Neuro-ophthalmology Flashcards
What is the afferent and efferent limb of the pupillary light reflex?
Afferent - optic
Efferent - parasympathetic and CN III
What is optic neuritis?
Inflammation of the optic nerve due to infection or demyelination
Name the common signs of optic neuritis
Decreased visual acuity, dyschromatopsia, visual field defect, diminished contract sensitivity, RAPD
Which colour is often affected in MS?
Red
What is anterior ischaemic optic neuropathy?
Ischaemic damage to the optic nerve
- arteritic
- non-arteritic
Describe non-arteritic anterior ischaemic optic neuropathy
> 50 years old, occlusion of short ciliary artery
Causes - idiopathic, HTN, diabetes, sleep apnoea, disc anomaly
How does non-arteritic anterior ischaemic optic neuropathy present?
Unilateral sudden painless visual loss with hyperaemic disc swelling
Describe arteritic anterior ischaemic optic neuropathy
GCA
Sudden painful unilateral visual loss, chalky white diffuse swollen disc
Oedema becomes atrophy
How is arteritic anterior ischaemic optic neuropathy investigated and treated?
Investigated - ESR, CRP, temporal artery biopsy
Treatment - high dose prednisolone
What is horner’s syndrome?
Lesion to sympathetic chain
Ptosis, miosis, ipsilateral anhydrosis (if below superior cervical ganglion)
Name some causes of Horner’s syndrome
Trauma, stroke, syringomyelia, pan coast tumour, dissection, cluster headache, cavernous sinus lesion
What is another name for Wallenberg’s syndrome?
Lateral Medullary Syndrome
Describe Lateral Medullary Syndrome
Ischaemic damage to lateral medulla oblongata due to blockage of posterior inferior cerebellar artery or vertebral artery
Name the features of Lateral Medullary Syndrome
Vestibular nucleus - tinnitus, balance Ipsilateral horner's Spinal trigeminal tract - sensory Spinothalamic tract - pain and temperature Dysphagia/hoarseness
What is Adie’s pupil?
Loss of parasympathetic innervation to the iris sphincter and ciliary muscle
