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Opthalmology > Neuro-opthalmology > Flashcards

Neuro-opthalmology Flashcards

1
Q

How long do you have to stop driving for if have a TIA?

A

1 month

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2
Q

Causes of headache (in neuro-ophthalmology)

A

Migraine
Acute glaucoma
Herpes Zoster virus
GCA

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3
Q

Features of acute glaucoma

A

Fixed dilated pupil
Red eye
Vomiting

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4
Q

Presentation of GCA

A

Headache
Jaw claudication / Jaw pain when eating
Scalp tenderness

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5
Q

What type of pain is claudication?

A

Ischaemic

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6
Q

What is noticed with HZV in terms of its presentation on the face/head?

A

Headache before the rash

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7
Q

Types of reduced vision

A

Transient

Vascular

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8
Q

Definition of amaurosis

A

Total vision loss that lasts a few seconds, with no visible changes in the eye

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9
Q

What does GCA stand for?

A

Giant cell arteritis

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10
Q

Common cause of transient reduced vision

A

TIA

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11
Q

Who commonly gets amaurosis?

A

Elderly

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12
Q

Common cause of vascular reduced vision

A

Migraine

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13
Q

How long does reduced vision due to migraine usually last?

A

20 minutes

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14
Q

Causes of reduced vision due to the anterior segment

A

Cornea; scar

Lens; cataracts

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15
Q

Causes of reduced vision due to the posterior nerve

A

Optic nerve

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16
Q

How is visual acuity scored?

A

X/Y
X = distance reading chart from
Y = distance a normal person can read from

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17
Q

What is a normal visual acuity?

A

6/6

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18
Q

If cannot read the Snellen chart, what is done?

A
  1. Move closer
  2. Finger counting
  3. Movements
  4. Light
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19
Q

Where is the damage when the patient presents with a homonymous hemianopia?

A

Damage after the optic chiasm

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20
Q

Where is the damage when the patient presents with an afferent pupillary defect?

A

Damage before optic chiasm

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21
Q

Where is there damage if there is only a defect in one eye?

A

Damage before the chiasm

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22
Q

Where is the damage if the patient presents with bitemporal hemianopia?

A

Damage at the optic chiasm

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23
Q

What causes a homonoymous hemianopia?

A

Cerebrovascular event

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24
Q

What type of eye is a hypermetropic eye?

A

Short eye

Long sighted

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25
Q

What type of eye is a myotropic eye?

A

Long eye

Short sighted

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26
Q

Causes of a swollen optic nerve head

A 
Systemic HTN 
Papilloedema 
Anterior ischaemic optic neuropathy 
Central retinal vein occlusion (CRVO)
Optic nerve head drusen 
Hypermetropia
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27
Q

If a swollen optic nerve head is caused by systemic HTN, what is usually present?

A

Swollen optic nerve head in BOTH eyes

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28
Q

Presentation of papilloedema

A

Bilateral swollen optic nerve heads
Headache
Increased IOP
Normal vision

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29
Q

Pathology of optic nerve drusen

A 
Hyaline deposits (drusen) deposits in the optic nerve 
Pseudopapillodema
30
Q

Pathology of optic nerve swelling in hypermetropia

A

NOT ACTUALLY SWOLLEN

just looks swollen just looks it due to its short eye

31
Q

What does optic nerve drusen look like on USS?

A

Refractile

32
Q

What does optic nerve drusen look like on CT?

A

A bright lesion

33
Q

What is optic neuritis?

A

Optic nerve head inflammation

34
Q

Causes of optic neuritis

A 
MS
Alcohol/tobacco 
Infective 
Syphillis (rare)
Lyme (rare)
35
Q

Presentation of optic neuritis in MS

A

Subacute vision loss over days - weeks
Pain on eye movement
Red desaturation

36
Q

What % of optic neuritis due to MS are retrobulbar? And what does this result in?

A

65%

The optic nerve head looks normal

37
Q

In what time frame does vision improve in due to optic neuritis from MS?

A

1 month

38
Q

What % of patients with optic neuritis will develop MS after 15 years?

A

50%

39
Q

What % of patients with optic neuritis will develop MS after 15 years if there are no lesions on the MRI?

A

25%

40
Q

What does AION stand for?

A

Anterior ischaemic optic neuropathy

41
Q

Presentation of AION

A

Pale optic nerve head
Sudden visual loss
Sudden severe pain

42
Q

What artery supplies the optic nerve head?

A

Anterior ciliary artery

43
Q

Treatment of non inflammatory AION

A

No treatment

44
Q

Causes / types of AION

A

GCA

Non inflammatory

45
Q

Who gets GCA causing AION?

A

Older - 70s

46
Q

Who gets non inflammatory AION?

A

Younger - 60s

Risk factors and assosiations

47
Q

Will the vision loss in the effected eye of GCA recover?

A

No

48
Q

What % of the other eye will be affected in GCA if untreated?

A

95%

49
Q

Why can a biopsy for GCA be -ve even if have the disease?

A

Skip lesions

50
Q

Definition of anisocoria

A

Different sized pupils

51
Q

Which pupil is abnormal in anisocoria?

A

The pupil that doesn’t change in shape

52
Q

Definition of Adie’s pupil?

A

Big pupil with delayed constriction in response to light

53
Q

What is damaged in Adies pupil?

A

Efferent pathway

54
Q

What is the damage in Horners syndrome?

A

Sympathetic pathway

55
Q

Causes of horners syndrome

A

CVA
Neck trauma
Demyelination
Syringomyelia

56
Q

Presentation of horners syndrome

A

Miosis
Ptosis
Anhidrosis

57
Q

Definition of myosis

A

Constriction of the pupil

58
Q

Definition of anhidrosis

A

Loss of sweating from the face

59
Q

What is painful horners syndrome caused by? What may this cause?

A

Carotid artery dissection

May cause a stroke

60
Q

What is the muscle that closes the eyelid?

A

Obicularis

61
Q

Causes of diplopia

A

Nerve palsy
Thyroid eye disease
Myasthenia gravis
Stroke

62
Q

What type of diplopia do you get with a 3rd or 4th nerve palsy?

A

Horizontal

63
Q

What type of diplopia do you get with a 4th nerve palsy or a thyroid eye disease?

A

Vertical

64
Q

Pathology of thyroid eye disease causing diplopia

A

Thickening and stiffening of muscles

Muscles can compress optic nerve and can make you lose vision

65
Q

What is usually done when there is a 3rd nerve palsy? Why? What may some of these patients develop?

A

Imagine
Concern that it is due to an aneurysm in the posterior communicating artery
May develop a SAH

66
Q

Eye features of myasthenia gravis

A

Variable diplopia

Ptosis

67
Q

What can be raised in myasthenia gravis?

A

ACh receptor antibodies

68
Q

Definition of laglopthalmos

A

Inability to completely close the eyelids

69
Q

What happens to the eyeball when the eyes close? Why does this happen? Does this happen in everyone

A

The eye rolls up
To protect the corneal surface
No, does not happen in everyone

70
Q

When there is a facial nerve palsy, where should you look?

A

Ear

71
Q

Pathology of lid retraction

A

Overactive sympathetic system

72
Q

Common cause of lid retraction

A

Thyroid eye disease

Opthalmology (8 decks)

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