Neuropthalmology

Question 1

What does PITS stand for?

Answer 1

Parietal lobe- Inferior visual field

Temporal lobe- Superior visual field

Question 2

What causes bilateral hemianopia & what is it?

Answer 2

Pituitary tumours press on optic chiasm

Missing inner or outer half of visual field in both eyes.

Question 3

What causes right homonymous hemianopia?

Answer 3

Lesion on the LEFT optic tract

Right visual field of both eyes blind

Question 4

What causes right superior quadrantopia?

Answer 4

Lesions in Meyer’s loop in Temporal lobe

Question 5

What causes Right Inferior quadrantopia?

Answer 5

Parietal lobe lesions

Question 6

What causes right homonymous hemianopia with macular sparing?

Answer 6

Lesion in striate/visual cortex

Question 7

What causes vision loss in one eye & what symptoms associated?

Answer 7

Optic nerve lesion or neuritis
Eye pain on movement
Decreased acuity
Decreased colour
Afferent pupilliary defect

Question 8

What causes a blind spot?

Answer 8

Lesion at nerve head

Question 9

Causes of Papilloedema

Answer 9

Increased ICP:
Hypertension
Addisons
Hypoparathryroidism
Hypercapnia
Right sided heart failure
Pulmonary Hypertension
Renal Failure

Question 10

What is papilloedema?

Answer 10

Raised ICP causes intra neuronal ischaemic damage affecting peripheral vision the most
Also swelling of optic disc (bilateral for several seconds)
If chronic causes optic atrophy and visual failure.

Question 11

3rd Nerve Palsy looks like..?

Answer 11

Down and Out Eye

Question 12

Trochlear nerve palsy looks like..?

Answer 12

Head tilt

Question 13

Abducens Nerve Palsy looks like…?

Answer 13

Eye pulled in

Question 14

What diseases cause nystagmus?

Answer 14

MS, Wernicke’s, Stroke

Question 15

Causes of transient visual loss

Answer 15

Amaurosis fugax
Migraine aura
Papilloedema

Question 16

What is amaurosis fugax?

Answer 16

Transient complete, sudden unilateral visual loss due to carotid artery atherosclerotic embolism

Question 17

Causes of acute persistant visual impairment?

Answer 17

Optic Neuritis

Retinal/ Optic nerve ischaemia, arterial thromboembolism of middle or posterior cerebral artery

Question 18

Causes of eye pain

Answer 18

Corneal abrasion or infection
Conjunctivitis
Glaucoma
Optic Neuritis
Sinusitis

Question 19

Investigations in vision loss

Answer 19

VEP (visual evoked potential)
MRI
ESR
fundoscopy
Tonometry (for occular pressure-glaucoma)
USS (vitreous haemorrhage)

Question 20

What are symptoms of retinal detachment?

Answer 20

Detaches from blood vessels:
Flashes and floats
Vision loss

Question 21

What is a vitreous haemorrhage & what are the causes?

Answer 21

Leakage of blood into vitreous humor, causes vision loss

Caused by DM or trauma due to weakened vessels

Question 22

What is the risk of MS in people with optic neuritis?

Answer 22

40% get it in 15 years

Question 23

What is optic neuritis?

Answer 23

Inflammation of optic nerve

Question 24

What are the causes of Optic Neuritis?

Answer 24

MS
GCA
Syphilis
Lyme
B12 deficiency

Question 25

Symptoms of optic neuritis

Answer 25

1. Decreased acuity over hours/days
2. Pain on eye movement
3. Dyschromatopia (decreased colour vision exacerbated by heat- Uhthoff’s)
   Also
   Afferent pupil defect
   Photopsias (flashes of light)

Question 26

Treatment of optic neuritis

Answer 26

Steroids and recovery in 6 weeks.