Pupils Flashcards
What is internuclear ophthalmoplegia and what causes it?
Disorder of the MLF
Caused by MS in younger people and stroke in older people
What is the symptom of internuclear ophthalmoplegia?
Horizontal diplopia
What is seen when observing the eye movements of someone with internuclear ophthalmoplegia?
Affected eye: cannot adduct
Contralateral eye: nystagmus on abduction
What is the name for unequal pupils?
anisocoria
What is the name for dilated and constricted pupils?
Dilated: mydriatic
Constricted: miotic
State some causes of unilateral dilated pupils
- CN3 palsy
- Holmes-Adie
- Dilating agents e.g. atropine
State some causes of unilateral constricted pupils
- Horner’s
- Uveitis
- Argyll Robertson
What is an RAPD?
Inability to react to light due to pathology of optic nerve or retina
What conditions can cause an RAPD?
- Optic neuritis: MS
- Optic nerve atrophy
- Vasculidities
- Acute closed angle glaucoma
- Thyroid eye disease compressing the nerve
- Retinal detachment
What nerves form the afferent and efferent pathway of the pupillary light reflex?
afferent: optic nerve and retina
efferent: parasympathetics on CN3
What can cause bilaterally fixed dilated pupils?
Diffuse intracranial pathology causing brainstem herniation and brain death
What can cause bilaterally fixed small pupils?
Pontine haemorrhage
What nerves form the afferent and efferent pathway of the accommodation reflex? What is the result of these being activated?
afferent: optic
efferent: oculomotor
- pupil constriction
- eye conversion (medial rectus)
- lens convex
What is light near dissociation? What can cause it?
The pupil will react to accommodation but not to light
What is Holme’s Adie? What is found on neurological examination?
A benign condition affecting females in their 40’s. It is due to damaged post-ganglionic parasympathetics or damage to the ciliary ganglion
- reduced knee reflexes
