Optic Nerve/Neuro Flashcards
1
Q
Hyaloid Remnants/Persistent Hyaloid Artery
A
- incomplete regression (usually done by 8 months)
- asymptomatic
- rare for vitreous hemorrhage
2
Q
Prepapillary Vascular Loops
A
- unilateral, arterial and embryonic in nature
Management:
- routine
3
Q
Congenital Macrovessels
A
- enlarged single vessel crossing the horizontal raphe
Management:
- recognition of leakages
4
Q
Cilioretinal Vessels
A
- usually derived from short posterior ciliary artery system or choroidal vascular system
- positioned temporally, hooking out of papillomacular bundle
- may remain patent even during CRAO because it is a different system
Management:
- routine eye examination
- occlusion may indicate giant cell arteritis
5
Q
Myelinated Nerve Fibres
A
- represent the continuation of normal myelinated tissue anterior to the lamina cribosa
- superficial retinal opacification with feathered edges
- may create visual field loss at threshold
Management:
- rule out CWS`
6
Q
Choroidal Crescent
A
- darker crescent due to absence of retina
7
Q
Scleral Crescent
A
- lighter/white crescent due to absence of choroid and retina
- may be associated with ROP, ectasia and sickle cell proliferation
8
Q
Circumpapillary Staphyloma
A
- usually unilateral
- area around the disc is depigmented and may have pigmentary migration
- variably reduced vision or constricted fields
- differential diagnosis helped with utlra sound
Management:
- patient education and provision of safety eyewear
- routine eye examinations indicated
9
Q
Coloboma
- absence of tissue due to failure of fetal tissue to close
A
- affected nerve head always larger than its fellow, unusual looking
- usually inferior portion affected with significant excavation and surround of pigment hyperplasia
- reduced VA and VF defects variable but present
- associated with systemic abnormalities
- associated with non-rhegmatogenous retinal detachment and rhegmatogenous in retinochoridal variety
Management:
- rule out systemic abnormalities
- protective eyewear
- ed RD
10
Q
Morning Glory Disc
A
- unilateral, affected head larger than its fellow
- unusual vascular pattern radiating from disc
- unilateral? severe vision loss. bilateral? mild-moderate.
- strong association with non-rhegmatogenous detachment
Management:
- rule out systemic involvement with neurological consultation
- ed on RD
11
Q
Congenital pits of the ONH
A
- affected disc larger than its fellow
- pit usually inferior temporal with VF loss
- often associated with RPE disruption adjacent to ONH/reactive hyperplasia secondary to tugging of retinal tissue
- strong association with non-rhegmatogenous retinal detachment
- possible inheritance pattern
Management:
- Amsler grid to monitor vision
- Ed RD
12
Q
Congenital optic nerve head hypoplasia
A
- ONH 1/2 to 1/3 smaller than fellow eye
- stronger association with astigmatism
- reduced vision due to maldevelopment of NFL
- variable VF defects (nasal or altitudinal)
- associated with multiple systemic abnormalities especially if bilateral
- present in 50% of fetal alcohol syndrome
Management:
- rule out so it’s not treated as amblyopia
- rule out systemic abnormalities
- communication with other health care providers
13
Q
Megalopapilla
A
- unilateral enlarged disc of congenital nature secondary to abnormal development of primitive epithelial papilla
- may stimulate asymmetric C/D of glaucomatous optic atrophy
Management:
- benign condition so just annual eye examinations
14
Q
Buried Drusen
A
- inherited in an autosomal irregular pattern
- calcium-like deposits anterior to lamina cribosa
- deposits can shear blood vessels, cause hemes,
15
Q
Optic Neuritis
A
- young female (20-45)
- MS associated
- unilateral, sudden, painful vision loss (VA 20/20 to NLP)
- (+) RAPD
- decreased vision sensitivity, VF defects
- VA may return to normal/near normal over 2-3 months although will have permanent reduced CSF and optic nerve pallor.
