Optic disc swelling and atrophy

Question 1

Spontaneous venous pulsations

Answer 1

Presence implies normal ICP

But absence does not imply abnormality - 20% of population

Question 2

Papilloedema

Answer 2

Optic disc swelling due to raised ICP
Visual acuity normal
Pt presents with headache and transient vision loss

Question 3

Papilloedema types

Answer 3

Early
Established
Chronic
Atrophic

Question 4

Causes of OD swelling + visual loss

Answer 4

Congenital
Trauma
Inflammatory (sarcoidosis)
Infective (TB, post uveitis)
Mechanical (ocular hypotony, retrobulbar mass, chronic papilloedema, thyroid EOM swelling)
Neoplastic (lymphoma, leukemia, glioma, metastatic)
Metabolic (diabetes)
Degenerative
Vascular (RV occlusion, ant ischaemic optic neuropathy, arteritis, proliferative retinopathies)

Question 5

Benign intracranial hypertension

Answer 5

No mass
Obese young female
Venous sinus thrombosis
Drugs

Question 6

Optic atrophy

Answer 6

End stage disease
Causes:
Ascending 
Descending
Vascular
Secondary to ICP

Question 7

Optic atrophy causes

Answer 7

Congenital
Trauma
Inflammatory non-infective (MS, perineuritis, vasculitis, sarcoidosis)
Inflammatory infective (TB, syphilis, Lyme, aspergillus, cryptococcus, measles, mumps, HZV)
Neoplastic (compressive, metastatic)
Toxic (alcohol, arsenic, tobacco, ethambutol)
Demyelinating (syphilis, MS, postviral)
Metabolic (B12)
Infiltrative (dyscrasia)

Question 8

Foster Kennedy syndrome

Answer 8

Optic n compression due to meningioma

Ipsilateral atrophy and contralateral OD swelling

Question 9

PseudoFKS

Answer 9

Ant ischaemic optic neuropathy

Papillitis

Question 10

Papilloedema vs papillitis

Answer 10

Papilloedema:
VA unaffected, normal pupil, swollen disc
Papillitis:
VA reduced, pupil affected, swollen disc