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Oc Motility > Week 8 > Flashcards

Week 8 Flashcards

1
Q

What are the 2 types of strabismus?

A

Non-restrictive

Binocular disorder

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2
Q

Conjugate eye movements reveal what?

A

subtle muscle paresis

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3
Q

What are the 2 types of innervation incomitant strabismus?

A
  1. Supranuclear/Internuclear

2. Nuclear/Infranuclear

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4
Q

What are the types of Supranuclea/internuclear strabismus?

A
  1. Skew Deviation
  2. INO
  3. Thalamic Esotropia
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5
Q

What are the types of Nuclear/Infranuclear strabismus?

A
  1. OMN Palsy
  2. Peripheral Neuropathy
  3. Disorders of neuromuscular junction
  4. Congenital cranial dysinnervation syndrome
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6
Q

What are the types of mechanical incomitant strabismus?

A
  1. Restrictive

2. Others

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7
Q

What are the types of restrictive strabismus?

A
  1. Brown’s syndrome
  2. Postoperative
  3. Trauma
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8
Q

What are the types of “other” strabismus?

A
  1. Orbital inflammation
  2. Orbital infection
  3. Orbital lesion
  4. Orbital Trauma
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9
Q

What type of head movement is found in a lateral rectus palsy?

A

Head turn

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10
Q

What type of head movement is found in an oblique muscle paresis?

A

Head tilt to shoulder

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11
Q

T/F: Saccades, pursuits OKN and VOR are impaired toward the side of the lsion

A

True

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12
Q

What % of CN VI palsies heal in 6 months?

A

60-75%

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13
Q

What are the 3 tx for a CN palsy?

A
  1. Prism
  2. Range of Motion exercises
  3. Head turn
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14
Q

What are the pros of Fresnel prism?

A
  1. Low cost
  2. Thin and light weight
  3. Cosmesis is OK
  4. Up to 40 pd
  5. Horiz. and Verti.
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15
Q

What are the cons of Fresnel prism?

A
  1. Blurry Vision
  2. Reduced contrast
  3. Age and Dirty
  4. Peel/fall off
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16
Q

What are the pros for prism goggles?

A
  1. Better clarity
  2. Low cost
  3. Easily ordered
  4. Switch prism power
  5. up to 30pd
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17
Q

What are the cons of prism goggles?

A
  1. No temples
  2. Uncomfortable frame
  3. Distortions
  4. Cosmesis
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18
Q

Deafness has what % association w/ Duane’s Retraction syndrome?

A

10%

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19
Q

Convergence spasm is caused by what?

A

trauma

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20
Q

What is the most common cause of acquired vertical strabismus?

A

CN IV palsy

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21
Q

Where is diplopia greatest in CN IV palsy?

A

downgaze

22
Q

WIT: mechanical restriction of superior oblique muscle causing difficulty of eye moving up on adduction?

A

Brown Syndrome

23
Q

What are the common causes of 3rd nerve palsies in adults?

A
  1. Aneurysms
  2. Vascular Disease
  3. Trauma
  4. Migraine
24
Q

What are the common causes of 3rd nerve palsies in kids?

A
  1. Birth trauma
  2. Accidental trauma
  3. Neonatal hypoxia
  4. Migraine
25
Q

WIT: 3rd NP + contralateral hemiparesis

A

Weber’s syndrome

26
Q

WIT: 3rd NP + contralateral tremor

A

benedikt’s syndrome

27
Q

WIT: 3rd NP + ipsilateral cerebellar ataxia

A

Nothnagel’s syndrome

28
Q

WIT: Benedikt’s + Nothnage’s syndrome

A

Claude’s syndrome

29
Q

What is the most common cause of 3rd nerve palsy with pupillary involvement?

A

Intracranial aneurysms

- junction of internal carotid + PCA

30
Q

What is the most common cause of 3rd NP w/ pupil sparing?

A

Ischemia

- DM, HTN, Migraine, SLE, Temporal Arteritis

31
Q

WIT: Involuntary eye oscillations that drive the eye away from the target?

A

Nystagmus

32
Q

Nystagmus is called by lesions of what 3 things?

A
  1. VOR
  2. Gaze-holding system
  3. Smooth Pursuits + OKN
33
Q

What are the characteristics of pendular nystagmus?

A

both phases slow

34
Q

What are the characteristics of jerk nystagmus?

A

1 fast phase, 1 slow phase

35
Q

What are the characteristics of plane nystagmus?

A

Horizontal, vertical, torsional rotary

36
Q

What are the characteristics of conjugacy nystagmus?

A

Direction, amplitude, frequences

37
Q

Oscillopsia of greater than __ degrees per second impairs vision

A

5 degrees

38
Q

What is the main difference between peripheral and central vestibular nystagmus?

A

Peripheral = can be suppressed with vision/adaptive

Central = no suppression/no adaptation

39
Q

A downbeat nystagmus is caused by what 6 things?

A
  1. Arnold-Chiari
  2. Cerebellar degeneration
  3. Vertebrobasilar infarction
  4. MS
  5. Drugs
  6. Idiopathic
40
Q

An upbeat nystagmus is caused by what 4 things?

A
  1. Cerebelllar degeneration
  2. Brainstem/Cerebellar infarct
  3. MS
  4. Tumors
41
Q

Gaze-evoked nystagmus is due to normal pulse but ___?

A

unsustained step signal

42
Q

What is the only normal nystagmus not associated with disease?

A

Physiological End-Point Nystagmus

43
Q

When does physiological end-point nystagmus start?

A

After 30 seconds of sustained view in lateral gaze (fatigue effect)

44
Q

A person with congenital nystagmus will have what 2 issues?

A
  1. head tremor

2. gaze-holding issues

45
Q

What are the 3 components that prevent drift nystagmus?

A
  1. VOR
  2. Neural integrator
  3. Long Term Recalibration
46
Q

What nerve accounts for most cases of acquired vertical strabismus?

A

CN4

47
Q

What is the triad for the ocular tilt reaction?

A
  1. Skew Deviation
  2. Ocular torsion
  3. Head tilt 10-13 deg
48
Q

Ocular tilt reaction is perceived when?

A

In the darkness

49
Q

In a skew deviation, they ___ eye is extorted, while in CN4 deviation the ___ eye is extorted

A 
Skew = hypo eye
CN4 = hyper eye (up and out)
50
Q

Convergence retraction nystagmus is due to ?

A

due to lesion in the rostral midbrain

Oc Motility (10 decks)

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