Neurological Conditions and the Eye

Question 1

what is the most common problem that affects the brain tissue?

Answer 1

vascular disease

Question 2

what pathologies/processes can cause neural issues?

Answer 2

• vascular
• tumours
• trauma
• demyelination
• inflammation/infection
• congenital abnormalities

Question 3

what nerves can be damaged that would cause ocular motility defects?

Answer 3

CN III, IV and VI

Question 4

what is the most common nerve palsy? (in terms of the nerves that supply ocular mobility)

Answer 4

VIth nerve palsy

Question 5

what muscle does CN VI supply?

Answer 5

the lateral rectus

Question 6

what is the lateral rectus muscle responsible for?

Answer 6

abduction

Question 7

what can be seen in the eye of someone with a VIth nerve palsy?

Answer 7

convergent squint. affected eye is facing inwards as the lateral rectus is not working to pull it out

Question 8

4 most common causes (in order) of VIth nerve palsy?

Answer 8

• microvascular
• raised ICP
• tumour
• congenital

Question 9

if there is raised ICP, what is the VIth nerve compressed against?

Answer 9

the petrous part of temporal bone

Question 10

second most common nerve palsy?

Answer 10

IVth nerve palsy - trochlear nerve

Question 11

3 most common causes of IVth nerve palsy?

Answer 11

• congenital
• microvascular
• tumour

Question 12

what is the most common cause of bilateral IVth nerve palsy?

Answer 12

closed head trauma

Question 13

what muscle does the IVth nerve supply?

Answer 13

superior oblique muscle

Question 14

what is a clinical sign of a IVth nerve palsy?

Answer 14

eyeball cannot look down and in

Question 15

what would you suspect in a child who sits with their head tilted to see better?

Answer 15

a IVth nerve palsy

Question 16

what is the least common nerve palsy?

Answer 16

IIIth nerve palsy - occulomotor nerve

Question 17

what muscles does the oculomotor nerve supply?

Answer 17

• medial, inferior and superior rectus
• inferior oblique
• sphincter pupillae
• levator palpebrae superioris

Question 18

what is the occular position in a 3rd nerve palsy?

Answer 18

down and out

Question 19

what might you notice in the pupil in a 3rd nerve palsy?

Answer 19

dilated pupil

Question 20

5 most common causes of IIIrd nerve palsy?

Answer 20

• microvascular
• tumour
• aneurysm
• MS
• congenital

Question 21

what would a painful 3rd nerve palsy indicate?

Answer 21

an aneurysm

Question 22

what are the causes of inter-nuclear Ophthalmoplegia?

Answer 22

• MS
• vascular
• etc etc

Question 23

what happens in inter-nuclear ophthalmoplegia?

Answer 23

the 2 eyes no longer work together so when one looks left, the other will not do this at the same rate and speed

Question 24

what nerve is involved in inter-nucleus ophthalmoplegia?

Answer 24

medial longitudinal fasciculus

Question 25

at what areas on the optic pathway can be affected to cause a visual field defect?

Answer 25

- optic nerve - optic chiasm - optic tracts - optic radiations - cortex

Question 26

what happens in optic neuritis in relation to visual loss?

Answer 26

progressive visual loss unilaterally

Question 27

what can a patient with optic neuritis present with?

Answer 27

pain behind the eye, loss of some colour vision

Question 28

what makes the pain worse in optic neuritis?

Answer 28

eye movement

Question 29

what is a gap in visual field called?

Answer 29

a scotoma

Question 30

in what age group does optic neuritis commonly affect?

Answer 30

young people/ young adults

Question 31

does optic neuritis recover?

Answer 31

yes

Question 32

over how long does optic neuritis recover?

Answer 32

over weeks-months

Question 33

what often happens the optic nerve after optic neuritis?

Answer 33

optic atrophy

Question 34

what can affect the optic chiasm causing visual defects?

Answer 34

- pituitary tumour - craniopharyngioma - meningioma

Question 35

what age group does craniopharyngioma affect?

Answer 35

children

Question 36

if something compresses the optic chiasm, what type of visual field loss is there?

Answer 36

bi-temporal field defect

Question 37

what type of visual defect occurs when a problem is affecting the optic tracts or radiations?

Answer 37

homonomous defects

Question 38

is the macula spared when the problem is affecting the optic tracts and radiations?

Answer 38

no

Question 39

is there macular sparing when there is damage to the occipital cortex?

Answer 39

yes

Question 40

what type of defect arises in when there is damage to the occipital cortex?

Answer 40

homonmous defect

Question 41

what is a ring enhancing lesion in the brain and what can cause them?

Answer 41

long held abscess- eg in TB, parasitic abscess, chronic bacterial abscess