Flashcards on Neuro-ophthalmology

Here are flashcards with basic neurology questions. Click on the cards for more information or if you’d like to leave a comment.

How do you diagnose and treat giant cell arteritis?

Diagnoses is by symptoms (temple pain, jaw claudication, polymyalgias, malaise), labs (ESR, CRP, PLT) and temporal artery biopsy. Treatment is steroids.

What’s a Marcus-Gunn pupil?

This is simply a relative afferent pupillary defect (RAPD).

What is a Horner’s pupil?

This is loss of sympathetic tone to the eye that makes the pupil small. It can be caused by tumors or lesions along the sympathetic chain.

What is an Adie’s pupil?

An Adie’s pupil is a dilated pupil caused by paralysis of the parasympathetics that normally constrict the pupil.

What imaging study is best for orbit, apex, and brain?

CT is best for orbit and bone injuries. MRI is best for looking at the brain.

Where do the cranial nerve nuclei sit in the brain?

The 4-4 rule can be used to figure out the location of the nuclei. You’ll need to click the more button to figure this one out.

What kind of workup would you perform for optic neuritis?

You need to consider multiple sclerosis and order an MRI to look for demyelinating lesions.

How does optic neuritis present?

Loss of vision, decreased color vision and contrast sensitivity. Central vision loss is common and some pt’s have pain with eye movement.

What’s the significance of pupil involvement with oculomotor nerve paralysis?

A 3rd nerve palsy with pupil involvement implies a compressive lesion (such as an an aneurysm or tumor) pushing on the nerve.

What does a sixth nerve palsy look like, and what causes it?

6th nerve palsies make the eye turn inward and can occur from HTN, DM, tumor, and high intracranial pressure.

What does a fourth nerve palsy look like and what causes it?

4th nerve palsies are hard to detect. They cause a mild vertical diplopia and can occur from DM, HTN, tumor, congenital damage, and mild head trauma.

What does a third-nerve palsy look like and what causes it?

3rd nerve palsies make the eye turn down and out. Causes include DM and HTN. A blown pupil implies tumor or aneurysm.

What should you first check with a patient complaining of diplopia?

Whether the diplopia is monocular (astigmatism or cataract) or binocular (nerve palsies, etc.)

What symptoms might a patient with temporal arteritis complain of?

Headaches, scalp tenderness, malaise, weight loss, night sweats, fevers, jaw claudication and muscle aches.

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