neuro opthalmologic disorders

Question 1

transfers information from the retina to the visual centers of the brain

Answer 1

optic nerve

Question 2

inflammatory, demyelination of the optic nerve that causes acute, usually monocular, visual loss

Answer 2

optic neuritis

Question 3

optic neuritis is often a presenting sign of

Answer 3

MS

Question 4

who is at risk for optic neuritis

Answer 4

women
pts between ages of 20 and 40

Question 5

inflammation of the retinal vascular endothelium can precede demyelination

myelin loss exceeds axonal loss

visual loss can be mild to complete without perception of light

Answer 5

optic neuritis pathology

Question 6

optic neuritis signs and symptoms

Answer 6

• subacute central vision loss (distinguishing feature: lasts a few days)
• may have some loss of color vision and decrease in brightness
• almost always have eye pain (worse with eye movement)
• in 1/3 optic disk is swollen
• in 2/3 optic disk is normal in acute stage and develops pallor later
• relative afferent pupillary defect (RAPD) (shine a light in normal eye and they constrict normally but other one doesn’t)

Question 7

optic neuritis etiology

Answer 7

• a lot of possibilities
• multiple sclerosis (or other autoimmune)
• infection: Lyme, herpes, syphilis
• methanol poisoning: moonshine
• B12 deficiency
• diabetes

Question 8

optic neuritis treatment

Answer 8

• IV steroids
• refer to ophthalmology

Question 9

in patients with a first episode of optic neuritis, MS will develop in ________% within ______ years

Answer 9

50%, 15 years

Question 10

optic neuritis prognosis

Answer 10

usually vision improves in 2-3 weeks and often returns close to normal

Question 11

what happens in optic neuritis if there has been damage to the nerve

Answer 11

optic atrophy

Question 12

what happens if vision does not return or pain persists in optic neuritis

Answer 12

MRI of the head and orbits to r/o compressive lesion

Question 13

nystagmus is part of the

Answer 13

vestibulo- ocular reflex (VOR)

alternating smooth pursuit in one direction and saccadic movement in the other direction

Question 13

repetitive, uncontrolled and involuntary eye movements

reduced vision and depth perception and can affect balance and coordination

Answer 13

nystagmus

Question 14

nystagmus is a

Answer 14

symptom

disruption of image stabilization system

Question 15

nystagmus may be due to

Answer 15

inner ear disorders

Question 16

often idiopathic
associated with low vision
most often develops by 2 to 3 months of age
eyes tend to move in a horizontal swinging fashion

Answer 16

infantile nystagmus

Question 16

nystagmus evaluation and management

Answer 16

other visual changes
vertigo/imbalance
any other neurologic symptoms
type of nystagmus
eye movement

Question 17

infantile nystagmus is often associated with what other condition

Answer 17

albinism

Question 18

optic disk swelling due to raised intracranial pressure
bilateral
not painful

Answer 18

papilledema

Question 19

what causes papilledema

Answer 19

• idiopathic intracranial hypertension
• space occupying lesions
• blockage of CSF flow
• cerebral edema
• meningitis/encephalitis

Question 20

produces enlargement of the blind spot without loss of acuity

Answer 20

acute papilledema

Question 21

associated with visual field loss and occasionally with profound loss of acuity

Answer 21

chronic papilledema or severe acute papilledema

Question 21

papilledema management

Answer 21

• reducing ICP (not an eye problem! it is an intracranial problem)
• weight loss and acetazolamide
• shunting