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Ophthalmology > week 2 systemic disease the eye:neurological condition > Flashcards

week 2 systemic disease the eye:neurological condition Flashcards

1
Q

what are features of neuro-ophthalmic disease?

A

Eye movement defects – double vision

Visual defects - visual acuity, field loss

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2
Q

aetiology of neuro-ophthalmic disease

A 
Vascular disease
Tumours (primary and secondary) - SOLs
Trauma
Demyelination
Inflammation/infection
Congenital abnormalities
depends on age, other clinical findings and site of lesion
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3
Q

how to investigate neuro-ophthalmic disease?

A
  • Full medical and neurological examination
  • Blood tests
  • Imaging - MRI scanning

Secondary prevention of vascular disease is important to reduce further morbidity

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4
Q

6th CN palsy symptoms

A

right LR palsy, cannot look to right creating double vision

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5
Q

causes of 6th nerve palsy

A

microvascular (main cause)
Raised Intracranial pressure
Tumour
Congenital (mainly in kids)

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6
Q

why does raised ICP cause 6th nerve palsy? what is seen on examination?

A

as in ICP, the brainstem moves downwards, meaning CN6 is stretched over the PETROUS TIP

papilloedema

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7
Q

Superior oblique function?

A

Intorsion
Depression in adduction
Abduction (weak)

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8
Q

symptoms of CN4 palsy?

A

head tilted to the right

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9
Q

what is CN4 due to?

A 
congenital decompensated
(mainly)
Microvascular
Tumour
Bilateral – closed head trauma
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10
Q

what causes bilateral 4th nerve palsy

A

blunt head trauma

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11
Q

signs of bilateral CN4 palsy?

A

Torsion

Chin depressed

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12
Q

3rd nerve palsy sign

A

down and out eye

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13
Q

what does the 3rd CN effect?

A 
Medial rectus muscle
Inferior rectus 
Superior rectus
Inferior oblique
Sphincter pupillae
Levator palpebrae superioris
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14
Q

causes of 3rd nerve palsy?

A 
Microvascular
	Tumour
	Aneurysm
  MS
	Congenital
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15
Q

severly painful (back of head), ptosis, large undiluted pupil, 3rd nerve palsy?

A

aneurysm - refer to storke unit

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16
Q

which artery is most usually aneurysm in 3rd nerve palsy?

A

posterior communicating artery

17
Q

tumour and vascular are causes of all 3 nerve palsy’s affecting the eye. which causes are specific to each?

A

3rd - aneurysm
4th - congenital, trauma
6th - inc ICP

18
Q

causes of visual field defect?

A

Vascular disease - CVA
Space occupying lesion (SOL)
Demyelination (MS)
Trauma - including surgical

19
Q

describe the visual pathway defect sites?

A 
optic nerve
 chiasm
 optic tracts
 optic radiations
 cortex
20
Q

problems affecting the optic nerve

A

Ischaemic Optic Neuropathy

Optic neuritis – commonly MS

Tumours (Meningioma, Glioma, Haemangioma)

21
Q

how do optic nerve defects present?

A

complete or abide the horizontal

22
Q

what is optic neuritis?

A

Progressive visual loss (unilateral)

23
Q

symptoms of optic neuritis

A 
unilateral (mostly)
Pain behind eye, especially on movement
Colour desaturation
Central scotoma
Gradual recovery over weeks - months
24
Q

complication of optic neuritis

A

optic atrophy - vision will not recovery fully

25
Q

pathology affects optic chasm giving bitemporal hemianopia

A

Pituitary tumour
Craniopharyngioma
Meningioma

26
Q

what occurs once pituitary tumour is removed to visual field defect?

A

commonly reversed after the tumour is decompressed or removed

27
Q

pathology in the optic facts and radiations

A
  • Tumours (primary or secondary)
  • Demyelination
  • Vascular anomalies
28
Q

when is the macula spared? why?

A

lesion in the occipital lobe, blood supply to macula different

29
Q

what causes a superior quadrantanopia?

A

temporal lobe (Meyer’s loop)

30
Q

what causes a inferior quadrantanopia?

A

parietal lobe (Baum’s loop)

31
Q

pathology of the occipital cortex?

A
  • Vascular disease (CVA)
  • Demyelination

(macula sparing)

32
Q

what to do to test optic nerve?

A

visual acuity, colour (red), pupil reflex, visual fields, Fundoscopy.

33
Q

4 parts of optic nerve route?

A 
intraocular
infraorbital
intracanicular (though sphenoid bone)
intracranial
34
Q

what are the 3 C’s to look for for optic disc?

A

cup, contour, colour (pink/orange but not pale =atrophy)

35
Q

how is cup to nerve ratio measured?

A

height of optic nerve ratio against cup height.

check other eye to compare

36
Q

when might you not see any cup in patient?

A

long sighted

37
Q

what causes an increases blind spot?

A

papilloedema

optic neuritis

Ophthalmology (17 decks)

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