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2 Ophthalmology > The Eye in Systemic Disease > Flashcards

The Eye in Systemic Disease Flashcards

1
Q

what are the key features of neuro-opthalmic disease

A
  1. eye movement defects (double vision)

2. visual defects (visual acuity, field loss)

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2
Q

causes of neurological-opthalmic disease

A

vascular disease (microvascular disease is the principle cause of vision loss)
Tumours (SOL)
Trauma
Demyelination
Inflammation/infection (sarcoidosis, meningitis, encephalitis)
Congenital abnormalities

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3
Q

what does damage to CNIV cause (abducens nerve)

A

lateral rectus palsy

  • presents with one eye unable to abduct
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4
Q

causes of CNVI palsy

A

microvascular disease
Raised ICP (papillodema)
Tumours
Congenital

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5
Q

what sort of double vision is seen with CNVI palsy

A

horizontal double vision

images present next to each other

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6
Q

what muscle does CNIV innervate

A

Trochlear muscle - innervating the superior oblique

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7
Q

what does the superior oblique do

A

moves the eye down and in

intorsion

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8
Q

what are the symptoms of CNIV palsy

A

eye doesn’t move down and in - when adducted it moves in but not down

also sits higher than normal - can see more white under eye

patients can compensate by tilting their head

all patients have double vision

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9
Q

causes of CNIV palsy

A

congenital decompensated

microvascular

tumour

head trauma - bilateral (comes out of brain stem so susceptible to trauma)

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10
Q

what type of double vision is see in CNIV palsy

A

vertical double vision

images one on top of other

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11
Q

what direction would a patient tilt their head to compensate for a CNIV palsy in the right eye

A

left

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12
Q

what muscles are innervated by CNIII

A 
Medial rectus 
inferior rectus 
superior rectus 
inferior oblique 
spinchter papillae 
Levator palpebral superiors
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13
Q

what does a CNIII palsy look like

A

eyes are in a ‘down and out’ position as the lateral rectus and superior oblique are still working

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14
Q

what causes a CNIII palsy

A 
microvascular 
tumour 
aneurysm 
MS (demyelinating disease) 
Congenital
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15
Q

what is inter-nuclear opthalmoplegia

A

problems with grey matter pathways in the Brian stem rather than the nerves themselves

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16
Q

what allows the eyes to work together (look in the same direction at same time and speed

A

inter-nuclear pathways in the brainstem

17
Q

what happens when there’s damages to the internuclear pathways in the brain stem

A

there is a lack of coordination within the eyes

eye jerks in the direction it thinks its meant to go to follow the good one as signals are still being fired down the nerves

18
Q

causes of inter-nuclear opthalmoplegia

A

MS

Vascular - stroke

19
Q

key stages in the optic pathways

A 
optic nerve 
optic chasm 
optic tracts 
optic radiations 
cortex
20
Q

damage to what part of the optic pathway leads to macular sparing

A

cortex

21
Q

what are some causes of optic pathway problems

A

vascular disease
SOL
Demyelination
Trauma

22
Q

where is the pathology if bitemporal hemiopia is seen

A

optic chiasm

23
Q

where is the pathology if one whole eye looses its visual fields

A

in the optic nerve or eye

24
Q

where must the pathology be if the visual field is missing quadrants

A

optic radiations

25
Q

what is ischaemic optic neuropathy

A

ischaemia of the optic nerve

leads to loss of site due to the death of the optic nerve

optic disc looks v pale

Marked ARPD

26
Q

what is optic neuritis

A

progressive visual loss due to MS

Pain behind eye - especially on movement, colour desaturation, central scotoma (missing macular vision)

gradual recovery over weeks-months

27
Q

what tumours can affect the optic nerve (rare)

A

meningioma
glioma
haemangioma

28
Q

where are horizontal visual defect pathologies found

A

in the eye or head of the optic nerve

29
Q

what causes bi-temporal haemanopia

A

swelling of the pituitary gland pressing on the optic chiasm

  • pituitary tumour
  • craniopharyngioma
  • meningioma
30
Q

what pathology can affect the optic tracts and radiations

A

tumours
demyelination
vascular anomalies

31
Q

when is all the visual field loss seen on one side

A

after chiasm (homonymous defects)

no sparing of the macula

32
Q

when is the visual field loss seen in one quadrant

A

when it is in the optic radiations

33
Q

what visual field loss is seen in occipital contex pathology

A

homonymous defect
macular sparing
congruous (same on both sides)

2 Ophthalmology (16 decks)

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