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CP2 Ophthlamology > Neuro-ophthalmology > Flashcards

Neuro-ophthalmology Flashcards

1
Q

What causes optic neuritis?

A

Demyelination of optic nn

- Usually 2’ to MS or ischaemic optic neuropathy (blood clot)

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2
Q

Sx optic neuritis (2)

A

Blurred vision

Retrobulbar pain on movement

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3
Q

O/E optic neuritis (3)

A

Red colour vision
RAPD
Central scotoma

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4
Q

If a patient has a repeat episode of optic neuritis, what should be done?

A

MRI (b/c risk MS)

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5
Q

What is papilloedema

A

Swelling of optic disc due to incr ICP

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6
Q

Is papilloedema usually uni or bilateral ?

A

Bilateral

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7
Q

Sx papilloedema (3)

A

Transient visual obscurations + enlarged blind spots

Gradually progressive

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8
Q

O/E (6)

A

May have - splint haemorrhages, exudates, cotton wool spots, retinal folds
Enlarged blinds spots
Progressive field loss

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9
Q

What is AAION

A

Inflammation of the aa to the optic discs which causes infarction

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10
Q

Sx AAION (5)

A 
Temporal headache + 
Jaw claudication 
W loss 
Myalgia 
Visual loss
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11
Q

O/E AAION (4)

A

Raised CRP/ESR
Margins blurred
Cup obliterated
Rest of fundus = pallor

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12
Q

Which aa is specifically affected in AAION

A

Posterior ciliary aa

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13
Q

Mx AAION (2)

A

Urgent high dose steroids
Continue for 2 years
Temporal aa biopsy within 1 week starting Tx

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14
Q

Which aa is affected in Non-arteritic AION

A

Posterior communicating aa

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15
Q

O/E NAION (3)

A

ESR not raised
Swelling not as gross as AAION, visual impairment not as excessive
No systemic Sx

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16
Q

What do 50% of patients with NAION have?

A

HTN

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17
Q

Tx NAION

A

Low dose aspirin

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18
Q

Features of optic atrophy (3)

A

Afferent pupillary defect
Optic nn - atrophic + palsies
Loss surface capillaries

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19
Q

Which mm are affected in CN III palsy? (5)

A 
MR
IF
SR
LPS
IO
20
Q

Appearance eyes IIICN palsy (3)

A

Eyes point down + out
Ptosis
Dilated/mydriasis

21
Q

Which mm is affected in CN IV palsy?

A

SO

22
Q

Appearance eyes CN IV palsy

A

Eyes can’t look down + in

23
Q

What may a patient with CN IV palsy complain of when looking down + in?

A

Vertical diplopia

24
Q

What is bilateral CN IV palsy associated with?

A

Head injuries

25
Q

What mm is affected in CN VI palsy?

A

LR

26
Q

Appearance CN VI palsy

A

Pt can’t abduct

Eye may drift medially b/c pull medial rectus

27
Q

What 2 things should you test to see if a patient has CN VII palsy?

A

Corneal sensation

Bells

28
Q

What part of the visual circuit is affected if patient presents with bitemporal hemianopia

A

Optic chiasm

29
Q

Causes of bitemporal hemianopia (3)

A

Pit tumour
Meningioma
Aneurysm of ant communicating aa

30
Q

What part of the visual circuit is affected if patient presents with homonymous hemianopia

A

Optic tract lesion

31
Q

Cause of homonymous hemianopia

A

Usually CVA

32
Q

Which loop is affected in L superior quandrantopia

A

Meyers

33
Q

What cortex of brain is affected in L superior quadrantopia

A

Temporal lobe

34
Q

What loop is affected in L inferior quadrantopia

A

Baum’s

35
Q

What cortex of brain is affected in L inferior quadrantopia

A

Parietal

36
Q

What part of brain is affected if you get homonymous hemianopia w/ macular sparing ?

A

Visual cortex CVA

37
Q

Why do you get macular sparing?

A

B/c macular fibres recieve a sep blood supply to peripheral visual cortex

38
Q

What is an afferent pupil defect?

A

Disruption of fibres travelling from RCG to PTN and from PTN to same + contralateral EWN

39
Q

Affect of Afferent pupil defect on pupillary responses

A

No consensual or direct response

40
Q

Affect of RAPD on pupillary responses

A

Reduce light + consensual response

Pupil dilates on swinging light test

41
Q

What causes Horner’s syndrome?

A

Lesion of sympathetic pathway

42
Q

PS Horner’s syndrome

A

Affected pupil smaller than usual
Apparent enophthalmos
Partial ptosis

43
Q

Cause fo Argyll Robertson Pupils

A

Congenital syphillis

44
Q

Appearance + response of Argyll Robertson Pupils (4)

A

Pupils small + irreg
Sluggish light responses
Light near dissociation
Sometimes blind

45
Q

Appearance + response Argyll Robertson Pupils (3)

A

Efferent defect
SLugish pupil response
LND

CP2 Ophthlamology (11 decks)

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