Ocular Motility/ Visual Field Defects Flashcards
ocular motility defects are due to …
CN 3,4,6 palsies
how does 6th nerve palsy present
no lateral rectus so…
medial deviation of eye
A: microvascular, raised ICP*, tumour, congenital, papilloedema
4th nerve palsy presentation
no superior oblique so…
up and middle
A: microvascular, trauma
what causes bilateral 4th nerve palsy
blunt head trauma
3rd nerve palsy presentation
down and out gaze with dilated pupil, ptosis
A: microvascular (no pupil change), tumour, aneurysm*, cavernous sinus thrombosis, raised ICP, MS
what is the main eye condition associated with MS
inter-nuclear ophthalmoplegia: eyes cannot work together- double vision, divergent squint, nystagmus
visual field defects occur as 4 areas are affected- what are these
optic nerve, optic chiasma, optic tracts, occipital cortex
optic nerve pathology is…
optic neuropathy, optic neuritis, tumours
t/f: optic nerve pathology means defect is usually not precise
F: usually precise
what is optic neuritis
progressive unilateral visual loss, pain behind eye- especially on movement, central scotoma*, colour deficits
proptosis is a tell tale sing of….
haemangioma
optic chiasma pathology is and classic presentation
pituitary tumour, craniopharyngioma, meningioma
bi-temporal hemianopia
optic tract pathology and s/s
tumours, demyelination, vascular anomalies e.g. stroke
s/s: homonymous defects, precise, macula not spared, quadrantanopia, incongruous
s/s of occipital visual field defects
macula spared so image is congruous, homonymous defect
what is Horner’s syndrome
characteristic facial appearance caused by damage to sympathetic facial supply
hornet’s can have different locations, this is dependent on if the event/lesion is at…
central, pre-ganglionic, post-ganglionic
aetiology of central
4Sentral: stroke, multiple sclerosis, swelling, syringomyelia (cyst in SC)
aetiology for pre-ganglionic
4Torso: tumour (Pancoasts), trauma, thyroidectomy, top rib (rib above 1st rib)
aetiology for post-ganglionic
4Cervical: carotid aneurysm, carotid artery dissection, cavernous sinus thrombosis, cluster headache
what is the main sign of congenital Horner’s
heterochromia
triad of Horner’s
ptosis, miosis anhidrosis
ix for Horner’s
adrenalin drops (+ve test= pupil dilation), cocaine drops (+ve test= no reaction)
what is Holmes-Adie Pupil
unnatural dilated pupil that is sluggish to react to light
cause of Holmes-Adie
damage to post-ganglionic parasympathetic fibres
s/s of holmes-adie
slow dilation of pupil following contraction reaction to light
what is Holmes-Adie syndrome
pupil + absent ankle and knee reflexes
what is Argyll-Robinson Pupil
pupil that doesn’t react to light- neurosyphilis symptom. often irregular shaped
