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OPHTHAL > neuro ophthalmology > Flashcards

neuro ophthalmology Flashcards

1
Q

what are the pupillary reflexes?

A

light reflex and near reflex

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2
Q

what are the pupillary reflexes?

A

direct and and consensual light reflex

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3
Q

Breifly describe the pupillary [athway?

A

retina to pretectal nucleus

pretectal nucleus to Edinger-Wesphal nucleus

edingar - westphal nucleus to third cranial nerve and ciliary nerve

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4
Q

what does near reflex consists of?

A

accomodation reflex and convergence reflex

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5
Q

what are the ways to check pupillary reflex ?

A

direct light
indirect light
swinging flashlight test

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6
Q

what are the abnormal pupillary reflexes and the reason behind every one of them?

A
  1. amauratic cat eye reflex - optic nerve damage
  2. efferent pathway defect
  3. marcus gunn pupil - RAPD (relative afferent pathway defect)
  4. wernickes hemianopic pupil - optic trat defect
  5. adies pupil post ganglionic parasym pupilarymotor damage
  6. argyll robertson pupil - neurosuphilis (accomodation reflex present )
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7
Q

what is optic neuritis?

A

inflammation and demylienation of the optic nerve

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8
Q

what are the causes of optic neuritis?

A 
idiopathic
hereditary -  leders disease
autoimmune - sarcoidosis , SLE
infectious - tb , syphilis
parainfectious - measles , chickenpox
toxic neuritis
demylienation disorders - multiple sclerosis
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9
Q

what are the types of optic neuritis according to anatomical classification?

A

papilitis
neuroretinitis
retro orbital neuritis

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10
Q

what is papillitis?

A

type of optic neuritis which involves the optic disc

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11
Q

what is neuroretinitis?

A

involvement of optic disc and macula of the retina in optic neuritis

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12
Q

what is retrobulbar neuritis?

A

neuritis of the optic nerve present behind the eye ball.

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13
Q

what does typical and atypical optic neuritis mean?

A

typical neuritis is demylination disorder that leads to optic neuritis (esp MS)

atypical is optic neuritis is due to other reasons other than demylienation.

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14
Q

clinical features of optic neuritis?

A 
# SUDDEN monoocular progressive loss of vision
# DIMINISHED dark adaptations
# visual obscuration (sudden grey transient loss of vision) in bright light
#IMPAIRED colour vision
#movement and sound PHOSPHENES
# transient obscuration of vision ON EXERTION
# PULFRICH'S PHENOMINON (DEPTH PERCEPTION FOR MOVING OBJECTS LOST)
# pain - mild  (mostly in retrobulbar)
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15
Q

reason for pain during movement and which movement causes more pain?

A

un and down movement causes more pain in RETROBULBAR optic neuritis because of superior rectus attachment to the dura mater.

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16
Q

what is the most affected thing in optic neuritis?

A

colour vision is IMPAIRED.

17
Q

SIGNS of optic neuritis?

A
  1. visual acuity - red.
  2. colour vision - impaired
  3. contrast sensitivity - impaired (desaturation)
  4. MARCUS GUNN PUPIL
  5. ophthalmoscope -
    # disc - hyperaemia , blurred margin, splinter hemorrhage,
    fine exudates, dics edema (2-3D)
    #cup - obliterated
    #retinal veins - engorged and tortuous.
    # vitreous - inflammatory cells.
    #macula - MACULAR STAR (inn neuroretinitis - involves
    retina + optic disc)
  6. visual feild changes - central and centrocaecal scotoma
  7. visually evoked response - low amplitude and red.
    transmission time.
  8. fundus fluorescein angiography - slight leak and inc. over time
18
Q

what kind of changes in examination is found in retrobulbar neuritis?

A

no changes that are noticiable except maybe sometimes temporal pallor of disc.

19
Q

DD for paillitis?

A

papilloedema
pseudopapilledema
ischemic optic neuropathy
ant. orbital compression neuropathy

20
Q

DD FOR ACUTE RETROBULBAR OPTIC NEURITIS?

A

Hysterical blidness
cortical blindness
indirect optic neuropathy
malingering

21
Q

what is the investigation found to diagnose optic neuritis early?

A

multifocal visually evoked response

22
Q

what are the investigations done for optic neuritis?

A

multifocal visually evoked response
mri of brain
optic nerve mri - gadolinium enhanced
brain - cerebral cerebellar, brainstem

OPHTHAL (3 decks)

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