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Module 8 Glaucoma & Neurophthalmology > Neuro Ophthalmology > Flashcards

Neuro Ophthalmology Flashcards

(72 cards)

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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
What are the clinical signs of horners syndrome?
``` Miosis Ptosis Enophthalmos Protrusion of the nictitans membrane Hyperthermia of the facial nerve? ```
26
First order (central) neutrons pass from the hypothalamus and exit where?
T1-T3
27
Second order (preganglionic) neurons pass from the spinal cord to synapse where?
Cranial cervical ganglion adjacent to the tympanic bulla
28
Third order (post ganglionic) fibres pass to where?
The eye
29
Which nerves can be affected by cavernous sinus syndrome? Is it normally uni or bilateral? What is the difference with this and horners?
CN III, IV, V, VI Unilateral Lack of sensation in this condition, not in horners
30
Which species does Pourfour du Petit syndrome affect? What is the cause? What are the clinical signs? How quickly does it resolve?
Cats Ear flushing Mydriasis (good direct PLR) Wide open palpebral fissure Exophthalmos (no protrusion of TEL) 1week
31
What can cause a D/ inverted D pupil in a cat? What nerves are affected for this to happen?
FeLV Lymphosarcoma Feline dysautonomia Medial/ lateral short ciliary nerve
32
What type of strabismus does hydrocephalus normally cause?
Ventrolateral
33
What ocular signs can myasthenia gravis cause?
Weakened PLR | Facial muscle paresis
34
What are the clinical signs of lafora disease? Which breeds are affected (2)? Young or adults affected?
Twitches with visual stimulation Miniature wire haired dachshund Basset hound Adult
35
Which species and breeds and age are affected by fibrosing esotropia? Which muscles are affected? Treatment?
Juvenile large/ giant breed dogs Medial rectus and dorsal oblique muscles During active inflammation - immunosuppressives Post fibrosis - surgical correction
36
Canine distemper virus causes what clinical signs?
Conjunctivitis KCS Chorioretinitis Optic neuritis, blindness Resp signs GI signs
37
What are the clinical signs for dysautonomia? What is a test for this?
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
Granulomatous meningoencephalitis affects what type of dogs? And can cause what ocular signs?
Toy breeds Sudden onset blindness
39
With cerebral hypoxia blindness can occur, are PLRs normal or abnormal?
Normal
40
Which breeds are over represented in idiopathic facial nerve paralysis? What are the clinical signs? What are 2 common causes?
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
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?
Normal PLR with blue light Abnormal PLR with red light Yes Reduced waveforms Steroids and doxycycline
42
What is the test for masticatory muscle myosotis? What are the clinical signs?
Antibodies for Type 2M muscle fibres Exophthalmos with TEL protrusion Swelling/ atrophy of masticatory muscles Pain on opening mouth
43
What age and size of dogs are normally affected by extraocular muscle myosotis? What is the tx? Does it normally recur?
Young Large breed dogs Systemic steroids No
44
Otitis media/ interna can cause which neuro-ophthalmic diseases?
Horners syndrome Neurogenic KCS Facial nerve paralysis Vestibular disease
45
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?
No Sudden Absent trace Normal PLR with blue light Abnormal PLR with red light
46
What can enrofloxacin cause?
Retinal degeneration
47
What test can be done to distinguish tora like virus causing TEL protrusion?
Phenylephrine will allow the TELs to return to normal
48
What are the clinical signs of thiamine deficiency? What is the cause? What is the treatment?
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
Following an RTA was is a worse prognostic factor… miosis v mydriasis
Mydriasis
50
What does the trochlear CN IV innervate? What does this do?
Dorsal oblique muscle Inward torsion
51
What does trigeminal nerve CN V innervate parasympathetically?
Lacrimal gland
52
Which nerve is involved in conjugate eye movement?
CN VIII vestibulocochlear
53
Which cranial nerve innervate which ocular muscle?
54
Is the dazzle reflex a subcortical or cerebrocortical response?
Subcortical
55
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
Blind with normal PLR
56
If there is a lesion in the optic nerve will that cause; - Blind with normal PLR - blind with abnormal PLR - visual with abnormal PLR
Blind with abnormal PLR
57
If there is a lesion in the optic chiasm will that cause; - Blind with normal PLR - blind with abnormal PLR - visual with abnormal PLR
Blind with abnormal PLR
58
If there is a lesion in the retina will that cause; - Blind with normal PLR - blind with abnormal PLR - visual with abnormal PLR
Blind with abnormal PLR
59
If there optic neuritis will that cause; - Blind with normal PLR - blind with abnormal PLR - visual with abnormal PLR
Blind with abnormal PLR
60
If there is SARDS will that cause; - Blind with normal PLR - blind with abnormal PLR - visual with abnormal PLR
Blind with abnormal PLR
61
Which is a worse sign post RTA? Miosis or mydriasis?
Mydriasis
62
Internal Ophthalmoplegia causes what signs? What is it?
Visual with dilated unresponsive pupil Loss of parasympathetic supply from CN III oculomotor nerve
63
What is external ophthalmoplegia? What does it cause?
Parasympathetic supply and somatic from CN III, IV, VI affected Abnormal eye position - lateral strabismus, cannot retract or move eye
64
Which nerves pass through cavernous sinus?
CN III, IV, V, VI
65
If you see case which looks like horners but has a dilated pupil and decreased facial sensation what condition is it?
Cavernous sinus syndrome
66
What causes this?
Static aniscoria | FeLV
67
What type of strabismus does a hydrocephalus dog have?
Ventrolateral
68
What age and size dogs does fibrosing esotropia affect? What does it cause?
Juvenile large breeds Inward squint Myositis of medial rectus and dorsal oblique muscles
69
What are the signs of facial nerve paralysis? Cause?
``` Paresis Saliva drooling No blink reflex No menace response Some have KCS ``` Idiopathic- cockers/ CKCS Otitis media/ interna
70
Which muscles are affected by masticatory myosotis?
Masseter muscle | Temporalis muscle
71
Explain how aqueous production occurs
72
What does the aqueous deliver nutrients to and remove waste from?
Lens Cornea Trabecular meshwork

Module 8 Glaucoma & Neurophthalmology (2 decks)

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