neurological + visual field diseases

Question 1

what are the two symptoms which would make you consider a neuro-ophthalmic disease

Answer 1

eye movement defect e.g double vision

visual defects e.g. visual acuity, field loss

Question 2

what does CN III innervate

Answer 2

Medial rectus muscle
Inferior rectus 
Superior rectus
Inferior oblique
Sphincter pupillae
Levator palpebrae superioris

all but 2 of the ocular muscles

Question 3

what does CN IV enervate

Answer 3

superior oblique muscle

remember by thinking of SO4 (sulphate)

Question 4

what does CN VI innervate

Answer 4

lateral rectus muscle

Question 5

what are the causes of a CN III palsy

Answer 5

Microvascular 
Tumour
Aneurysm 
MS
Congenital

Question 6

what are the symptoms of a CN III palsy

Answer 6

drooping lid
eye is looking down and out in a neutral position
basically almost every eye movement is a bit off

Question 7

when would you suspect that an aneurysm was the cause of a CN III palsy

Answer 7

if the patient was in pain

Question 8

what are the causes of a CN IV palsy

Answer 8

Congenital decompensated
Microvascular
Tumour
Closed head trauma

Question 9

what are the symptoms of a CN IV palsy

Answer 9

one eye being higher than the other when looking straight a head
head tilt

Question 10

when would you suspect that closed head trauma was the cause of a CN IV palsy

Answer 10

if the symptoms were bilateral

Question 11

what movements are affected in CN IV palsy

Answer 11

adduction
abduction (slightly)
torsion

Question 12

what are the causes of a CN VI palsy

Answer 12

Microvascular
Raised ICP
Tumour
Congenital

Question 13

what eye movement will be affected by a CN VI palsy

Answer 13

abduction

Question 14

what symptoms would make you suspect that raised ICP was the cause of a CN VI palsy

Answer 14

both eyes affected

papilloedema

Question 15

what is Inter-nuclear ophthalmoplegia

Answer 15

lack of co-ordination between the eyes

Question 16

what are the causes of Inter-nuclear ophthalmoplegia

Answer 16

MS
Vascular
some very, very rare diseases

Question 17

what are the symptoms of Inter-nuclear ophthalmoplegia

Answer 17

lack of conjugate lateral gaze

affected eye will have nystagmus

Question 18

describe the visual pathway from eye to brain

Answer 18

retina (eye)
optic nerve
optic chiasm
optic tract
optic radiation (temporal and parietal) 
occipital cortex (brain)

Question 19

what will a defect in the optic nerve result in

Answer 19

complete loss of vision in one eye

Question 20

what are the causes of a defect in the optic nerve

Answer 20

Ischaemic optic neuropathy
Optic neuritis = usually due to MS
Tumours (rare)

Question 21

what are the symptoms of optic neuritis

Answer 21

Progressive, unilateral visual loss = scotoma
Pain behind eye, especially on movement
Colour desaturation, especially red

Question 22

what type of tumours could cause a defect in the optic nerve

Answer 22

meningioma
glioma
haemangioma

Question 23

what will a defect in the optic chiasm result in

Answer 23

bi-temporal visual loss

Question 24

what are the causes of a defect in the optic chiasm

Answer 24

Pituitary tumour
Craniopharyngioma
Meningioma

Question 25

what will a defect in the optic tracts and radiations result in

Answer 25

homonymous visual loss that does NOT spare the macula

Question 26

what are causes of a defect in the optic tracts and radiations

Answer 26

tumours demyelination vascular anomalies

Question 27

what will a defect in the occipital cortex result in

Answer 27

macular sparing homonymous visual loss

Question 28

what are the causes of a defect in the occipital cortex r

Answer 28

vascular disease | demyelination