Jakirlic

Question 1

Increased diameter of ONH

Answer 1

Stage 3 moderate

Question 2

Normal temporal disk,

No elevation

Answer 2

Stage 1 very early

Question 3

Complex metamorphopsia

Answer 3

Parietal tumor/stroke, parietal seizures and migraine. Persist covering both eyes

Question 4

Brain tumor can cause

Answer 4

Complex hallucinations

Simple and complex illusions

Question 5

Migraines

Answer 5

Simple hallucinations

Complex metamorphopsia

Question 6

Pareto-occipital tumor/stroke causes

Answer 6

Complex Illusion:
Diplopia not changing covering both eyes
Polyopia
Palinopsia

Question 7

Drug abuse

Answer 7

Can cause complex illusion called Palinopsia

Question 8

Bilateral Occipito-Temporal lobe tumor/stroke

Answer 8

Complex Illusion-akinetopsia “motion blindness “

Question 9

Hallucinations cause : simple

Answer 9

Retinal disease (PVD, tear, RD)
Optic nerve disease
Migraine: visual aura

Question 10

Hallucinations cause : complex

Answer 10

Dementia
Metabolic disease
Illegal drug use
Occipital tumor/stroke
Occipital epilepsy
Charles Bonnet Syndrome

Question 11

Transient Visual Loss-Monocular

Answer 11

Incipient retinal vascular occlusion (CRAO, CRVO)
Retinal vasospasm (ocular migraine)
GCA
Papilledema (IIH) (usually bilateral but can be unilateral due posture change)
Amaurosis fugax (hypoperfusion)
Cardiac valvular disease

Question 12

Most common cause of monocular vision loss

Answer 12

Amaurosis fugax (hypoperfusion) d/t carotid artery stenosis

Question 13

Most common cause of binocular visual disturbance:

Answer 13

migraine

Question 14

Non-migraine TVL

Answer 14

sign of serious vascular disease

Question 15

Transient Visual Loss-Binocular

Answer 15

Migraine
Papilledema (IIH)
Vertebrobasilar insufficiency
Postural hypotension

Question 16

Amaurosis Fugax

Answer 16

Sudden onset of severe visual loss in one eye
All or part of monocular visual field
Lasts seconds to minutes
Completely resolves within 10 minutes (can last up to 1 hour)
Fellow eye unaffected
No other neurologic symptoms
No symptoms of GCA
50+ year olds with cardiovascular risk factors

Question 17

Amaurosis Fugax: examination

Answer 17

Normal ocular examination in both eyes

May visualize Hollenhorst plaque in retinal arteriole

Question 18

Amaurosis Fugax Workup

Answer 18

Laboratory;
CBC with differential
ESR & CRP
Hypercoagulable state in young patients
Carotid artery investigation

Question 19

Ocular Ischemic Syndrome

Answer 19

Entire eyeball suffers from hypoperfusion
Severe ICA stenosis or occlusion
GCA

Question 20

Ocular Ischemic Syndrome Symptoms

Answer 20

Transient monocular visual loss or blur improved with laying down
Orbital ache improved on laying down
Dull ocular pain all around the eye that improves laying down.
Transient neurologic symptoms: contralateral weakness or numbness

Question 21

Ocular Ischemic Syndrome signs

Answer 21

Decreased BCVA
Decreased IOP
Mild anterior uveitis
Retinal venous engorgement and tortuosity
Mid-peripheral retinal hemorrhages (classic sign)
Iris neovascularization
Cataract (forms quicker)

Question 22

Ocular Ischemic Syndrome workup and treatment

Answer 22

Investigations: carotid doppler, ESR, CRP
Treatment
Carotid endarterectomy: symptomatic patients with severe 70-99% stenosis

Question 23

Vasospastic monocular TVL

Answer 23

retinal migraine
Typically young adult
Same eye affected every time

Question 24

Vertebrobasilar Insufficiency

Answer 24

Age 50+
Sudden onset visual loss in both eyes
Vision recovers completely within minutes (can take up to 1 hour)

Question 25

Chiasmal Disease

Answer 25

``` Vision loss; Typically painless Progressive Bilateral asymmetric Headache possible ```

Question 26

Anything to Anterior to chiasm and LGN

Answer 26

optic atrophy and contralateral APD possible

Question 27

Posterior the LGN,

Answer 27

no optic atrophy and RAPD.

Question 28

Post-Chiasmal Disease

Answer 28

Homonymous: nasal VF of one eye and temporal VF of fellow eye Congruous: nasal and temporal defects closely resemble each other Decreased VA not common unless lesion also involves optic nerve or occipital lobes Usually due to cardiovascular disease (stroke)

Question 29

Optic Tract Lesions

Answer 29

Tumors Ischemic stroke Aneurysms of superior cerebellar or PCA

Question 30

Lesions of optic radiations

Answer 30

``` Vascular occlusions (common causes) Primary & secondary tumors Trauma Incomplete incongruous quandranopsias Neurologic deficits predominate ```

Question 31

Neurologic symptoms predominate | Temporal Lobe Lesions

Answer 31

Seizures Hemiparesis (loss of motor control ) Hemisensory loss (loss of sensation) Aphasia

Question 32

Neurologic symptoms predominate | Parietal Lobe Lesion

Answer 32

Hemiplegia (paralysis of one side of the body.) Hemisensory loss Visual neglect Aphasia

Question 33

Lesions of the visual cortex

Answer 33

will Not have any neurologic defect .

Question 34

Calcarine cortex lesions;

Answer 34

always due to stroke, completely Congruous no neurological deficits +/- macular sparing