Ophthalmology 3 Flashcards
What are the causes of a dilated pupil?
- Holmes-Adie (myotonic) pupil
- Third nerve palsy, and
- Drugs and poisons (atropine, CO, ethylene glycol).
What are the causes of a constricted pupil?
- Horner’s syndrome
- Old age
- Pontine haemorrhage
- Argyll Robertson pupil, and
- Drugs and poisons (opiates, organophosphates).
What’s the diagnosis?
There is bilateral severe irritation and photophobia in a sheet metal worker, with diffuse corneal epithelial staining after the instillation of drops of fluorescein dye.
UV keratitis or “arc eye”
What can cause idiopathic intracranial hypertension (IIH)? How do you treat it?
- pregnancy
- combined oral contraceptive therapy
- obesity, and
- may be associated with oral tetracycline therapy.
- The condition may be treated by weight reduction and/or stopping the offending drug.
- Generally conservative approaches suffice although in more serious cases where sight may be threatened, cerebrospinal fluid removal or shunting may be required.
What’s the diagnosis?
A 60-year-old man was complaining of double vision and difficulty in walking over the last three days. On examination he had weakness (power 4/5), absent deep tendon reflexes and bilateral ophthalmoplegia.
Guillian Barre syndrome
Sudden onset weakness and absent tendon reflexes are classical of this syndrome. Ophthalmoplegia occurs in the Miller-Fisher variant of this disease (also includes ataxia).
Which visual field defect would you expect with internal capsular infarction?
Homonymous hemianopia
What visual field defect would you expect with a temporal lobe tumour?
Superior homonymous quadrantanopia
Retinal detachment is more common in which type of patients?
patients with high myopia
