130: Sudden Visual Disturbance

Question 1

Occulomotor nerve palsy symptoms

Answer 1

ptosis (levitator palpebrae), dilated pupil (edinger westphal nucleus -consensual constriction due to light and accommodation), eye down and out. (medial, lateral and superior rectus, inferior oblique)

Question 2

Horner’s Syndrome Symptoms

Answer 2

ptosis, miosis, anhidrosis (disruption of sympathetic fibres- centrally = hypothalamus; preganglion = sympathetic chain compression ( lung cancer); post = carotid artery, cavernous sinus).

Question 3

Abducens Nerve Palsy Symptoms

Answer 3

Cannot abduct the eye

Question 4

Trochlear nerve palsy symptoms

Answer 4

the eye is deviated up (superior oblique not working), patient may feel dizzy walking downstairs.

Question 5

What is strabismus?

Answer 5

misalignment of the eyes

Question 6

What is a Hutchinson’s Sign?

Answer 6

blistered tip of nose - herpes Zoster (nasociliary branch of the trigeminal nerve)

Question 7

which nerve does accommodation test?

Answer 7

nasociliary

Question 8

which nerve does pupillary response to light test?

Answer 8

occulomotor

Question 9

what is anisocoria?

Answer 9

difference in pupil size

Question 10

loss of vision in one eye = damage to?

Answer 10

optic nerve

Question 11

bitemporal hemianopia= damage to?

Answer 11

optic chiasm

Question 12

right homonymous hemianopia = damage to?

Answer 12

left optic tract lesion

Question 13

upper right quadrantanopia = damage to?

Answer 13

the lower fibres of the optic radiation in the temporal lobe

Question 14

lower quadrantanopia = damage to?

Answer 14

the upper fibres of the optic radiation in the anterior part of the parietal lobe

Question 15

right homonymous hemianopia with macular sparing

Answer 15

optic radiation of the occipital lobe.

Question 16

Adie’s Syndrome

Answer 16

Parasympathetic nerve pathway damage (viral). Dialated pupil, reacts slowly to light but better to accomodation

Question 17

Argyll Robertson Syndrome

Answer 17

bilaterally small pupils that can accomodate to near objects, but do not react to light. can be a sign of neurosyphillis.