63. Intro to Neuro-Opthalmology Flashcards
Damage to optic chiasm is called?
Causes of damage for kids? Elderly?
Bitemporal Hemianopia
Peds: chiasmal-hypothalamic glioma or craniopharyngioma
Elderly: pituitary ademona, meningioma, ICA aneurysm
Optic Neuritis
- pt characteristics
- sx
- tx
- assoc
- mri
-young pts
-reduced central visual acuity, pain with eye movement, color desaturation, acute unilateral vision loss
-tx: steroids
-assoc with MS
MRI: enhanced optic nerve and white matter lesions in brain (high risk of MS)
Anterior Ischemic Optic Neuropathy (AION)
- what it is
- pt type
- signs
- must rule out what
Acute vascular neuropathy (stroke) of eye
- pts are 60-70y.o - most common cause of sudden optic nerve dysfx
- signs: crowded disc (hyperopia), HTN, DM, Hyperlipidemia
- must rule out temporal arteritis
Temporal Arteritis / Arteritic AION
- signs
- pt type
- CP
- exam
- tx
OPTHALMIC EMERGENCY
Optic nerve infarction due to vessels narrowed by vasculitis
W>M 3:1, 65-80yo, caucasains
CP: amaurosis fugax/diplopia/eye pain, HA, scalp tenderness, jaw claudication, fever, weight loss, malaise
Temporal Artery shows chalky white swelling, AION/Retinal Artery occlusion, Cotton Wool Spots
Tx: steroids/hydration, temporal artery biopsy, anti-coagulants
Emboli Amaurosis Fugax
what it is, 3 causes and signs of each
Transient vision loss
- Hollenhorst plaque - cholesterol, asx, bright yellow spots on retina vessels, blood flow not blocked
- Platelet-Fibrin Emboli - dull white-gray plugs, long smooth shape - more likely to occlude
- Calcific - Chalky white, large oval, globular - occlusive
Papilledema
what it is, sx, cause, special etiology
Disc swelling 2/2 high ICP
sx: headache (worse in AM), pulsatile tinnitus, transient vision gray-outs, N/V
cause: EMERGENCY if space-occupying lesion, also venous sinus thrombosis, intracranial HTN, severe HTN
special etiology: pseudotumor cerebri (idiopathic intracranial HTN - HA, blinding visual loss, diplopia, CN6 palsy - tx: diuretics)
