go. If there’s a topic you’d like me to focus on, let me know in the comments section or contact me!

Horner Syndrome: Pharmacologic Diagnosis

Horner syndrome describes the constellation of findings associated with a lesion affecting the oculosympathetic pathway. Clinically, ipsilateral miosis, ptosis, and anhidrosis form the classic triad, with other features potentially being present.

Without getting into too much detail about the sympathetic pathways and differential diagnosis of Horner syndrome (those will be covered in other articles), I will attempt to highlight the 3 pharmaceutical agents used in the diagnosis of Horner syndrome, discuss the tests, and point out the key ideas that often find themselves in tests.

Introduction To Clinical Prisms

Prisms, like double vision, seem to be pretty dreaded by most people (aside from strabismus specialists and optics fans). For testing purposes and clinical applications, we thankfully don't have to know a ton of things about prisms apart from the essential applications within our clinics. Hopefully this will help you understand the principles of prisms better so that you can use them effectively in clinic as well as answer any test questions that might pop up!

Ophthalmology Basics Study Guide

I just released a new study guide for the "basics" of ophthalmology (anatomy, embryology, pharmacology, and principles of pathology) as part of my plan to format and release my notes from residency. It's been a slow process, but depending on the feedback and response I'll work on releasing study guides for other subjects within Ophthalmology!

Studying After Failing A Test

I’ve been humbled by the many people who have had the courage to contact me over the past few years to ask my advice on preparing for various exams. I don’t claim to be an expert at the various exams, but I do want to help my fellow colleagues succeed in any way possible, and if this website helps more people fare better on their tests and also become better ophthalmologists, that’s great.

Glaucoma Genetics

Glaucoma Genetics

There are many inheritable forms of glaucoma, both primary and secondary. While inheritance patterns and genetics are not perfectly mapped out for glaucoma, there are some basic observations that can help us screen for glaucoma among family members:

Last Minute OKAP Review

One of the things I want to do on this site is to provide more finished "products" for you, in addition to the subject/literature reviews, test preparation and study ideas, and book reviews.  These will hopefully include charts, outlines, and other media that will help augment your studies.  I am working on several book-length projects for the site as well, including a mnemonics-style cheat book and a "textbook" of ophthalmology, with the goal of bridging the gap between the traditional high-academic works of the highly reputable textbooks and shorter-length review books.  Since those books are going to take me a considerable time to write and prepare (probably several years at the rate I'm going now), I plan to publish those for sale.  However, I still want to make the bulk of the content free, so the articles won't be hidden behind a paywall.

Hydroxychloroquine And Chloroquine Screening (2016 AAO Recommendations)

The American Academy of Ophthalmology released an updated set of screening recommendations for hydroxychloroquine (Plaquenil) and chloroquine to account for the many studies that have shown the effects of these medications on the retina (1).  It succinctly makes the case for screening, and outlines the evidence for screening methods and parameters to know for screening.

Conditions Associated With Congenital Nystagmus: The 4 A's

There are many different eye conditions that are associated with congenital nystagmus; theoretically, any bilateral visually-significant pathology present at birth or in infancy during the critical period of visual development may interfere with the development of stable fixation (1)  Eventually I'll get around to discussing the finer points of nystagmus; but for now, I'm sticking to some basic study stuff.

Diagnostic Criteria For Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)

Pseudotumor cerebri syndrome (PTC, also referred to as idiopathic intracranial hypertension [IIH]) is classically taught as presenting in young, overweight women of childbearing age, with a history of headaches and findings of bilateral optic nerve swelling, associated with an elevated intracranial pressure.  However, as with every "textbook" definition of a disease, there are atypical cases (children, men, thin people, older people), and so I am often confronted with some interesting diagnostic challenges when I am referred a patient that does not fit the typical picture of PTC who has bilateral optic nerve swelling.

Ciliary Ganglion

The ciliary ganglion serves as the site of synapse for the parasympathetic nerves innervating the eye.  Because of the many nerves that course through it (not all of them synapse!) and its anatomical location, this structure is of importance in learning the basics of ophthalmology.  According to the Basic and Clinical Science Course, it is located lateral to the ophthalmic artery, situated between optic nerve and lateral rectus muscle, approximately 1 cm (10 mm) anterior to the annulus of Zinn and 1.5-2 cm (15-20 mm) posterior to the globe (1-5).

Phakomatoses: Overview

Phakomatoses are a multidisciplinary category of systemic diseases that is often tested for a multitude of reasons.  Although the incidence of these conditions is fairly low (though chances are you will see at least 1 case of many of these conditions), there are many ocular findings that need to be considered.

I've been debating how to organize this information in a useful manner for review for quite some time.  The subject material is pretty massive, and each condition could easily take several articles (and probably eventually will).  But I wanted to make sure there was a useful review out there on this subject before the written board exam, in case the test covers one of these conditions.

Conditions With Increased Risk Of Glaucoma

This review is somewhat multi-disciplinary in nature. As you wrap up your reviews, one of the things I found useful was to create tons of different lists. Regardless of which test you're studying for, there are many questions that are organized differently than how one might go about learning a particular disease. As such, I started making lists of different ways to group otherwise disparate diseases that might show up as a test question, or at least help me remember a specific feature of the disease.