neuro-ophthalmic disease

Question 1

what is papilloedema

Answer 1

swelling of the optic nerve due to increased intracranial pressure

Question 2

what are the 3 main causes of raised ICP in pappiloedema

Answer 2

space occupying lesion
problems with cerebral blood flow
problems with CSF

Question 3

give an example of a problem with cerebral blood flow that can cause papilloedema

Answer 3

malignant hypertension

Question 4

give the 3 main causes for problems with CSF that can lead to papilloedema

Answer 4

obstruction to circulation
overproduction
inadequate absorption

Question 5

what is the most common cause of bilateral disc swelling in young females

Answer 5

idiopathic intracranial hypertension

Question 6

clinical presentation of papilloedema

Answer 6

headache, N+V
enlarged blind spot, blurring of vision, loss of vision

Question 7

fundoscopy finding of papilloedema

Answer 7

disk swelling

Question 8

complication of chronic papilloedema

Answer 8

optic atrophy

Question 9

what is ischaemic optic neuropathy

Answer 9

occlusion of the posterior ciliary arteries, resulting in infarction of the optic nerve head

Question 10

name a cause of ischaemic optic neuropathy

Answer 10

giant cell arteritis

Question 11

clinical presentation of ischaemic optic neuropathy

Answer 11

sudden, painless visual loss

Question 12

give 3 signs of ION associated with GCA

Answer 12

• Headache
• Scalp tenderness
• Enlarged temporal arteries

Question 13

fundoscopy finding of ischaemic optic neuropathy

Answer 13

pale, swollen disc

Question 14

clinical presentation of internuclear ophthalmoplegia

Answer 14

impairment of adduction of one eye and nystagmus in the other

Question 15

pathophysiology of internuclear ophthalmoplegia

Answer 15

injury or dysfunction in the medial longitudinal fasciculus

Question 16

name 2 conditions associated with dysfunction of the medial longitudinal fasciculus

Answer 16

MS, stroke

Question 17

name some features of optic neuritis

Answer 17

progressive unilateral visual loss
pain behind the eye, especially on movement
colour desaturation
central scotoma

Question 18

name a complication of optic neuritis

Answer 18

optic atrophy

Question 19

management of idiopathic intracranial hypertension

Answer 19

carbonic anhydrase inhibitor