8: Eye in neurological disease Flashcards Preview

Ophthalmology Week 2 2017/18 > 8: Eye in neurological disease > Flashcards

Flashcards in 8: Eye in neurological disease Deck (31)
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1

What are the cardinal features of neurological eye disease?

Problems with eye movement - e.g diplopia

Visual field defects - test visual acuity and fields

2

What causes neurological eye disease?

VASCULAR DISEASE!!!

Space occupying tumours

Trauma

Demyelinating diseases

Inflammation

Infection

3

Which scan is used to check the brain for vascular disease and space occupying lesions?

MRI head

4

Which mnemonic tells you the cranial nerve supplies to the extraocular muscles?

LR6 SO4 AO3

5

Apart from elevation and depression, what do the oblique muscles do?

Superior oblique causes INTORSION

Inferior oblique causes EXTORSION

6

Which cranial nerve palsy produces a medial manifest squint?

CN VI palsy

7

What symptom does CN VI palsy produce?

Diplopia

8

Patients with a CN VI palsy poorly (abduct / adduct) the affected eye.

abduct

9

What most commonly causes a CN VI nerve palsy?

Raised ICP secondary to a vascular problem

10

CN VI is compressed by raised ICP producing a palsy.

What sign is seen in the eye?

Medial manifest squint

Papilloedema

11

What symptoms does a CN IV palsy cause?

Diplopia when looking DOWN (impaired depression)

Compensatory HEAD TILT due to intorsion

12

In CN IV palsy, which direction does the affected eye look in the central position?

Upwards

13

Why do patients with a CN IV palsy tilt their heads?

Superior oblique normally intorts the eye

So head tilt to compensate for that not working

14

What is the most common cause of a CN IV palsy?

Congenital defcts

15

What are common causes for any nerve palsy?

Microvascular

Tumour

Trauma

16

What two muscles apart from the extraocular ones does a CN III palsy affect?

LPS

Sphincter papillae

17

What position does the eye sit in due to CN III palsy?

Why?

DOWN AND OUT

Only lateral rectus and superior oblique are working

18

What is the most common cause of CN III palsy?

Microvascular problems

19

If a CN III palsy is painful what do you need to strongly suspect?

Aneurysm

20

Life-threatening CN III palsies are caused by ___.

aneurysm

21

6th raised icp

4th congenital, trauma

3rd aneurysm

22

What is an example of a demyelinating disorder which causes visual loss?

MS

23

Lesions before the optic chiasm cause which kind of visual field loss?

Lesions at the optic chiasm?

Lesions after?

Monocular vision loss

Bitemporal hemianopia

Loads of symmetrical visual losses e.g homonymous hemianopia. quadrantanopias etc.

24

What is ischaemic optic neuropathy?

Optic nerve damage due to vascular causes

25

What are the symptoms of optic neuritis?

Progressive unilateral visual loss

Pain on eye movement

Loss of colour vision

Scotoma (loss of central vision)

26

Is optic neuritis reversible?

Yes, gradually

27

What does a pale disc indicate?

Optic atrophy

28

What causes bitemporal hemianopia?

Almost always pituitary tumours

29

Is visual loss due to compression irreversible?

Not always

30

Which compressions give you homonymous visual field losses?

Those AFTER optic chiasm