Lecture X Flashcards
What is the difference between papillitis and glaucoma?
Glaucoma will have decreased VF slowly, with an atrophic optic nerve
Papillitis will have a sudden loss of vision and RAPD
What are the fundoscopic findings congenital anomalies that appear as pseudopapilledema?
Blurred disc margins, but without edema or hemorrhages
What are the causes of pseudopapilledema?
- Hyperopia
- Persistent hyaloid remnants (in utero vessel between the retina and the iris)
Do hyperopic or myopic patients have pseudopapilledema?
Hyperoptic
How does a persistent hyaloid artery appear on a fundoscopic exam?
White outpouching of the disc
How do drusen cause pseudopapilledema?
If close to the optic disc, can blur margins
True or false: papilledema is always bilateral
True
What are the fundoscopic exam findings of papilledema?
- Hyperemia of the disc
- Tortuosity of the vessels
What are spontaneous venous pulsations, and what happens to the with papilledema?
Venous pulsations–if present, then pressure in the eye is normal.
If not present, may be normal, or could be indicative of papilledema
What is pseudotumor cerebri? Who usually gets this?
Idiopathic intracranial HTN
Usually in young, overweight women
What is the issue with the grading system of ocular findings in the eye?
High stage usually says papilledema, but this is actually just phlebitis–not true increased ICP
What are the s/sx of pseudotumor cerebri?
- Cephalalgia
- Visual obscurations
- Pulsatile tinnitus
- Horizontal diplopia
- Pain on EOM
What are the etiologies of pseudotumor cerebri?
- Steroids
- Excessive vitamin A/retinoic acid
- Li
What is the treatment for pseudotumor cerebri? (4)
- Weight loss
- CAI
- CSF shunting
- Optic nerve fenestration
What is the diuretic that can be used to treat pseudotumor cerebri?
CAI
In which gender is optic neuritis more common in? Age?
15-45 yo Females
What are the s/sx of optic neuritis? (4)
- Decreased vision
- Color desaturation
- VF defects
- RAPD
What are the etiologies of optic neuritis? (3)
- MS
- Ischemia
- Lyme disease
What is the prognosis of optic neuritis?
Good after 1st attack, especially if young
What is the treatment for optic neuritis?
IV steroids
Is optic neuritis generally unilateral, or bilateral?
unilateral
What are the s/sx of retrobulbar neuritis?
- RAPD
- Pain on EOM
Is there disc edema with retrobulbar neuritis?
No
What are the S/sx of papillitis?
RAPD
Poor vision
Is papillitis usually unilateral or bilateral?
Unilateral
What are the fundoscopic findings of optic neuritis?
- Disc edema
- Tortuosity of the vessels
Which has pain on EOM,: retrobulbar neuritis or papillitis? Why?
Retrobulbar–EOMs pull on optic nerve
What are the fundoscopic exam findings of optic atrophy?
Pallor of the optic nerve
What are the causes of optic atrophy?
Anything that inflames or compresses the optic nerve
What is the major chemical intoxication that can cause optic atrophy?
-Methanol
What TB drug can cause optic atrophy?
Ethambutol
What are the fundoscopic characteristics of optic atrophy?
Clear optic disc without color
What is cortical blindness?
Visual pathways are intact, but there is an issue in the cortex that prevents the processing of the image
What is the name of the inferior optic radiation?
Meyer’s loop
What are the blood vessels that supply the optic radiations?
Middle and posterior cerebral artery
What is the calcarine fissure?
an anatomical landmark located at the caudal end of the medial surface of the brain.
What is Charles Bonnet syndrome?
the experience of complex visual hallucinations in a person with partial or severe blindness, but is cognitively intact
Who usually gets Charles Bonnet syndrome?
Old people
What are the characteristics of the hallucinations in Charles Bonnet syndrome?
Pleasant/interesting that the pt knows are not real
What is the treatment for Charles Bonnet syndrome?
Simple reassurance, maybe psych testing
What is cognitive visual loss?
visual variant of Alzheimer’s–normal VA, but inability to process correctly
What is simultagnosia?
Inability to group letters into words, or words into sentences
How do you test for cognitive visual loss?
Clock drawing
