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Neurology > Eye > Flashcards

Eye Flashcards

1
Q

What are refractive errors?

A

Impaired vision that improves w/ glasses

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2
Q

What is Hyperopia?

A

Eye too short for refractive power of cornea & lens→ light focused behind retina

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3
Q

What is Myopia?

A

Eye too long for refractive power of cornea & lens→ light focused in front of retina

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4
Q

What is Astigmatism?

A

ABN curvature of cornea resutling in different refractive power at different axes

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5
Q

What is Accomodation?

A

Focusing on near objects→ ciliary muscles tighten→ zonular fibers relax→ lens becomes more convex

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6
Q

What does Accommodation occur with?

A

Convergenc & miosis

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7
Q

What is Presbyopia?

A

Dec change in focusing ability during accomadation d/t sclerosis & dec elasticity

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8
Q

What is Uveitis?

A

Inflam of uveal coat (iris, ciliary body & choroid)

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9
Q

What is Uveitis assoc w/?

A
  • Systemic inflam disorders
  • Sarcoid
  • RA
  • Juvenile idiopathic arthritis
  • TB
  • HLA-B27 assoc cond
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10
Q

What is Retinitis?

A

Retinal edema & necrosis leading to scar

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11
Q

What causes Retinitis?

A

Often viral (CMV, HSV, HZV)

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12
Q

What is Retinitis assoc w/?

A

Immunosuppression

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13
Q

What is Central retinal artery occlusion?

A

Acute, painful monocular vision loss

Retina whitening w/ cherry-red spot

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14
Q

What is Glaucoma?

A

Optic neuropathy, usually w/ inc intraocular pressure (IOP)

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15
Q

What is Open/wide angle Glaucoma char by?

A

Peripheral then central vision loss usually assoc w/ inc IOP

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16
Q

What is Open/wide angle Glaucoma?

A

Optic disc atrophy w/ cupping

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17
Q

What is Open/wide angle glaucoma assoc w/?

A
  • Inc age
  • African American race
  • FHx
  • Inc IOP
  • MC in US
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18
Q

What is the primary cause of open/wide angle glaucoma?

A

Unclear

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19
Q

What is the secondary cause of open/wide angle glaucoma?

A
  • Uveitis
  • Trauma
  • Corticosteroids
  • Vasoproliferative retinopathy that can block or dec outflow at the trabecular meshwork
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20
Q

What is Closed/narrow angle glaucoma?

A

Enlargement or forward movement of lens against central iris l/t obstruction of normal aqueous flow through pupil→ fluid build up behing iris, pushing peripheral iris against cornea & impeding flow through the trabecular network

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21
Q

What is Chronic closure closed/narrow angle glaucoma?

A

Often asx w/ damage to optic nerve & peripheral vision

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22
Q

What is Acute closure closed/narrow angle glaucoma?

A

Ture ophthalmic emergency

Inc IOP iris forward→ angle closes abruptly

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23
Q

What are the clinical features of Closed/narrow angle glaucoma?

A
  • Very painful
  • Sudden vision loss
  • Halos around lights
  • Rock-hard eye
  • Frontal HA
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24
Q

Why can’t you give Epi in closed/narrow angle glaucoma?

A

Mydiratic effect

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25
Q

What is a Catarct?

A

Painless, often bilateral, opacification of lens→ dec in vision

26
Q

What are the risk factors of Cataracts?

A
  • Age
  • Smoking
  • Alcohol
  • Excessive sunlight
  • Prolonged corticosteroid use
  • Classic galactosemia
  • Galactokinase def
  • DM (sorbitol)
  • Trauma
  • Infection
27
Q

What is Pailledema?

A

Optic disc swelling (usually bilateral) d/t inc intracranial pressure

28
Q

What will be found on fundascopic exam in papilledema?

A

Enlarged blind spot & elevated opotic disc w/ blurred marigins

29
Q

What happens in CN III damage?

A
  • Eye looks down & out
  • Ptosis
  • Pupillary dilation
  • Loss of accommodation
30
Q

What happens in CN IV damage?

A
  • Eye moves upward particularly w/ contralateral gaze & ipsilateral head tilt
31
Q

What happens in CN VI damage?

