Kellogg neuroophthalmologist solves mystery Patient is diagnosed and successfully treated in just four days— after five months of unexplained illness Wayne Cornblath, M.D., must often look “beyond the eyes” for the correct diagnosis.
When Amy Jo Gray, of Bay City, Michigan, arrived at the Kellogg Eye Center last summer, she had already been through a five-month odyssey of illness. Although Ms. Gray had been
of her skin lesions and a CT scan to examine lung tissue. He
evaluated locally by a number of physicians, no diagnosis had
also referred Ms. Gray to U-M pulmonary specialist Ryan J.
been made and her illness remained a mystery.
Hadley, M.D., who agreed that her symptoms were consistent
with sarcoidosis.
In early winter, Ms. Gray began to experience headaches
accompanied by swollen lymph nodes. In the months that fol-
lowed, she developed double vision and a host of associated
for sarcoidosis. “The skin lesions provided us with a way to get
symptoms, including fatigue, weight loss, shortness of breath,
a diagnosis easily and quickly, sparing Ms. Gray more invasive
loss of sense of taste, and, eventually, patches of skin lesions on
testing,” says Dr. Cornblath. “From this diagnosis, we were able
her legs.
In the meantime, Ms. Gray’s skin biopsy came back positive
to start Ms. Gray on a regimen of corticoste-
“In the course of four days, Ms. Gray
roids—the standard treatment for sarcoidosis.
was diagnosed and successfully
In the course of four days, Ms. Gray was
continued to baffle her doctors. During her
treated— all with excellent resolution
excellent resolution of her symptoms.”
evaluation, Ms. Gray underwent MRI testing,
of her symptoms.”
With no resolution in sight, Ms. Gray
drove two hours to the U-M emergency room hoping to find answers to the questions that
which revealed subtle abnormalities in an area near the right cavernous sinus, a large collec-
diagnosed and successfully treated—all with Although there is no cure for sarcoidosis, most individuals respond well and remain in
—Wayne Cornblath, M.D.
remission with moderate treatment. “I had become very frustrated with my
tion of thin-walled veins in the head. Given these abnormalities, and her prominent symptom of double
situation and was beginning to lose hope,” says Ms. Gray.
vision, Ms. Gray was referred to Kellogg neuro-ophthalmologist
“I am thankful for the doctors at the Kellogg Eye Center, and
Wayne T. Cornblath, M.D., professor of ophthalmology and
throughout the U-M Health System, who came together to find
visual sciences and of neurology.
a diagnosis.”
“We examined Ms. Gray and found that her sixth cranial
nerve was not functioning properly. We wanted to find out why this was happening to a 44-year-old woman,” says Dr. Cornblath. “After talking with Ms. Gray about her other symptoms, we looked at the skin lesions on her legs and realized there had to be some kind of systemic process going on. It was clear that we had to expand our focus beyond the eyes.”
Dr. Cornblath’s presumptive diagnosis was sarcoidosis, a
relatively uncommon condition which results in the growth of inflammatory cells in different parts of the body— most commonly the lungs, eyes, lymph nodes, and skin. To confirm the diagnosis, Dr. Cornblath arranged that day for Ms. Gray to see U-M dermatologist Frank Wang, M.D., for a biopsy on one
Urgent Appointments for Our Referrers Kellogg’s Neuro-Ophthalmology Clinic has reserved urgent appointment slots for referring physicians who wish to schedule new patient appointments with one of our four neuro-ophthalmologists. To schedule an urgent appointment, coordinate a patient transfer, request a physician-to-physician consultation, or inquire about clinical services, please contact M-LINE at 1.800.962.3555. Innovation in vision
19