neuro-optho Flashcards
RAPD test
marcus gunn defect
efferent defect
CN 3
adies tonic pupil
benign ciliary ganglion
unilateral small pupils
horners syndrme
bilateral tonic small pupils
argyll robertson pupil
blurred vision (near), periocular discomort, decr depth perception
adies tonic pupil
adies tonic pupil is seen in who?
age 20-50, females, unilateral
how to dx adies tonic pupil
pilocarpine
dx of horners
apraclonidine
Pupils accommodate but do not react to light; irregular and small pupils
argyll robertson pupil
diseases assc’d wtih argyll robertson pupil (3)
- syphilis
- diabetes
- alcoholism
vertical oblique diplopia with compensatory head tilt to opposite shoulder
CN IV paresis
loss of abduction, horizontal diplopia
CN VI paresis
spontaneous rhyhmic back and forth movement
nystagmus
how is nystagmus named
named by fast component
bitemporal hemianopia
pituitary apoplexy
heterochromic miosis and ptosis
congenital horners
diplopia during heaving exercise
aneurysm
diplopia only when fatigured
myasthenia
diplopia only when looking right
CN VI
diplopia with HA, retro-orbital pain
aneurysm
Loss of abduction, horizontal diplopia
CN VI paresis
what is the great imitator for causing diplopia?
myasthenia gravis
searching pendular nystagmus
congenital (benign)
young person with acute vision loss with severe HA, eye pain, bitemporal depression
pituitary tumor
disc edema due to incr ICP
papilledema
20-40 yo female, obese, papilledema present with cephalgia, visual obscurations, pulsatile tinnitus, horizontal diplopia, pain on EOM
idiopathic intracranial HTN
woman age 15-45; decr vision; unilateral; red color desaturation; visual field defects
optic neuritis
tx of optic neuritis
parental corticosteroids
what is optic neuritis most commonly due to?
optic neuritis
which type of optic neuritis: disc edema, hyperemia of disc, tortuosity of vessels; generally unilateral; RAPD, poor vision
papillitis
which type of optic neuritis: NO disc edema, pain on EOM, RAPD
retrobulbar neuritis
pallor of the optic nerve
optic atrophy
loss of half of visual field
hemianopia
loss of either right or left visual field
homonymous
Elderly patients; significant visual loss (VA 20/80), cognitively intact with repeated, formed pleasant visual hallucinations
Charles bonnet syndrome visual hallucinations
simultagnosia
cognitive visual loss
if unilateral optic nerve lesion >equal pupils; RAPD
optic neuritis or giant cell arteritis
slowly progressive visual loss or CN palsy
work up compressive lesions
abrupt visual loss of diplopia
vascular disease
how to check CN V?
check corneal sensitivity with cotton wisp & face sensation
how to check CN VII
weakness in smile or ability to close eyes while you attempt to open it
