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Ophthalmology > The eye in neurological conditions > Flashcards

The eye in neurological conditions Flashcards

1
Q

What will eye movement defects cause?

A

Double vision

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2
Q

What will visual defects cause?

A

Problems with visual acuity and field loss

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3
Q

What can cause neurological eye problems?

A 
Vascular disease 
Turmous (primary and secondary) 
Trauma
Demyelination 
Inflammation/ infection: sarcoidosis, neuroinflammatory, meningitis, encephalitis
Congenital abnormalities
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4
Q

What ocular motility defects can occur?

A 
3rd nerve palsy
4th nerve palsy
6th nerve palsy
Inter-nuclear
Supra-nuclear
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5
Q

What will a 6th nerve palsy cause?

A

Lateral rectus palsy - lack of abduction

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6
Q

What commonly causes a 6th nerve palsy?

A

Microvascular
Raised ICP
Tumour
Congenital

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7
Q

Why is the 6th nerve susceptible to raised ICP?

A

Passes over the petrous tip and a slight rise in ICP will cause impingement

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8
Q

How will a raised ICP present in the fundus?

A

Swollen disc - papilloedema

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9
Q

What action does the superior oblique muscle have?

A

Test by looking down and in
Action is down and out
Intorsion, depression and weakly abduction

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10
Q

What can cause a 4th nerve palsy?

A

Congenital decompensated
Microvascular
Tumour
Bilateral - closed head trauma

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11
Q

What muscles does CN3 supply?

A

SR, MR, IR, IO, LPS, sphincter pupillae

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12
Q

Where will the eye sit in a 3rd nerve palsy?

A

Down and out

Ptosis

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13
Q

What commonly causes a 3rd nerve palsy?

A 
Microvascular
Tumour
Aneurysm - posterior communicating artery 
MS
Congenital
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14
Q

What inter-nucleus connects the 3rd and 6th CN to allow for left or right movement of the eye together?

A

Medial longitudinal fasciculus

Allows for coordinated movements of the eye to look to the left or right

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15
Q

How will INO present?

A

Nystagmus of abducted eye

Eye trying to adduct will go slowly or won’t manage

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16
Q

What can cause INO?

A

MS

Vascular - stroke

17
Q

What is pathognomonic of MS?

A

Hyperintensity at the lateral ventricles showing plaques

18
Q

Where can visual field defects occur?

A 
Optic nerve
Chiasm
Optic tracts
Optic radiations
Cortex
19
Q

What lobes will the superior and inferior visual field radiations travel through?

A

Superior - temporal

Inferior - parietal

20
Q

What can cause problems to the visual field?

A

Vascular disease - CVA
Space occupying lesion - SOL
Demyelination (MS)
Trauma - inc surgical

21
Q

What type of visual field loss will occur after the lateral geniculate bodies?

A

Superior or inferior quadrantonopia

22
Q

What will be spared if there is a lesion at the occipital cortex?

A

Macular sparing

23
Q

What pathologies can occur at the optic nerve?

A

Ischaemic optic neuropathy - stroke of optic nerve
Optic neuritis - MS
Tumours - meningioma, glioma, haemangioma

24
Q

What visual field loss will optic nerve defects cause?

A

Abide the horizontal - only inferior or superior affected

Common in glaucoma

25
Q

What is optic neuritis?

A

Progressive visual loss
Pain behind eye on movement
Colour desaturation
Central scotoma

26
Q

What signs are present in optic atrophy?

A

Pale disc

Marked RAPD

27
Q

What can affect the optic chiasm?

A

Pituitary tumour
Craniopharyngioma
Meningioma - common around sphenoid wing

28
Q

What pathologies can affect the optic tract or radiations?

A

Tumours (primary or secondary)
Demyelination
Vascular anomalies

29
Q

What visual field defects occur with optic tract and radiation pathologies?

A

Homonymous defects
Macula NOT spared
Quadrantanopia - if after lateral geniculate nucleus
Incongruous

30
Q

What pathologies can occur at the occipital cortex?

A 
Vascular disease (CVA) 
Demyelination
31
Q

What visual field defects occur with occipital cortex pathologies?

A

Homonomous defect
Macular sparing
Congrous

Ophthalmology (14 decks)

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