Pupillary defects Flashcards
Whate are the categories of pupil abnormalities
Abnormal pupil size
Abnormal pupil reaction
Condition with abnormal pupil size
Adies tonic pupil
Horner’s syndrome
What is blocked in adie’s tonic pupil
Parasympathetic block
What is blocked in horner’s syndrome
Sympathetic block
Condition with abnormal pupil reaction
Marcus gun pupil
Parinauds syndrome
Argyll Robertson pupil
Points to remember in pupillary defect/ anomalies.
> Any lesion located from the retina to the pretectal nucleus is considered a relative afferent pupillary defect.
> Any lesion located from pre-ganglionic to post ganlionic fiber is considered a telative afferent pupillary defect.
Defect with lesion is at retina—> pretectal nucleus
Relative afferent pupillar defect
Defect when lesion is at preganglionic —> postganglionic
Relative efferent pupillary defect
Location of lesion if relative afferent pupillary defect
Retina
Location pf lesion if relative efferent pupillary defect
Pre-ganglionic to post-anlionic fiber
What are the diseases that can cause marcus gun?
CRAO
CRVO
BRVO
Optic Atrophy
Marked retinal Detachment
Asymmetric POAG
T/F | Does a loss of vision due to corneal, lenticular, vitreous refractive or emotional can produce marcus gun response?
F
What is the method of diagnosis in marcus gun?
Swinging flashlight test
In an affected eye with marcus gun the ____?response is greater than ____?
Consensual
Direct
What will happen when the light is directed into the normal right eye? (Direct and consensual) bothe eyes are _____?
Smaller
In patient with marcus gun, when the light is directed into affected eye, both eyes are____
Larger
It is a parasympathetic condition that is central and bilateral in nature.
Argyll Robertson Pupil
What are the 3 characteistic of Argyll Robertson Pupil?
Dilates poorly in the darkness
Does not respont to light
Normal near response
What caused Alrgyll robertson pupil?
By interruption in the pattern of CN2 and CN3
In Argyll Robertson Pupil, any interruption of both afferent pathway and central inhibitory fibers ______ to tge aqueduct
Ventral
What are the common causes of Argyll Robertson?
Neurosyphilis
Long term diabetes
Alcoholism
It is a bacterial Infection of the brain or spinal cord.
Neurosyphilis
It is usually occur in people who have untreated syphilis for many years.
Neurosyphilis
What are the 4 types of neurosyphilis?
Primary
Secondary
Latent
Tertiary
What is Syphilis?
Sexually Transmitted Infection (STI)
How does syphilis spread?
Spreads through Syphilis Sores
T/F | is syphilis is treatable and relatively simple to prevent?
T
What will happen if syphilis is untreated?
It will develop to Neurosyphilis (life threatining disease)
Slowly progressive degeneration of the spinal cord that occur in the tertiary (third) phase of syphilis.
Tabes dorsalis
What is the form of neurosyphilis that is Rare?
Tabes Dorsalis
Other name of Tabes Dorsalis?
Syphilitic Myelopathy
How many years does a tabes doralis affect the spinal cord after the initial syphilis infection?
20 years or more
Tabes Dorsalis was characterized by ____, ____, _____?
Gait unsteadiness, lighting pains and urinary incontinence.
It is a chronic disorder of carbohydrate metabolism due to relative or absolute insulin deficiency.
Long term diabetes mellitus
Long term diabetes mellitus is a disease of?
Pancreas (organ that produces insulin)
_______? Works together with glucose in the bloodstream to help it enter the body cells to be burned for energy.
Insulin
What happened if the insulin isn’t fuctioning properly?
The glucose cannot enter the cells
What is a Central Defect?
Parinaud’s sydrome
A lesion affecting the _____? and ______? with interruption to the __________?
Posterior commissure
Pretectal Nuclei
More dorsal afferent light pathway
What happened if you have parinaud’s syndrome?
Large Pupil
Constrictly Briskly to an acommodative target
Constrict poorly to light (dilate)
Parinaud’s syndrome other names:
Dorsal midbrain
Pretectal
Sylvian aqueduct or
Koerbesalus-Elshing Syndrome
Associated symptoms in Parinaud’s syndrome!
Vertical Gaze Defecit
Collier’s sign
Convergence- retraction nystagmus
Other name of Marcus Gun?
Pupillary Escape
