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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
What type of eye is a myotropic eye?
Long eye | Short sighted
26
Causes of a swollen optic nerve head
``` Systemic HTN Papilloedema Anterior ischaemic optic neuropathy Central retinal vein occlusion (CRVO) Optic nerve head drusen Hypermetropia ```
27
If a swollen optic nerve head is caused by systemic HTN, what is usually present?
Swollen optic nerve head in BOTH eyes
28
Presentation of papilloedema
Bilateral swollen optic nerve heads Headache Increased IOP Normal vision
29
Pathology of optic nerve drusen
``` Hyaline deposits (drusen) deposits in the optic nerve Pseudopapillodema ```
30
Pathology of optic nerve swelling in hypermetropia
NOT ACTUALLY SWOLLEN | just looks swollen just looks it due to its short eye
31
What does optic nerve drusen look like on USS?
Refractile
32
What does optic nerve drusen look like on CT?
A bright lesion
33
What is optic neuritis?
Optic nerve head inflammation
34
Causes of optic neuritis
``` MS Alcohol/tobacco Infective Syphillis (rare) Lyme (rare) ```
35
Presentation of optic neuritis in MS
Subacute vision loss over days - weeks Pain on eye movement Red desaturation
36
What % of optic neuritis due to MS are retrobulbar? And what does this result in?
65% | The optic nerve head looks normal
37
In what time frame does vision improve in due to optic neuritis from MS?
1 month
38
What % of patients with optic neuritis will develop MS after 15 years?
50%
39
What % of patients with optic neuritis will develop MS after 15 years if there are no lesions on the MRI?
25%
40
What does AION stand for?
Anterior ischaemic optic neuropathy
41
Presentation of AION
Pale optic nerve head Sudden visual loss Sudden severe pain
42
What artery supplies the optic nerve head?
Anterior ciliary artery
43
Treatment of non inflammatory AION
No treatment
44
Causes / types of AION
GCA | Non inflammatory
45
Who gets GCA causing AION?
Older - 70s
46
Who gets non inflammatory AION?
Younger - 60s | Risk factors and assosiations
47
Will the vision loss in the effected eye of GCA recover?
No
48
What % of the other eye will be affected in GCA if untreated?
95%
49
Why can a biopsy for GCA be -ve even if have the disease?
Skip lesions
50
Definition of anisocoria
Different sized pupils
51
Which pupil is abnormal in anisocoria?
The pupil that doesn't change in shape
52
Definition of Adie's pupil?
Big pupil with delayed constriction in response to light
53
What is damaged in Adies pupil?
Efferent pathway
54
What is the damage in Horners syndrome?
Sympathetic pathway
55
Causes of horners syndrome
CVA Neck trauma Demyelination Syringomyelia
56
Presentation of horners syndrome
Miosis Ptosis Anhidrosis
57
Definition of myosis
Constriction of the pupil
58
Definition of anhidrosis
Loss of sweating from the face
59
What is painful horners syndrome caused by? What may this cause?
Carotid artery dissection | May cause a stroke
60
What is the muscle that closes the eyelid?
Obicularis
61
Causes of diplopia
Nerve palsy Thyroid eye disease Myasthenia gravis Stroke
62
What type of diplopia do you get with a 3rd or 4th nerve palsy?
Horizontal
63
What type of diplopia do you get with a 4th nerve palsy or a thyroid eye disease?
Vertical
64
Pathology of thyroid eye disease causing diplopia
Thickening and stiffening of muscles | Muscles can compress optic nerve and can make you lose vision
65
What is usually done when there is a 3rd nerve palsy? Why? What may some of these patients develop?
Imagine Concern that it is due to an aneurysm in the posterior communicating artery May develop a SAH
66
Eye features of myasthenia gravis
Variable diplopia | Ptosis
67
What can be raised in myasthenia gravis?
ACh receptor antibodies
68
Definition of laglopthalmos
Inability to completely close the eyelids
69
What happens to the eyeball when the eyes close? Why does this happen? Does this happen in everyone
The eye rolls up To protect the corneal surface No, does not happen in everyone
70
When there is a facial nerve palsy, where should you look?
Ear
71
Pathology of lid retraction
Overactive sympathetic system
72
Common cause of lid retraction
Thyroid eye disease

Opthalmology (8 decks)

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