Correspondence
Access, an unintended consequence of virtual continuing medical education during COVID-19: a department's experience at the University of Toronto
Coronavirus disease 2019 (COVID-19) has irreversibly affected the lives of millions of people globally; to control its spread, many activities including clinical care have been limited to essential services.1 Continuing medical education (CME) activities in many specialities, however, have expanded and even flourished by moving to online platforms, allowing for broader interactions across hospitals, organizations, and borders. In this perspective, we highlight what we believe is the most important benefit to come from the rise in virtual CME during the pandemic drawing from our own department's experience, namely, increased access to those who have historically been excluded from traditional CME activities.Gardening and dilated pupils: an interesting case of anisocoria from Brugmansia versicolor
Anisocoria is a relatively common condition that is characterized by unequal pupil size and affects up to 20% of the normal population.1 As causes of anisocoria range from benign conditions such as physiologic anisocoria to life-threatening emergencies such as a carotid artery dissection or third nerve palsy, careful clinical evaluation is essential for establishing a diagnosis and management plan.Enhancement of optic nerve sheath in AAION: a case of visual recovery in fulminant GCA
Enhancement of the optic nerve sheath on brain magnetic resonance imaging (MRI) post-gadolinium administration on T1 is frequently seen in acute inflammatory (demyelinating and nondemyelinating), some compressive, and infiltrative optic neuropathies. There have been only a few reports describing this radiologic finding in arteritic anterior ischemic optic neuropathy (AAION) in biopsy-proven giant cell arteritis (GCA). We present a case of fulminant GCA that demonstrated bilateral optic nerve sheath and orbital fat stranding on brain MRI post-gadolinium administration.A case of POEMS and chronic papilledema with preserved optic nerve function
A 44-year-old male developed bilateral symmetric lower limb weakness, numbness, and absent ankle jerk reflexes over the course of 2 months. A lumbar puncture (demonstrating protein of 101 mg/dL), electromyography, nerve conduction studies, and mild monoclonal gammopathy were consistent with the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). He was treated with intravenous immunoglobulins and azathioprine by a neurologist with resolution of his symptoms. A year after discontinuing treatment he developed visual scotomas and periodic headaches and was referred to our ophthalmology clinic.
