Ophthalmology relating to Neurology

Question 1

What is anterior ischaemic optic neuropathy?

Answer 1

Occlusion to optic nerve circulation

-Occlusion of short posterior ciliary artery

Question 2

What can cause anterior ischaemic optic neuropathy?

Answer 2

GCA
HT
Diabetes

Question 3

What should be given in GCA?

Answer 3

Steroids

Question 4

What is papilloedema?

Answer 4

Bilateral optic disc swelling due to raised ICP

Question 5

What causes Horner’s syndrome?

Answer 5

Lesion in sympathetic pathway

Question 6

Characteristics of Horner’s?

Answer 6

Ptosis (droopy eyelid)
Miosis (Constriction of pupil because symps have aren’t working
Anhidrosis

Question 7

Most discussed cause of Horner’s?

Answer 7

Pancoast tumour

Question 8

Another term for lateral medullary syndrome?

Answer 8

Wallenbergs

Question 9

What is Wallenbergs?

Answer 9

Syndrome caused by ischaemia to lateral part of medulla due to blockage of posterior inferior cerebellar artery or vertebral artery

Question 10

Clinical signs of Wallenbergs?

Answer 10

-Nausea
-Vomiting
-Vertigo
-Nystagmus
-Loss of pain and temp in limbs and trunk
-Loss of pain and temp in face and corneal reflex
-Horner’s syndrome
Dysphagia/hoarseness

Question 11

What is Adie’s pupil?

Answer 11

Loss of postganglionic PS innervation to risi sphincter and ciliary muscle which causes pupil to dilate

Question 12

Adie’s pupil usually?

Answer 12

Occurs in females and is unilateral

Question 13

Argyll Robertson pupil?

Answer 13

Bilateral irregular and small pupils

Question 14

Argyll Robertson pupil ______ in response to pilocarpine

Answer 14

DONT CONSTRICT

Question 15

Main causes of Argyll Robertson Pupil?

Answer 15

Diabetes

Neurosyphilis

Question 16

Chiasmic lesions cause?

Answer 16

Bitemporal hemianopia

Question 17

Optic tract lesion cause?

Answer 17

Contralateral homonymous hemianopia

Question 18

Optic radiations cause?

Answer 18

Contralateral hemianopias potentially with macular sparing

Question 19

3rd nerve palsy causes?

Answer 19

Ptosis and down and out eye
Dilated pupil
Accommodation abnormality

Question 20

Why does 3rd nerve palsy cause down out eye

Answer 20

All that is left is abduction for lateral rectus and depression from superior oblique

Question 21

4th nerve palsy cause?

Answer 21

Vertical diplopia
Person tends to have an eye elevated and adducted
Most ptnts tend to tilt their head to counteract the double vision

Question 22

Why 4th nerve palsy elevated and adducted?

Answer 22

SO causes eye depression and abduction so eye will move opposite

Question 23

6th nerve palsy causes?

Answer 23

Horizontal double vision worsened by looking at distant targets

Abnormal eye adduction

Question 24

Most common causes of 6th nerve palsies are?

Answer 24

Diabetes
HT
Raised ICP

Question 25

What is benign essential blepharospasm?

Answer 25

Bilateral idiopathic condition characterized by involuntary contraction of orbicularis oculi muscle

Question 26

When does benign essential blepharospasm present?

Answer 26

6th decade of life

Females

Question 27

Management of BEB?

Answer 27

Artificial tears for dry eyes

Botox eye injections