Neuro Opthalmic Disorders

Question 1

• Paradoxical dilation (dilates when should constrict) when flashlight swung from normal to affected eye
• Optic neuropathy; retinal defect

Answer 1

Afferent Pupillary Defect (Marcus Gunn Sign)

Question 2

• Triad: 1) Miosis; 2) partial ptosis; 3) Loss of hemifacial sweating
• Lesion, stroke, trauma, tumors–>sympathetic trunk damage
• Tx underlying Cause

Answer 2

Horner Syndrome

Question 3

• Subacute unilateral vision loss w/ signs of optic nerve dysfunction. Pain worse w/ eye mov’t. Loss of color vision.
• Demylenating dz
• Inflammation of optic nerve
• Tx with steroids

Answer 3

Optic neuritis

Question 4

• Swollen optic disc. HA, vison changes. Common in obese women of childbearing age.
• Optic disc swelling related to increased IOP
• Acetazolamide
• Idiopathic, infectious, inflammatory

Answer 4

Papilledema

Question 5

• Repetitive, rhythmic, oscillations

- Decreased visual acuity 2/2 inability to focus

Answer 5

Nystagmus

Question 6

• Normally dilated pupil which reacts slowly to light but shows more response to accommodation
• Damage to nerves usually d/t infection
• Hallmark 1) Lower extremity DTRs absent; 2) Abnormally dilated pupils which do not respond to light; 3) Abnormalities in sweating

Answer 6

Tonic (Adie) Pupil

Question 7

• Bilateral small pupils which reduce in size when focusing on near object (accommodate) but not bright light
• Neurosyphilis, DM neuropathy

Answer 7

Argyll Robertson Pupil