Ophthalmology relating to Neurology Flashcards
What is anterior ischaemic optic neuropathy?
Occlusion to optic nerve circulation
-Occlusion of short posterior ciliary artery
What can cause anterior ischaemic optic neuropathy?
GCA
HT
Diabetes
What should be given in GCA?
Steroids
What is papilloedema?
Bilateral optic disc swelling due to raised ICP
What causes Horner’s syndrome?
Lesion in sympathetic pathway
Characteristics of Horner’s?
Ptosis (droopy eyelid)
Miosis (Constriction of pupil because symps have aren’t working
Anhidrosis
Most discussed cause of Horner’s?
Pancoast tumour
Another term for lateral medullary syndrome?
Wallenbergs
What is Wallenbergs?
Syndrome caused by ischaemia to lateral part of medulla due to blockage of posterior inferior cerebellar artery or vertebral artery
Clinical signs of Wallenbergs?
-Nausea
-Vomiting
-Vertigo
-Nystagmus
-Loss of pain and temp in limbs and trunk
-Loss of pain and temp in face and corneal reflex
-Horner’s syndrome
Dysphagia/hoarseness
What is Adie’s pupil?
Loss of postganglionic PS innervation to risi sphincter and ciliary muscle which causes pupil to dilate
Adie’s pupil usually?
Occurs in females and is unilateral
Argyll Robertson pupil?
Bilateral irregular and small pupils
Argyll Robertson pupil ______ in response to pilocarpine
DONT CONSTRICT
Main causes of Argyll Robertson Pupil?
Diabetes
Neurosyphilis
Chiasmic lesions cause?
Bitemporal hemianopia
Optic tract lesion cause?
Contralateral homonymous hemianopia
Optic radiations cause?
Contralateral hemianopias potentially with macular sparing
3rd nerve palsy causes?
Ptosis and down and out eye
Dilated pupil
Accommodation abnormality
Why does 3rd nerve palsy cause down out eye
All that is left is abduction for lateral rectus and depression from superior oblique
4th nerve palsy cause?
Vertical diplopia
Person tends to have an eye elevated and adducted
Most ptnts tend to tilt their head to counteract the double vision
Why 4th nerve palsy elevated and adducted?
SO causes eye depression and abduction so eye will move opposite
6th nerve palsy causes?
Horizontal double vision worsened by looking at distant targets
Abnormal eye adduction
Most common causes of 6th nerve palsies are?
Diabetes
HT
Raised ICP
What is benign essential blepharospasm?
Bilateral idiopathic condition characterized by involuntary contraction of orbicularis oculi muscle
When does benign essential blepharospasm present?
6th decade of life
Females
Management of BEB?
Artificial tears for dry eyes
Botox eye injections
