The Eye in Systemic Disease Flashcards
(33 cards)
what are the key features of neuro-opthalmic disease
- eye movement defects (double vision)
2. visual defects (visual acuity, field loss)
causes of neurological-opthalmic disease
vascular disease (microvascular disease is the principle cause of vision loss)
Tumours (SOL)
Trauma
Demyelination
Inflammation/infection (sarcoidosis, meningitis, encephalitis)
Congenital abnormalities
what does damage to CNIV cause (abducens nerve)
lateral rectus palsy
- presents with one eye unable to abduct
causes of CNVI palsy
microvascular disease
Raised ICP (papillodema)
Tumours
Congenital
what sort of double vision is seen with CNVI palsy
horizontal double vision
images present next to each other
what muscle does CNIV innervate
Trochlear muscle - innervating the superior oblique
what does the superior oblique do
moves the eye down and in
intorsion
what are the symptoms of CNIV palsy
eye doesn’t move down and in - when adducted it moves in but not down
also sits higher than normal - can see more white under eye
patients can compensate by tilting their head
all patients have double vision
causes of CNIV palsy
congenital decompensated
microvascular
tumour
head trauma - bilateral (comes out of brain stem so susceptible to trauma)
what type of double vision is see in CNIV palsy
vertical double vision
images one on top of other
what direction would a patient tilt their head to compensate for a CNIV palsy in the right eye
left
what muscles are innervated by CNIII
Medial rectus inferior rectus superior rectus inferior oblique spinchter papillae Levator palpebral superiors
what does a CNIII palsy look like
eyes are in a ‘down and out’ position as the lateral rectus and superior oblique are still working
what causes a CNIII palsy
microvascular tumour aneurysm MS (demyelinating disease) Congenital
what is inter-nuclear opthalmoplegia
problems with grey matter pathways in the Brian stem rather than the nerves themselves
what allows the eyes to work together (look in the same direction at same time and speed
inter-nuclear pathways in the brainstem
what happens when there’s damages to the internuclear pathways in the brain stem
there is a lack of coordination within the eyes
eye jerks in the direction it thinks its meant to go to follow the good one as signals are still being fired down the nerves
causes of inter-nuclear opthalmoplegia
MS
Vascular - stroke
key stages in the optic pathways
optic nerve optic chasm optic tracts optic radiations cortex
damage to what part of the optic pathway leads to macular sparing
cortex
what are some causes of optic pathway problems
vascular disease
SOL
Demyelination
Trauma
where is the pathology if bitemporal hemiopia is seen
optic chiasm
where is the pathology if one whole eye looses its visual fields
in the optic nerve or eye
where must the pathology be if the visual field is missing quadrants
optic radiations
