EYE in systemic disease

Question 1

cardinal features of neuro-opthalmic disease is 2

Answer 1

eye movement defects - dbl vision

visual defects - acuity/field loss

Question 2

most common cause of eye disease

Answer 2

vascular disease

Question 3

demyelination of optic nerves is associated with what

Answer 3

MS

Question 4

after history, what investigations

Answer 4

blood tests

imaging - MRI - gold standard

Question 5

if thinking MS, what investigation

Answer 5

lumbar puncture

Question 6

ocular motility defects will be due to what 5 nerve

Answer 6

CN III/IV/VI
Inter-nuclear
supra-nuclear - initiation of movement of eyes is broken

Question 7

6th nerve palsy - which muscle affected, what will they be unable to do ?

if nerve is fine, what else could it be?

Answer 7

lateral rectus
abduction

impingement
muscle detachment

Question 8

4 causes of CN VI palsy

Answer 8

microvascular
raised ICP
tumour
congenital

Question 9

if pressure in skull, brainstem can push doown on CNVI at the __ __ causing impingmene t

Answer 9

petrous tip

Question 10

movent of SO

Answer 10

inwards and downwards

- keeps eye in horizontal plane (will see an upshoot in eye when abducting)

Question 11

to compensate for a CN IV palsy, the patient mayy

Answer 11

tilt head

Question 12

most common cause of IVth nerve palsy

Answer 12

congenital decompensated

Question 13

muscles innervated by CN III 6

Answer 13

MR 
IR
SR
IO 
sphincter pupillae 
LPS

Question 14

muscle defect that causes ptosis

Answer 14

LPS

Question 15

IIIrd nerve palsy ocular position

dilated or constricted pupil?

Answer 15

down and out

dilated

Question 16

a PAINFUL 3rd nerve palsy indicates

Answer 16

aneurysm

MRI angiogram!!!

Question 17

a pupil sparing 3rd nerve palsy indicates

Answer 17

microvascular

Question 18

inter-nuclear opthalmoplegia causes 2

Answer 18

MS

vascular

Question 19

___ are the hallmark (MRI) for MS

Answer 19

plaques

shows demyelination

Question 20

outline optic ppathway

Answer 20

optic nerve - chiasm - optic tracts - optic radiations - cortex

Question 21

lesion in occipital cortex will cause __ sparing

Answer 21

macula

Question 22

most common cause of opticnerve problems

Answer 22

ischaemic optic neuropathy - stroke

Question 23

optic neuritis is commonly seen in

Answer 23

MS

v good prognosis - 4wk

Question 24

tumours are rare, 3 examples which affect the nerve alone

Answer 24

meningioma
glioma
haemangioma

Question 25

optic neuritis will seee progressive __ __ (unilateral or bi?). there will be pain behind eye, especially on __. Colour __, __ scotoma(?). good/bad prognossi?

Answer 25

``` visual loss uni desaturation central good - weeks/months ```

Question 26

behind the chiasm, all visual defects will be oon one side/ both

Answer 26

one side

Question 27

in optic tracts/radiation defects, will macula be spared? will it be in quadrants?

Answer 27

no macula not spread yes quad

Question 28

occipital cortex esion will be macular sparing and ___

Answer 28

congruent