Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Ophthal > Eye Manifestations In Neurological Disease > Flashcards

Eye Manifestations In Neurological Disease Flashcards

1
Q

Direct Pupillary Reflex Pathway

A

Light is shone on one eye to check for constriction of stimulated pupil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Consensual Pupillary Reflex Pathway

A

Light is shone on one eye to check for constriction of contralateral pupil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Accommodation reflex

A

Response of the eyes when focused on one near object, then trying to focus on a distant object afterwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Convergence reflex

A

Looking at a near object

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the features of amaurotic light reflex?

A
  1. Direct light reflex -ve (affected side)
  2. Consensual light reflex -ve (normal side)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does amaurotic light reflex indicate?

A
  1. Lesion of optic nerve/retina (affected side)
  2. Complete blindness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the features of efferent pathway defect?

A
  1. Both direct & consensual light reflex -ve (affected side)
  2. Both direct & consensual light reflex +ve (normal side)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does efferent pathway defect indicate?

A

Sphincter paralysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the causes of efferent pathway defect?

A
  1. Parasympatholytic drugs (atropine, homatropine)
  2. Internal ophthalmmoplegia
  3. 3rd nerve paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the features of Wernicke’s hemianopic pupil?

A

When light thrown on temporal 1/2 of retina (affected side) and nasal 1/2 (opposite side)

Ipsilateral direct & contralateral consensual light reflex -ve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does Wernicke’s hemianopic pupil indicate?

A

Lesions of optic tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Marcus Gunn pupil?

A

Paradoxical response of pupil to light in presence of relative afferent pathway defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Marcus Gunn pupil is an early indication of?

A

Optic nerve disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the causes of Marcus Gunn pupil?

A
  1. Incomplete optic nerve lesions
  2. Severe retinal diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the test you can do to check for RAPD?

A

Swinging flash light test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the features of Argyll Robertson pupil (ARP)?

A
  1. Both pupils are slightly small
  2. Light reflex -ve
  3. Accommodation reflex +
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the causes of argyll Robertson pupil?

A

Lesion in the region of tectum
(Neurosyphilis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the features of adie’s tonic pupil?

A
  1. Light reflex -ve
  2. Near reflex is slow & tonic
  3. Affected pupil is larger (ANISOCORIA)
  4. Unilateral
  5. Knee jerk -ve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the causes of adie’s tonic pupil?

A

Post ganglionic parasympathetic pupillomotor damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are etiologies of optic neuritis?

A
  1. Idiopathic
  2. Hereditary
  3. Demyelinating
  4. Parainfectious
  5. Infectious
  6. Autoimmune
  7. Toxic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is papilitis?

A

Type of optic neuritis which affects the optic disc (unilaterally)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is neuroretinitis?

A

Type of optic neuritis where optic disc & surrounding retina in the macular area are affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is retrobulbar optic neuritis?

A

Optic nerve behind eyeball is affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the key visual symptoms of optic neuritis?

