8: Eye in neurological disease Flashcards Preview

Ophthalmology Week 2 2017/18 > 8: Eye in neurological disease > Flashcards

Flashcards in 8: Eye in neurological disease Deck (31)
Loading flashcards...
1
Q

What are the cardinal features of neurological eye disease?

A

Problems with eye movement - e.g diplopia

Visual field defects - test visual acuity and fields

2
Q

What causes neurological eye disease?

A

VASCULAR DISEASE!!!

Space occupying tumours

Trauma

Demyelinating diseases

Inflammation

Infection

3
Q

Which scan is used to check the brain for vascular disease and space occupying lesions?

A

MRI head

4
Q

Which mnemonic tells you the cranial nerve supplies to the extraocular muscles?

A

LR6 SO4 AO3

5
Q

Apart from elevation and depression, what do the oblique muscles do?

A

Superior oblique causes INTORSION

Inferior oblique causes EXTORSION

6
Q

Which cranial nerve palsy produces a medial manifest squint?

A

CN VI palsy

7
Q

What symptom does CN VI palsy produce?

A

Diplopia

8
Q

Patients with a CN VI palsy poorly (abduct / adduct) the affected eye.

A

abduct

9
Q

What most commonly causes a CN VI nerve palsy?

A

Raised ICP secondary to a vascular problem

10
Q

CN VI is compressed by raised ICP producing a palsy.

What sign is seen in the eye?

A

Medial manifest squint

Papilloedema

11
Q

What symptoms does a CN IV palsy cause?

A

Diplopia when looking DOWN (impaired depression)

Compensatory HEAD TILT due to intorsion

12
Q

In CN IV palsy, which direction does the affected eye look in the central position?

A

Upwards

13
Q

Why do patients with a CN IV palsy tilt their heads?

A

Superior oblique normally intorts the eye

So head tilt to compensate for that not working

14
Q

What is the most common cause of a CN IV palsy?

A

Congenital defcts

15
Q

What are common causes for any nerve palsy?

A

Microvascular

Tumour

Trauma

16
Q

What two muscles apart from the extraocular ones does a CN III palsy affect?

A

LPS

Sphincter papillae

17
Q

What position does the eye sit in due to CN III palsy?

Why?

A

DOWN AND OUT

Only lateral rectus and superior oblique are working

18
Q

What is the most common cause of CN III palsy?

A

Microvascular problems

19
Q

If a CN III palsy is painful what do you need to strongly suspect?

A

Aneurysm

20
Q

Life-threatening CN III palsies are caused by ___.

A

aneurysm

21
Q

6th raised icp

4th congenital, trauma

3rd aneurysm

A
22
Q

What is an example of a demyelinating disorder which causes visual loss?

A

MS

23
Q

Lesions before the optic chiasm cause which kind of visual field loss?

Lesions at the optic chiasm?

Lesions after?

A

Monocular vision loss

Bitemporal hemianopia

Loads of symmetrical visual losses e.g homonymous hemianopia. quadrantanopias etc.

24
Q

What is ischaemic optic neuropathy?

A

Optic nerve damage due to vascular causes

25
Q

What are the symptoms of optic neuritis?

A

Progressive unilateral visual loss

Pain on eye movement

Loss of colour vision

Scotoma (loss of central vision)

26
Q

Is optic neuritis reversible?

A

Yes, gradually

27
Q

What does a pale disc indicate?

A

Optic atrophy

28
Q

What causes bitemporal hemianopia?

A

Almost always pituitary tumours

29
Q

Is visual loss due to compression irreversible?

A

Not always

30
Q

Which compressions give you homonymous visual field losses?

A

Those AFTER optic chiasm

31
Q

What is the most common cause of visual field defects which should be eliminated along with space occupying tumours?

A

Vascular disease