Eye Disease and Visual Disturbance

Question 1

what is an easy way to interpret the red glass test?

holding up red piece of glass in front of eyes

Answer 1

the eye is not moving where the red image appears to be.

red glass over the impaired eye

Question 2

what is the most common form of retinal degeneration from the following:

• serous retinitis
• retinitis pigmentosa
• confluent drusen
• drug induced retinopathy
• paraneoplastic retinal degradation

Answer 2

retinitis pigmentosa

Question 3

lack of red reflex in newborn should make you suspect what diseases?

Answer 3

congenital rubella, MCV, or retinoblastoma

Question 4

Glaucoma is associated with which of the following diseases:

NF1
NF2
sturge-weber
arnold chiari
Tuberous sclerosis

Answer 4

Sturge weber (up to 1/3 of pts)

Question 5

treatment for CMV?

Answer 5

gangcyclovir

Question 6

Methyl alcohol intoxication can produce what acute change in visual field?

Answer 6

large central scotoma

Question 7

Key finding that will distinguis papilledema from increased ICP vs papillitis

Answer 7

visual loss with papillitis

Question 8

key difference between tunnel vision and concentric constriction?

Answer 8

with tunnel the field is always the same near and far

with CC the field appears bigger farther away (associated with neurosyphilis)

Question 9

Swinging flashlight test with marcus gun pupil; what is finding and what is association?

Answer 9

dilation of one pupil when light is moved from that pupil to other eye and back again to affected eye

associated with MS

Question 10

most common ocular motor paresis?

Answer 10

CN VI - lateral rectus palsy

Question 11

what is Gradenigo syndrome

Answer 11

arises secondary to otitis media, mastoiditis, involving apex of petrous pyramid
results in irritation to abduscens and trigeminal nerve

Question 12

cranial nerve most likely to by injured with trauma to the face?

Answer 12

CN IV - superior oblique

because it extends far into the orbit

injury to this nerve may induce a slight head tilt to compensate for the affected eye

Question 13

varicella with involvement of facial nerve is also likely to involve what other CN?

Answer 13

CN IV because it shares the nerve sheath with opthalmic division of trigeminal nerve

Question 14

initial sign of pressure on CN III will be?

Answer 14

pupilloconstrictor fibers

Question 15

CN III palsy associated with DM will show?

Answer 15

pain in and about the eye.

DM spares pupillary function because it affects the nerve deep not superficial

Question 16

pupillary constriction with adduction of the globe suggests?

Answer 16

abberant regeneration of the third CN

Question 17

describe what is seen on MLF syndrome

Answer 17

incomplete ipsilateral adduction on conjugate lateral gaze, then nystagmus in abducting eye with fast component directed temporally

internuclear opthalmoplegia

Question 18

what type of nystagmus is produced in a normal patient by having them look at a rotating drum?

Answer 18

optokinetic nystagmus

Question 19

young woman with poorly responsive pupils and some absent reflexes indicates?

Answer 19

Adie tonic pupil - totally benign

Question 20

sudden painless vision loss in one eye (usually starts with inferior field) with papillitis on exam

Answer 20

ischemic optic neuritis

Question 21

after optic nerve injury resolves what is likely to be seen on exam

Answer 21

disc pallor

Question 22

what change in vision will result from damage to one side of the occipital lobe

Answer 22

contralateral homonymous hemianopsia

Question 23

what will you see on lesion impinging on optic chiasm

Answer 23

upper quadrant affected in contralateral side of contralateral eye as well as ipsilateral central scotoma