A

Medially directed eye that cannot abduct

32
Q

What is Miosis?

A

Constriction controlled by PNS

33
Q

What is the 1st neuron involved in miosis?

A

Edinger-Westphal nucleus to ciliary ganglion via CN III

34
Q

What is the 2nd neuron involved in miosis?

A

Short ciliary nerves to pupillary sphincter muscles

35
Q

What is Mydriasis?

A

Pupil dilation controlled by SNS

36
Q

What is the 1st neuron involved w/ Mydriasis?

A

Hypothalamus to ciliospinal center of Budge (C8-T2)

37
Q

What is the 2nd neuron involved w/ Mydriasis?

A

Exit at T1 to superior cervical ganglion (travels along cervical SNS chain near lung apex, subclavian vessels)

38
Q

What is the 3rd neuron involved w/ Mydriasis?

A

Plexus along internal carotid, through cavernous sinus; enters orbit as long ciliary nerve to pupillary dilator muscles

39
Q

What is the Pupillary light reflex?

A

Light in either retina sends a signla via CN II to pretectal nuclei in midbrain that activate bilateral Edinger-westphal nuclei; pupils contract bilaterally

40
Q

What is Marcus Gunn pupil?

A

Afferent pupillary defect d/t to damage or retinal detachment . Dec bilateral pupillary constriction when light is shone in affected eye relative to uneffected eye

41
Q

What is CN III motor output to ocular muscles affected by?

A

Vascular dz d/t dec diffusion of oxygen & nutrients to the interior fibers from compromised vasculature that resides on outside of nerve

42
Q

What are the signs of CN III moto damage?

A

Ptosis, “down & out gaze”

43
Q

What is 1st affected in the PNS fibers of CN III?

A

Peripheral fibers 1st affected by compression

44
Q

What are the signs of damage to PNS fibers of CN III?

A

Diminished or absent pupillary ligh reflex

“blown pupil”

45
Q

What is Retinal detachment?

A

Separation of neurosensory layer of retina from outermost pigment epithelium→ degen of photoreceptors→ vision loss

46
Q

What can retinal dettachment be secondary to?

A
  • Retinal breaks
  • Diabetic traction
  • Inflam effusions
47
Q

Who are retinal breaks MC in?

A

Pt w/ high myopia & often preceded by posterior detachment & eventual monocular loss of vision like a “curtain drawn down”

48
Q

Which area of the retina affected in Age-related macular degeneration?

A

Central area of retina

49
Q

What does Age-related macular degeneration cause?

A

Distortion (metamorphopsia) & eventual loss of central vison (scotomas)

50
Q

What is Dry age-related macular degeneration?

A

Nonexudative >80%

51
Q

What is seen on PE in Dry age-related macular degeneration?

A

Deposition of yellowish extracellular material beneath retinal pigment epi w/ gradual dec in vision

52
Q

What can prevent the progression of Dry age-related macular degeneration?

A

Multivitamin & antioxidant supplements

53
Q

What is Wet age-related macular degeneration?

A

Exudative, 10-15%

54
Q

What causes Wet age-related macular degeneration?

A

Rapid loss of vision d/t bleeding secondary to choroidal neovasculaization

55
Q

What is the tx for Wet age-related macular degeneration?

A

Anti-vascular endothelial growth factor injections (anti-VEGF) or laser

56
Q

What is Meyer’s loop?

A

Ineferior retina

Loops around inferior horn of lateral ventricle

57
Q

What is Dorsal optic radiation?

A

Superior retina

Takes shortest path via internal capsule

58
Q

What is the Medial longitudinal fasiculus (MLF)?

A

Pair of tracts that allows for crosstalk b/w CN VI & CN III nuclei. Cooridnates both eyes to move in same horizontal direction

59
Q

Who get MLF lesions?

A

Pts w/ demyelination since the MLF is highly myelinated

60
Q

What is Internuclear ophthalmoplegia?

A

MLF syndrome

61
Q

What happens in a MLF lesion?

A

When CN VI nucleus activates ipsi lateral nucleus, contra CN III nucleus doesn’t stim medial rectus to fire. Abductin eye gets nystagmus

Neurology (9 decks)

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