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OHADM2 > Neuro-ophthalmology > Flashcards

Neuro-ophthalmology Flashcards

1
Q

Definition of Nystagmus

A

Repetitive, involuntary to-and-fro eye oscillation which may be pathological or physiological

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2
Q

Primary congenital nystagmus, primary gaze

A

low amplitude pendular nystagmus that converts jerk nystagmus on side gaze

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3
Q

Explain Latent Nystagmus

A

Associated with infantile esotropia or dissociated vertical deviation
both eyes open, no nystagmus
nystagmus apparent when covering one eye or when light entering eye is reduced.

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4
Q

Describe classical migraine

A

migraine with aura that last for 20 minutes, headache is hemicranial and associated with symptoms of nausea, photophobia and phonophobia

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5
Q

Describe common migraine

A

Pounding or throbbing headache, absent of symptoms, patient often photophobic and phonophobic

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6
Q

Managements for migraines

A

Avoid food, beverages such as coffee/chocolate/cheese/alcohol, oral contraceptive pills, stress, lack of sleep, long intervals without food
Medicine for prophylaxis and acute attack

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7
Q

Signs of optic nerve dysfunction

A

Poor VA, APD, poor light brightness sensitivity, poor contrast sensitivity, dyschromatopsia, visual field defect

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8
Q

Primary optic atrophy pathogenesis

A

Occurs without swelling of ONH, may be due to lesions affecting the visual pathway from the retrolaminar portion of the optic nerve to the lateral geniculate body

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9
Q

Primary optic atrophy signs

A

pale, flat disc with clearly delineated margins.

atrophy may be diffused or sectoral

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10
Q

Primary optic atrophy causes

A

Demyelinating optic neuritis, toxic and nutritional optic neuropathy

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11
Q

Demyelinating optic neuritis presentation

A

2nd to 5th decade of life subacute monocular visual impairment with discomfort around eye, worsen with eye movement

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12
Q

Demyelinating optic neuritis signs

A

Disc is normal, temporal disc pallor indicates previous attacks, signs of optic nerve dysfunction

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13
Q

Demyelinating optic neuritis course

A

worsen up to 2 weeks then begins to improve

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14
Q

Demyelinating optic neuritis prognosis

A

VA better than 6/9 in 75%, associated with multiple sclerosis

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15
Q

Demyelinating optic neuritis management

A

refer neuro-ophthalmologist for confirmation and treatment to speed recovery

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16
Q

Nutritional optic neuropathy presentation

A

Insidious onset of progressive, bilateral, symmetrical visual impairment associated with dyschromatopsia

17
Q

Nutritional optic neuropathy signs

A

Normal optic disc, bilateral centrocaecal scotomas

18
Q

Nutritional optic neuropathy management

A

Refer to ophthalmologist for treatment

19
Q

Secondary optic atrophy pathogenesis

A

Preceded by swelling of the ONH

20
Q

Secondary optic atrophy signs

A

White/ dirty grey, slightly elevated disc, poorly delineated margin
Reduction in number of vessels

21
Q

Secondary optic atrophy causes

A

Chronic papilloedema, Anterior ischemic optic neuropathy

22
Q

Non-Arteritic Anetrior Ischaemic Optic Neuropathy pathogenesis

A

infarction of ONH caused by occlusion of short posterior ciliary arteries

23
Q

Non-Arteritic Anterior Ischaemic Optic Neuropathy presentation

A

6th to 7th decade, sudden, painless mono visual loss, no forewarning of visual obscuration

24
Q

Non-Arteritic Anterior Ischaemic Optic Neuropathy signs

A

Hyperaemic disc swelling often few peripapillary splinter shaped haemorrhages
Swelling grad. resolves, pallor after 3-6 weeks

25
Q

Non-Arteritic Anterior Ischaemic Optic Neuropathy treatment

A

No

26
Q

Arteritic Anterior Ischaemic Optic Neuropathy pathogenesis

A

Occlusion of posterior ciliary arteries due to giant cell arterities

27
Q

Arteritic Anterior Ischaemic Optic Neuropathy presentation

A

8th to 9th decade, sudden profound vision loss, periocular pain, transient visual obscuration, flashing lights

28
Q

Arteritic Anterior Ischaemic Optic Neuropathy signs

A

Severe visual loss; to light perception or worse
Strikingly pale oedematous disc
over 1-2 months, swelling gradually resolves and optic atrophy ensues

29
Q

Arteritic Anterior Ischaemic Optic Neuropathy management

A

Refer to ophthalmologist for intravenous steroids to prevent blindness

30
Q

Arteritic Anterior Ischaemic Optic Neuropathy prognosis

A

poor

31
Q

Papilloedema pathogenesis

A

Swelling of ONH secondary to raised intracranial pressure

32
Q

Papilloedema signs

A

Disc hyperaemia, elevation, indistinct margins,

Venous engorgements, peripapillary flame shaped haemorrhages, cotton wool spots

33
Q

Papilloedema management

A

Refer to ophthalmologist urgently, suspicious of intracranial mass

34
Q

Absolute afferent papillary defect characteristics

A

Eye complete blind, Both pupils equal in size, affected eye stimulated both no reaction, if norm eye stimulated reacts normally, near reflex is normal1

35
Q

Argyll Robertson Pupil cause and signs

A

Caused by neurosyphilis,
Bilateral small pupils do not react to light
Near response normal

36
Q

Adie pupil causes

A

denervation of the postganglionic supply to the sphincter pupillae and ciliary muscle

37
Q

Adie pupil signs

A 
Large regular pupil
Direct light reflex: absent/sluggish
Consensual light reflex: absent/sluggish
Near reflex: slow contrsict, redilation
Accomodation: manifest similar tonicity
38
Q

Horner syndrome causes

A

Lesion occur anywhere on sympathetic supply, diff conditions can affect the three different sympathetic neurons.
Central
preganglionic
postganglionic

39
Q

Horner syndrome signs

A 
unilateral 
Mild ptosis
Miosis
Slight elevation of inferior eyelid
Hypochromic heterochromia
Reduced ipsilateral sweating
normal pupillary reaction to light and near

OHADM2 (9 decks)

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