Opth- neuro-opthalmic disease

Question 1

what is diplopia

Answer 1

double vision

Question 2

what is esotropia

Answer 2

squint or ‘cross eyed’ where one or both eyes turn inwards towards the nose

Question 3

what is exotropia

Answer 3

one or both eyes turn outwards

Question 4

what is hypertropia

Answer 4

one of eyes looks upwards

Question 5

what is hypotropia

Answer 5

one of eye looks downwards

Question 6

horizontal double vision is associated with problems with which muscles of the eye

Answer 6

lateral rectus
medial rectus

Question 7

vertical double vision is associated with problems with which muscles of the eye

Answer 7

superior oblique
inferior oblique
super rectus
inferior rectus

Question 8

which muscle of the eye would be affected by a cranial nerve IV palsy (trochlear nerve)

Answer 8

superior oblique muscle

Question 9

which muscles of the eye would be affected by a cranial nerve III palsy (oculomotor nerve)

Answer 9

superior rectus
medial rectus
inferior rectus
inferior oblique

Question 10

which muscle of the eye would be affected by a cranial nerve VI palsy (adjacent)

Answer 10

lateral rectus muscle

Question 11

CN III supplies all extra ocular muscles except which two-

Answer 11

lateral rectus
superior oblique

Question 12

causes of CN III (oculomotor) palsy

Answer 12

microvascular
tumour
aneurysm !!!
MS
congenital

Question 13

‘down and out’ appearance of eye suggests which CN palsy

Answer 13

CN III (oculomotor)

Question 14

what is ptosis

Answer 14

upper eyelid dropps over eye

Question 15

what is miosis

Answer 15

small or constricted pupils

Question 16

what does a painful CN III palsy indicate

Answer 16

aneurysm

Question 17

causes of CN IV palsy

Answer 17

congenital decompensated !!!
microvascular
tumour
blunt head trauma can result in bilateral CN IV palsy!!!

Question 18

which nerve palsy results in affected eye turned upwards in primary position

Answer 18

CN IV

Question 19

which compensatory head position is seen in patients with bilateral CN IV palsy

Answer 19

chin down head posture

Question 20

which compensatory head position is seen in patients with unilateral CN IV palsy

Answer 20

contralateral head tilt

Question 21

causes of CN VI nerve palsy

Answer 21

microvascular
raised intracranial pressure!!!
tumour
congenital

Question 22

CN VI palsy results in which eye fault

Answer 22

squint- eye turned inward

Question 23

what is optic neuritis

Answer 23

inflammatory optic neuropathy usually affecting one eye at a time and typically presents with acute or subacute vision loss

Question 24

typical optic neuritis is strongly associated with what?

Answer 24

MS

Question 25

atypical causes of optic neuritis

Answer 25

antibody-mediated non-infectious- neurosarcoidosis and systemic autoimmune conditions such as SLE infectious- syphilis, Lyme disease, cat-scratch disease, herpes zoster, sinus disease post-infectious

Question 26

symptoms of optic neuritis

Answer 26

acute/subacute unilateral vision loss retrobulbar and peri-ocular pain photopsias (flashes) exacerbated by eye movements reduced colour vision

Question 27

most likely cause of CN III palsy

Answer 27

posterior communicating artery aneurysm

Question 28

most important investigation for optic neuritis

Answer 28

MRI

Question 29

what is internuclear ophthalmoplegia

Answer 29

disorder of conjugate lateral gaze in which the affected eye shows impairment of adduction

Question 30

in younger patients, what is a common cause of internuclear opthalmoplegia

Answer 30

MS

Question 31

in older patients, what is a common cause of internuclear ophthalmoplegia

Answer 31

vascular aetiology- stroke

Question 32

what vision loss occurs from a lesion of the left optic nerve

Answer 32

complete blindness of left eye

Question 33

what vision loss occurs from a lesion of the optic chiasm

Answer 33

bitemporal hemianopia- loss of outer (temporal) visual fields in both eyes

Question 34

what vision loss occurs from a lesion of the left optic tract

Answer 34

right homonymous hemianopia- loss of right visual fields of both eyes

Question 35

lesions before the optic chiasm affect one/two eyes?

Answer 35

one eye

Question 36

what vision loss defects occurs from lesions after the optic chiasm

Answer 36

homonymous defects (same side of both eyes)

Question 37

causes of optic nerve defects

Answer 37

ischaemic optic neuropathy optic neuritis- commonly MS tumours (rare)

Question 38

optic nerve field defect-

Answer 38

unilateral vision loss

Question 39

complication of optic nerve defects

Answer 39

optic atrophy

Question 40

most common cause of optic chiasm defects

Answer 40

pituitary tumour

Question 41

causes of ischaemic optic neuropathy

Answer 41

giant cell arteritis non-arteritis ION

Question 42

clinical features of ischaemic optic neuropathy

Answer 42

sudden usually painless vision loss

Question 43

signs of ischaemic optic neuropathy associated with GCA

Answer 43

headache scalp tenderness enlarged temporal arteries

Question 44

how does ischaemic optic neuropathy appear on fundoscopy

Answer 44

pale, swollen disc

Question 45

what is papilloedema

Answer 45

swelling of the optic nerve due to increased intracranial pressure

Question 46

intracranial pressure is the sum of what-

Answer 46

brain, blood, CFS

Question 47

what is optic atrophy

Answer 47

optic nerve shrinkage caused by degeneration of retinal ganglion cell axons

Question 48

acquired causes of optic atrophy

Answer 48

MS papilloedema (longstanding) raised intracranial pressure (glaucoma, tumour) retinal damage ischaemia toxins nutritional deficiencies

Question 49

clinical signs of optic atrophy

Answer 49

reduced visual acuity reduced contrast sensitivity RAPD