Neuro-Ophthalmology

Question 0

Primary visual cortex a.k.a.? Receives information from?

Answer 0

#Visual area 1
#Brodmann's area 17
#Striate cortex

Contralateral visual hemisphere

Question 1

90% of retinal axons terminate where? Subsequent path?

Answer 1

Lateral geniculate nucleus – optic radiations – cerebral cortex

Question 2

Lesion at parietal optic radiation versus Myers Loop/temporal optic radiation?

Answer 2

Left inferior homonoymous quadrantanopiia versus left superior homonoymous quadrantanopia

Question 3

If a pinhole improves visual acuity – problem is in?

Answer 3

Refraction

Question 4

Red desaturation suggests what nerve problem?

Answer 4

Optic neuritis

Question 5

Alternating flashlight test detects?

Answer 5

Marcus Gunn pupil

Question 6

Retinal causes of visual loss?

Answer 6

#Retinal detachment
#Infection – CMV/toxoplasmosis
#Toxin – ethambutol
#Degenerative – macular degeneration, retinitis pigmentosa
#Ischemic – embolic

Question 7

Optic disc pathologies that result in vision loss?

Answer 7

#Anterior ischemic optic neuropathy
#Optic neuritis
#Glaucoma
#Papilledema
#Sarcoidosis
#Tumor

Question 8

Optic nerve causes of vision loss?

Answer 8

#Demyelination
#Neoplasm – meningioma, glioma
#Thyroid ophthalmopathy
#Trauma

Question 9

Optic chiasm specific causes of visual loss?

Answer 9

#Neoplasm – adenoma, craniopharyngioma, glioma
#Sphenoid mucocele
#Vascular - Internal carotid artery aneurysm
#Demyelination
#Trauma

Question 10

Retrochiasmal causes of visual loss?

Answer 10

#Neoplasm – glioma, meningioma, metastasis
#Stroke
#Demyelination
#Degenerative

Question 11

Anisocoria?

Answer 11

Unequal pupil size

Question 12

Anatomy of light induced pupil constriction?

Answer 12

Light – retinal ganglionic cells – optic nerve – optic chiasm – optic tract – pre-tectal midbrain nuclei a.k.a. Edinger-Westphal nuclei– efferent parasympathetic fibers – ciliary ganglion – pupillary constrictor

Question 13

Sympathetic system that innervates pupils begins where?

Answer 13

First Order: Ipsilateral posterior lateral hypothalamus to intermediolateral cell column at C8-T1

Second order: to superior cervical ganglion

Third order: travels along internal carotid artery to cavernous sinus to pupillary dilator muscles

Question 14

Visual loss at eye level – symptoms/signs? Most common problem? Marcus Gunn pupil?

Answer 14

#Monocular vision loss
#Ipsilateral Marcus Gunn pupil
#Improves with pinhole

Refractory error

Question 15

Lesion optic nerve – signs/symptoms?

Answer 15

#Monocular vision loss
#Ipsilateral Marcus Gunn pupil
#Optic disc swelling

Question 16

Lesion at level optic chiasm – signs and symptoms?

Answer 16

#Binocular vision loss
#Marcus Gunn pupil

Question 17

Lesion at lateral geniculate nucleus – signs/symptoms?

Answer 17

#Binocular vision loss
#NO Marcus Gunn pupil

Question 18

Lesion affecting optic radiations in temporal lobe results in?

Parietal lobe?

Answer 18

Superior contralateral quadrantanopia

Inferior contralateral quadrantanopia

Question 19

Lesion to occipital lobe results in what defect?

Answer 19

Congruous contralateral hemianopia with macular sparing