A
  1. Visual loss
  2. Dark adaptation lowered
  3. Visual obscuration in bright light
  4. Impairment of color vision
  5. Episodic transient obscuration of vision
  6. Impaired depth perception (pulfrich’s phenomenon)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are phosphenes, and how do they relate to optic neuritis?
Phosphene are visual sensations (flashes/glows) w/o actual light stimulus Optic neuritis = movement & sound-induced phosphenes
26
What is pulfrich’s phenomen, and how is it linked to optic neuritis?
- a depth perception disorder where moving objects appear to follow an elliptical path instead of straight line - caused by delay in visual signal transmission in one eye due to optic nerve inflammation
27
What symptom of optic neuritis is commonly associated with pain?
Retrobulbar pain (pain behind the eye); often worsened by eye movement
28
What are the key visual signs of optic neuritis?
1. Marked reduced visual acuity 2. Severely impaired color vision 3. Visual field changes
29
What pupillary abnormality is associated with optic neuritis?
Marcus Gunn pupil (relative afferent pupillary defect - RAPD)
30
What happens to visually evoked response (VER) in optic neuritis?
1. Reduced amplitude 2. Delay in transmission time
31
What are the fundus fluorescein angiography (FFA) findings in optic neuritis?
1. Mild to moderate leak in the early phase 2. Leakage increase with time
32
What are the ophthalmoscopic features of papillitis in optic neuritis?
1. Hyperemia of disc with blurred margins 2. Disc edema 3. Congested & tortuous retinal veins 4. Splinter hemorrhage & fine exudates on disc 5. Slit lamp exam = inflammatory cells in vitreous
33
What are the ophthalmoscopic features of retrobulbar optic neuritis?
1. Fundus normal 2. Temporal pallor of disc
34
What is the 1st step of treatment of optic neuritis?
Treat underlying causes
35
When is corticosteroid therapy used in optic neuritis?
When multiple sclerosis is suspected
36
What is the IV corticosteroid regimen for optic neuritis?
IV methylprednisolone 1g OD for 3 days
37
What is the oral corticosteroid regimen for optic neuritis?
Oral prednisolone 1mg/kg/day for 11 days - tapered over 4 days
38
What is other immunomodulatory therapy used in optic neuritis?
Interferon therapy
39
What is papilloedema?
- passive disc swelling due to increased ICP - always bilateral
40
What are the inflammatory causes of disc edema?
1. Papillitis 2. Neuroretinitis 3. Uveitis
41
How does ocular hypotonia contribute to disc edema?
Low Intraocular pressure -> passive disc swelling
42
What are the vascular causes of disc edema?
Diabetic papillopathy
43
What orbital conditions can cause disc edema?
1. Orbital tumors 2. Grave’s orbitopathy
44
What infiltrative condition can cause disc edema?
Leukemia
45
What is the etiology of papilloedema?
1. Congenital condition 2. Intracranial space occupying lesion (ICSOLs) 3. Intracranial infections 4. Intracranial hemorrhage 5. Obstruction of CSF absorption 6. Tumors of spinal cord 7. Diffuse cerebral edema
46
What are the general C/F of papillodema due to raised ICP?
1. Headache (aggravated by coughing, straining, sneezing) 2. Nausea 3. Projectile vomiting 4. Diplopia 5. Focal neurological deficit
47
What are the ocular C/F of papillodema?
1. Recurrent attacks of transient blackout vision 2. Visual acuity & pupillary reaction (N) 3. Central vision affected later
48
What are the early ophthalmoscopic features of papilloedema?
1. Blurring of disc margins 2. Gradual elevation of the disc -> vessels bend sharply over the margin 3. Apparent optic disc edema 4. Hyperemia of the disc + capillary dilation 5. Marked venous dilation & tortuosity
49
What retinal changes can be seen in early papilloedema?
1. Macular star 2. Cotton wool spots (soft exudates) 3. Flame-shaped & punctate hemorrhages around the optic disc
50
What is Paton’s line, and what causes it?
Circumferential greyish-white folds due to separation of nerve fibers - Seen in early papilloedema
51
What are the late ophthalmoscopic features of papilloedema?
1. Post-neuritic optic atrophy 2. Generalized retinal pigmentation 3. Thickening of the perivascular sheath 4. Contraction of arteries
52
What is the treatment for papilloedema?
Immediate admission 1. CT scan/MRI 2. Treat causative disease 3. Surgical decompression
53
What is optic atrophy?
Degeneration of the optic nerve, which occurs as an end result of any pathologic process that damages axons in the anterior visual system
54
What is primary optic atrophy?
simple degeneration of the nerve fibres w/o any complicating process within the eye
55
What is secondary optic atrophy?
occurs following any pathologic process which produces optic neuritis/papilloedema
56
What are the ophthalmoscopic classification of optic atrophy?
1. Primary (simple) optic atrophy 2. Consecutive optic atrophy 3. Glaucomatous optic atrophy 4. Post-neuritic optic atrophy 5. Vascular (ischaemic) optic atrophy
57
What is ascending/autograde optic atrophy?
**Wallerian degeneration** 1. Follows damage to ganglion cells/nerve fibre layer due to diseases of the retina or optic disc. 2. Nerve fibre degeneration progresses (ascends) from the eyeball towards the geniculate body
58
What is descending/retrograde optic atrophy?
Proceeds from the region of the optic tract, chiasma or posterior portion of the optic nerve towards the optic disc. - Damage beyond lateral geniculate nucleus (LGN)
59
What are the pathological features of optic atrophy?
1. Degeneration of the nerve fibers associated with excessive/negligible gliosis 2. Degeneration and gliosis = orderly & astrocytes arranged in longitudinal column
60
What are the C/F of optic atrophy?
1. Loss of vision 2. Pupil = semidilated - direct light reflex is sluggish or absent 3. Visual field loss vary with distribution of the fibers that have been damaged
61
What are the ophthalmoscopic appearance in primary optic atrophy?
1. Disc color = chalky white/white with bluish hue. 2. Edges (margins) are sharply outlined. 3. Lamina cribrosa is clearly seen 4. Major retinal vessels & surrounding retina are normal.
62
What are the ophthalmoscopic appearance in consecutive optic atrophy?
1. Disc = yellow waxy 2. Edges = not sharply defined 3. Retinal vessels are attenuated
63
What are the ophthalmoscopic appearance in post-neuritis optic atrophy?
1. Disc color = dirty white 2. Due to gliosis, its edges are blurred. 3. Retinal vessels are attenuated 4. Perivascular sheathing is often present.
64
What are the ophthalmoscopic appearance in glaucomatous optic atrophy?
1. deep and wide cupping of disc 2. nasal shift of vessels
65
What are the ophthalmoscopic appearance in ischemic optic atrophy?
Pallor of disc associated with marked attenuation of the vessels
66
What is the treatment for optic atrophy?
Treatment of underlying cause -> preserving some vision (in partial optic atrophy)

Ophthal (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions