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Module 8 Glaucoma & Neurophthalmology > Neuro Ophthalmology > Flashcards

Neuro Ophthalmology Flashcards

1
Q

What does the Brain, spinal cord and optic nerves make up?

A

Central nervous system

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2
Q

What are cell bodies called in the CNS? PNS?

A

CNS- nuclei

PNS- ganglia

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3
Q

With vestibular disease, does the fast phase indicate towards or away from the lesion in;
Peripheral vestibular disease?
Central vestibular disease?

A

Peripheral- away from the lesion

Central- towards the lesion

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4
Q

What is the definition of nystagmus?

A

Rhythmic and involuntary eye movements

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5
Q

Which nerves are involved with pathological nystagmus (3)?

A

CN III OCULARMOTOR
CN IV TROCHLEAR
CN VI ABDUCENS

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6
Q

Which nerves innervate which extraocular muscles?

A
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7
Q

CNs III, IV & VI control the extraocular muscles originate in the brain stem, 2 out of 3 of them remain ipsilateral, 1 crosses to the extraocular muscles, which CN?

A

CN IV

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8
Q

Which CN or it’s nucleus is affected if there is ipsilateral ventrolateral strabismus and ptosis?

A

CN III

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9
Q

Which CN is affected if there is ipsilateral extorsion strabismus?

A

CN IV

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10
Q

Which CN is affected if there is contralateral extorsion strabismus?

A

Nucleus of CN IV

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11
Q

Which CN is affected if there is ipsilateral esotropia strabismus?

A

CN VI or it’s nucleus

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12
Q 
In the iris what is the innervation (sympathetic v parasympathetic) to;
Dilator muscles (radial)
Constrictor muscles (circumferentially)
A

Dilator - sympathetic

Constrictor - parasympathetic

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13
Q

Which nerves supplies the iris dilator muscle and causes the eyelids to be open?

A

CN V

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14
Q

Why do cats have an elliptical pupil?

A

Only have 2 ciliary nerves (medial and lateral)

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15
Q

What nerves are involved in PLR?

A

II -> III

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16
Q

What is a Marcus Gunn sign?

What is this pathognomonic for?

A

When an illuminated eye fails to constrict (it dilates)

Unilateral retinal or prechiasmal disease

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17
Q

Which nerve is fired when the inner ear (3 semicircular canals), the utricle, saccule and movement of endolymph and perilymph stimulated?

A

CN VIII

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18
Q

Is the optic nerve myelinated or unmyelinated?

A

Myelinated

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19
Q 
What % of the optic nerve decussates at the optic chiasm?
Cat
Dog
Human
Horses/farm animals
A

Cat 33%
Dog 25%
Human 50%
Horses/farm animals 10-20%

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20
Q

What 2 tests are used to check vision?

A

Maze test

Visual placing tests

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21
Q

Does STT test sympathetic or parasympathetic system?

And which CNs are involved in tear production?

A

Parasympathetic

CN V, VII

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22
Q

Sensory innervation of the lacrimal gland us detected by which CN?

A

CN V

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23
Q

Pilocarpine acts on the parasympathetic system and causes what to happen to the eye?

A

Pupil constriction

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24
Q

What is the test for horners?
Does it work on testing the sympathetic or parasympathetic?
How does it differentiate lesions?

A

Phenylephrine

Sympathetic (Denervation hypersensitivity)

Post ganglion lesion pupil dilated within 20mins,
takes 20-60mins in preganglionic

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25
Q

What are the clinical signs of horners syndrome?

A 
Miosis
Ptosis 
Enophthalmos
Protrusion of the nictitans membrane
Hyperthermia of the facial nerve?
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26
Q

First order (central) neutrons pass from the hypothalamus and exit where?

A

T1-T3

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27
Q

Second order (preganglionic) neurons pass from the spinal cord to synapse where?

A

Cranial cervical ganglion adjacent to the tympanic bulla

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28
Q

Third order (post ganglionic) fibres pass to where?

A

The eye

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29
Q

Which nerves can be affected by cavernous sinus syndrome?

Is it normally uni or bilateral?

What is the difference with this and horners?

A

CN III, IV, V, VI

Unilateral

Lack of sensation in this condition, not in horners

30
Q

Which species does Pourfour du Petit syndrome affect?

What is the cause?

What are the clinical signs?

How quickly does it resolve?

A

Cats

Ear flushing

Mydriasis (good direct PLR)
Wide open palpebral fissure
Exophthalmos (no protrusion of TEL)

1week

31
Q

What can cause a D/ inverted D pupil in a cat?

What nerves are affected for this to happen?

A

FeLV
Lymphosarcoma
Feline dysautonomia

Medial/ lateral short ciliary nerve

32
Q

What type of strabismus does hydrocephalus normally cause?

A

Ventrolateral

33
Q

What ocular signs can myasthenia gravis cause?

A

Weakened PLR

Facial muscle paresis

34
Q

What are the clinical signs of lafora disease?

Which breeds are affected (2)?

Young or adults affected?

A

Twitches with visual stimulation

Miniature wire haired dachshund
Basset hound

Adult

35
Q

Which species and breeds and age are affected by fibrosing esotropia?

Which muscles are affected?

Treatment?

A

Juvenile large/ giant breed dogs

Medial rectus and dorsal oblique muscles

During active inflammation - immunosuppressives
Post fibrosis - surgical correction

36
Q

Canine distemper virus causes what clinical signs?

A

Conjunctivitis
KCS
Chorioretinitis
Optic neuritis, blindness

Resp signs
GI signs

37
Q

What are the clinical signs for dysautonomia?

What is a test for this?

A

Decreased tear production
Dilated unresponsive pupils
Protruding TELs

Anorexia, vomiting, regurgitation, bradycardia, malaise, decreased appetite, dehydration

0.1% pilocarpine, will cause rapid pupil constriction

38
Q

Granulomatous meningoencephalitis affects what type of dogs?

And can cause what ocular signs?

A

Toy breeds

Sudden onset blindness

39
Q

With cerebral hypoxia blindness can occur, are PLRs normal or abnormal?

A

Normal

40
Q

Which breeds are over represented in idiopathic facial nerve paralysis?

What are the clinical signs?

What are 2 common causes?

A

CKCS
Cocker spaniels

Drooping of the lip, saliva spillage
Reduced/ absent menace and palpebral
Tear production may be reduced - no blink

Hypothyroidism
Otitis media/ interna

41
Q

With immune mediated retinitis (IMR) when using which light is the PLR normal and abnormal?

With IMR do they normally have a dazzle reflex?

What will show on ERG?

What is the treatment?

A

Normal PLR with blue light
Abnormal PLR with red light

Yes

Reduced waveforms

Steroids and doxycycline

42
Q

What is the test for masticatory muscle myosotis?

What are the clinical signs?

A

Antibodies for Type 2M muscle fibres

Exophthalmos with TEL protrusion
Swelling/ atrophy of masticatory muscles
Pain on opening mouth

43
Q

What age and size of dogs are normally affected by extraocular muscle myosotis?

What is the tx?

Does it normally recur?

A

Young
Large breed dogs

Systemic steroids

No

44
Q

Otitis media/ interna can cause which neuro-ophthalmic diseases?

A

Horners syndrome
Neurogenic KCS
Facial nerve paralysis
Vestibular disease

45
Q

Is sudden acquired retinal degeneration syndrome (SARDS) reversible?

Is it a sudden or long onset?

What will the results of an ERG be?

What will the results be with blue and red light testing PLR?

A

No

Sudden

Absent trace

Normal PLR with blue light
Abnormal PLR with red light

46
Q

What can enrofloxacin cause?

A

Retinal degeneration

47
Q

What test can be done to distinguish tora like virus causing TEL protrusion?

A

Phenylephrine will allow the TELs to return to normal

48
Q

What are the clinical signs of thiamine deficiency?

What is the cause?

What is the treatment?

A

Dilated pupils (normal vision)
Inappetence
Ventroflexion of the head and neck

Raw fish diet
Rarely GI disease causing malabsorption

Parenteral vitamin B, then ora

49
Q

Following an RTA was is a worse prognostic factor… miosis v mydriasis

A

Mydriasis

50
Q

What does the trochlear CN IV innervate?

What does this do?

A

Dorsal oblique muscle

Inward torsion

51
Q

What does trigeminal nerve CN V innervate parasympathetically?

A

Lacrimal gland

52
Q

Which nerve is involved in conjugate eye movement?

A

CN VIII vestibulocochlear

53
Q

Which cranial nerve innervate which ocular muscle?

A
54
Q

Is the dazzle reflex a subcortical or cerebrocortical response?

A

Subcortical

55
Q

If there is a lesion in the distal visual cortex will that cause;

  • Blind with normal PLR
  • blind with abnormal PLR
  • visual with abnormal PLR
A

Blind with normal PLR

56
Q

If there is a lesion in the optic nerve will that cause;

  • Blind with normal PLR
  • blind with abnormal PLR
  • visual with abnormal PLR
A

Blind with abnormal PLR

57
Q

If there is a lesion in the optic chiasm will that cause;

  • Blind with normal PLR
  • blind with abnormal PLR
  • visual with abnormal PLR
A

Blind with abnormal PLR

58
Q

If there is a lesion in the retina will that cause;

  • Blind with normal PLR
  • blind with abnormal PLR
  • visual with abnormal PLR
A

Blind with abnormal PLR

59
Q

If there optic neuritis will that cause;

  • Blind with normal PLR
  • blind with abnormal PLR
  • visual with abnormal PLR
A

Blind with abnormal PLR

60
Q

If there is SARDS will that cause;

  • Blind with normal PLR
  • blind with abnormal PLR
  • visual with abnormal PLR
A

Blind with abnormal PLR

61
Q

Which is a worse sign post RTA? Miosis or mydriasis?

A

Mydriasis

62
Q

Internal Ophthalmoplegia causes what signs?

What is it?

A

Visual with dilated unresponsive pupil

Loss of parasympathetic supply from CN III oculomotor nerve

63
Q

What is external ophthalmoplegia?

What does it cause?

A

Parasympathetic supply and somatic from CN III, IV, VI affected

Abnormal eye position - lateral strabismus, cannot retract or move eye

64
Q

Which nerves pass through cavernous sinus?

A

CN III, IV, V, VI

65
Q

If you see case which looks like horners but has a dilated pupil and decreased facial sensation what condition is it?

A

Cavernous sinus syndrome

66
Q

What causes this?

A

Static aniscoria

FeLV

67
Q

What type of strabismus does a hydrocephalus dog have?

A

Ventrolateral

68
Q

What age and size dogs does fibrosing esotropia affect?

What does it cause?

A

Juvenile large breeds

Inward squint
Myositis of medial rectus and dorsal oblique muscles

69
Q

What are the signs of facial nerve paralysis?

Cause?

A 
Paresis 
Saliva drooling
No blink reflex 
No menace response
Some have KCS

Idiopathic- cockers/ CKCS
Otitis media/ interna

70
Q

Which muscles are affected by masticatory myosotis?

A

Masseter muscle

Temporalis muscle

71
Q

Explain how aqueous production occurs

A
72
Q

What does the aqueous deliver nutrients to and remove waste from?

A

Lens
Cornea
Trabecular meshwork

Module 8 Glaucoma & Neurophthalmology (2 decks)

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