Neuro-opthalmology Flashcards
signs of optic nerve dysfunction?
decrease in visual acuity visual colour impairment visual field defects diminished contrast sensitivity RAPD
what is dyschromatopsia?
visual colour impairment
charcot’s triad of cerebellar dysfunction?
tremor
dysarthria
ataxia
describe uhthoff phenomenon
worsening of symptoms due to increase in temperature such as exercising or hot showers
autonomic features of MS
bladder
bowel
sexual dysfunction
a decreased visual acuity visual field defect is also called….
a central scotoma
Tx for optic neuritis?
methylprednisolone IV followed by oral prednisolone
GCA can cause what eye problem?
arteritic anterior ION
who gets non-arteritic AION
patients >50
what artery is occluded in AION?
short posterior ciliary artery
causes of non-arteritic AION?
idiopathic
hypertension
diabetes
sleep apnoea
sudden painless unilateral visual loss….
AION
does arteritic or non-arteritic AION have a higher risk of the other eye being affected?
arteritic
Tx of non-arteritic AION?
treat cause
Tx of arteritic AION?
high dose methylprednisolone IV
oral prednisolone + aspirin
what kind of visual loss presents in papilloedema?
transient visual loss lasting seconds
most common cause of horner’s in children
trauma
a painful horner’s syndrome should raise suspicion of…
carotid dissection
Ix for horners
apraclonidine to dilate pupils
CT/MRI for dissection
define adie’s pupil?
loss of postganglionic parasympathetic innervation to the iris sphincter and ciliary muscle
who gets adie’s pupil?
young females
features of adie’s pupil?
anisocoria (left pupil larger) and blurs on near vision
light reflex absent
Ix of adie’s pupil?
slit lamp
0.125% topical pilocarpine into both eyes (if affected pupil constricts = positive)
bilateral, irregular, small pupils that dont react to light?
argyll robertson pupil
an argyll robertson pupil will do what reflex correctly?
accomodation reflex
ipsilateral 3rd nerve palsy with contralateral hemiparesis….
webers syndrome
ipsilateral 3rd nerve palsy with contralateral tremor, ataxia, chorea….
benedikt’s syndrome
main causes of CN4 palsy?
trauma
congenital
clinical features of CN4 palsy?
vertical diplopia (check for head tilt)
hypertropia
can’t depress eye (SO not working)
CN6 palsy features
horizontal double vision
esotropia
limited abduction
what eye movement is decreased in CN6 palsy?
abduction
most common cause of CN6 palsy
diabetes
hypertension
increases ICP
pathophysiology of myaesthenia gravis?
autoimmune disease of ACh receptors at post-synaptic NM junctions
who primarily gets myaesthenia gravis?
females in their 30s
myaesthenia affects ___ muscle
skeletal
what muscles are affected first in myaesthenia gravis?
smaller muscles
presenting features of myaesthenia gravis?
bilateral ptosis worse at end of day lid twitch diplopia opthalmoplegia weakness of face and proximal limb muscles
Ix of myaesthenia gravis?
ice test (See if ptosis improves after 2 mins)
antibodies
EMG
muscle biopsy
Tx of myaesthenia gravis
pyridostigmine (ACh-esterase)
steroids
immunomodulators
delayed muscle contraction and muscle wasting with ptosis and hypermetropia…
myotonic dystrophy
what are lisch nodules and what condition are they found in?
hamartomous pigmented lesions protruding above the iris
NF1
cataracts present in what NF type
NF2
what happens in benign essential blepharospasm?
involuntary contraction of the orbicularis oculi muscle
Tx of benign essential blepharospasm?
artificial tears
botox injection
the lateral wall of the cavernous sinuses contain what cranial nerves (specifically)?
3, 4, CNV1, CNV2
features of cavernous sinus syndrome?
features of CN 3 4, 5 loss
