W6_10 Approach to Diplopia Flashcards

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1
Q

what’s cerebral polyopia?

A

an uncommon disorder that has a homonymous visual field defect due to some cerebral lesion

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2
Q

how can you decrease monocular diplopia acutely (non-medical)?

A

using a pinhole

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3
Q

if diplopia is worse in left gaze, which cranial nerve is likely affected?

A

left CN VI

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4
Q

a head tilt could indicate a palsy of which cranial nerve?

A

CN IV of opposite side of tilt of tilt

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5
Q

hypotropia, contralateral lid retraction, dermatochalasis, brow ptosis are all what?

A

pseudoptosis

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6
Q

three types of true ptosis?

A

neurogenic (e.g. CN III, horners);
myogenic;
mechanical

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7
Q

the alternate cover test is used for testing what?

A

binocular diplopia

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8
Q

what can cause comitant bip. diplopia?

A

childhood strabismus or chronic innervational disease

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9
Q

what can cause incomitant bip diplopia?

A
innervational (eg. CN III palsy);
mechanical disease (eg. Graves disease)
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10
Q

what should you r/o when you see CN VI palsy? why?

A

r/o increased ICP, so check for papilledema; recall CN VI has to climb the clivus and has to bend, so it’s susceptible to pressure

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11
Q

if patient tilts head to the left, what CN palsy does that indicate?

A

right CN IV palsy (contralateral to the tilting)

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12
Q

what’s the 3 step test for CN IV palsy?

A

1: hypertropia of affected eye
2: lateral gaze to opposite side increases diplopia
3: head tilt to same side of palsy increases diplopia

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13
Q

you see signs of CN III lesions, and see that pupil is affected. what are you worried about?

A

aneurysm (along the circle of willis arteries, esp PComm)

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14
Q

you see signs of CN III lesions, and see that pupil is not affected. what is likely cause?

A

microvascular ischemic

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15
Q

what is amblyopia?

A

impaired or dim vision of a greater degree than it looks

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16
Q

what is internuclear ophthalmoplegia?

A

lesion of MLF that causes ipsilateral adduction deficit

17
Q

what is orbital apex syndrome?

A

when multiple CNs of the eye are involved: e.g. II with III, IV, or VI

18
Q

pituitary apoplexy can cause which symptoms?

A

bitemporal hemianopsia,

CN III palsy

19
Q

difference between recession and resection in strabismus surgery?

A

recession is to decrease tension;

resection is to increase tension

20
Q

what are the emergency diplopia situations?

A
aneurysm (CN III)
high ICP (CN VI)
pituitary growth (CN II, III)
giant cell arteritis
myasthenia