Vision Problems 1

Question 1

Gradual progressive loss of vision should always be watched closely as it may indicate…

Answer 1

brain tumor

Question 2

Sudden loss of vision in one eye in older adults generally suggests what type of problem

Answer 2

vascular

Question 3

Sudden loss of vision in kids

Answer 3

optic neuritis

Question 4

Transient vision loss in one eye

Answer 4

TIA

Question 5

Transient loss of vision in both eyes

Answer 5

Basilar Artery Insufficiency

Question 6

Short lived loss of vision in one eye (just a few seconds)

Answer 6

Papilledema

Question 7

Amblyopia

Answer 7

lazy eye

Question 8

Numerator in 20/20

Answer 8

Testing distance

Question 9

near reflex?

Answer 9

miosis (constriction), convergence, accomodation

Question 10

The presence of a non-reactive pupil in one eye that does not respond to consensual stimulation indicates the presence of a defect in the efferent arc of the pupillary reflex.

Answer 10

And if that non-reactive pupil reacts to consensual stimulation then the abnormal pupil is non-reactive due to defect in the afferent

Question 11

A scotoma in only one eye is usually associated with

Answer 11

retinal or optic nerve lesion in that eye

Question 12

One of the common causes of optic nerve disease in young to middle aged pts is optic neuritis. What are the complaints in optic neuritis

Answer 12

Loss of central vision
Positive RAPD (abnormal)
Fundus exam will show either a normal optic disc or a swollen optic disc
Patient will complain of loss of color brightness.

Question 13

centrocecal scotoma?

Answer 13

when the scotoma connects with a physiologic blind spot

Question 14

Natural history of optic neuritis

Answer 14

Vision gets poor quickly and then returns to normal slowly. Usually vision returns but if the initial epsiode is severe or rerepeat episodes occur, you may get permanent loss.

Question 15

Treatment for significant visual loss due to optic neuritis

Answer 15

IV steroids

Question 16

Retrobulbar ON?

Answer 16

Optic disc looks normal

Question 17

Papillitis

Answer 17

Optic disc swollen

Question 18

Telling the difference between Papilledema and Papillitis?

Answer 18

• both discs usually involved in papilledema and only rarely with papillitis.
• Patients with papilledema will not usually have an RAPD (Relative Afferent Pupillary Defect) based solely on the disc swelling. Patients with Papillitis will.

_ visual acuity usually normal in pts iwth paiplledema

Question 19

Optic neuritis generally seen in what dz

Answer 19

MS

Question 20

Lesion at optic chiasm

Answer 20

Reduced VA in one or both eyes
Bitemporal hemianopsia- blindness in the outer half of the visual field of both eyes
Optic atrophy- asymmetric

Question 21

Most common cause of a lesion at the optic chiasm?

Answer 21

Pituitary Adenoma

Question 22

The more aneterior the lesion is located in the post chiasmal pathway….

Answer 22

The more incongruus the visual field is

Question 23

The more posterior the lesion is located in the post chiasmal pathway….

Answer 23

The more congrupous the visual field defect usually is

Question 24

Papilledema

Answer 24

SERIOUS
Two most common causes are
1) Tumor
2) Pseudotumor cerebri

Question 25

Ischemic optic neuropathy

Answer 25

• acute loss of vision in an older pt
• usually only one eye
• afferent pupl defect present
• disc is sollen and pale
• Visual defect generally altitudinal… that is it is superior or inferior and respects the horizontal midline where optic neuritis respects teh vertical midline

Question 26

Must rule out what with optic neuropathy

Answer 26

temporal arteritis

Question 27

central retinal artery occlusion appears like what on fundic exam

Answer 27

Pale.
Optic disc will be pale and arteries narrowed
TEMPORAL ARTERIRITS MUST BE RULED OUT

Question 28

Central retinal vein occlusion

Answer 28

causes hemorrhagic infarct of the retina

disc is swollen and hyperemic with prominent venous distension.