Term
| Name the 4 sections of the optic nerve |
|
Definition
Intraocular
Intraorbital
Intracanalicular
Intracranial |
|
|
Term
| Describe a malinserted disc |
|
Definition
| Instead of inserting at 90 degrees the disc inserts at an angle. The nasal portion of the disc will be more raised than the temporal portion. |
|
|
Term
|
Definition
| The disc comes in at an angle both horizontally and vertically |
|
|
Term
| 3 parts of the optic nerve head blood supply |
|
Definition
Short posterior ciliary arteries
Recurrent choroidal vessels
Pial arterial network |
|
|
Term
| What section of the optic nerve contributes to the pain experienced with eye movements in optic neuritis |
|
Definition
| The bend in the intracanalicular region can put pressure on an inflamed nerve. |
|
|
Term
| What color is bone on CT scans |
|
Definition
|
|
Term
| What color is blood on MRIs |
|
Definition
| Black, since it is flowing quickly |
|
|
Term
| Name 4 signs of optic neuropathy |
|
Definition
Reduced VA
Decreased color vision
RAPD
Visual field defects |
|
|
Term
| 3 ways the optic disc may change with optic neuropathy |
|
Definition
|
|
Term
| Signs of optic nerve swelling |
|
Definition
blurring of surrounding NFL
Obscuration of BV at edge of disc
Hyperemia
Loss of SVP
Hemorrhages
cotton wool spots
hard exudates |
|
|
Term
| Signs of optic disc atrophy |
|
Definition
sectoral or diffuse pallor
attenuation of retinal arteries
cupping
NFL loss |
|
|
Term
Name 5 causes of temporal optic disc pallor
|
|
Definition
Toxic ON
Nutritional ON
Autosomal dominant ON
Leber's hereditary ON
Optic neuritis |
|
|
Term
| Common cause for superior/inferior disc pallor |
|
Definition
|
|
Term
| Cause of bilateral band/bow tie atrophy |
|
Definition
| Problems with optic chiasm |
|
|
Term
| Cause of unilateral band/bow tie disc atrophy |
|
Definition
|
|
Term
Macular Dysfxn vs. Optic Neuropathy
Effects on visual acuity |
|
Definition
| Will be markedly reduced with macular but can be variable with ON |
|
|
Term
Macular Dysfxn vs. Optic Neuropathy
Characteristics of Vision |
|
Definition
Macular-metamorphopsia and reduced in low and bright light
ON-central cloud scotoma |
|
|
Term
Macular Dysfxn vs. Optic Neuropathy
RAPD |
|
Definition
| Absent with macular dysfxn unless extremely advanced and present with ON |
|
|
Term
Macular Dysfxn vs. Optic Neuropathy
Which tends to have more affected color vision |
|
Definition
ON have very reduced color vision,
Macular only slightly reduced |
|
|
Term
Macular Dysfxn vs. Optic Neuropathy
Which tends to cause change in refractive error? |
|
Definition
Macular-possible hyperopic shift
ON-unchanged |
|
|
Term
Macular Dysfxn vs. Optic Neuropathy
Which tends to also have proptosis, ptosis and EOM problems |
|
Definition
|
|
Term
| How may optic atrophy be differentiated from glaucoma? |
|
Definition
The cup may get larger/rim get smaller in both, however in glaucoma the remaining rim will be pink but pallorous in optic atrophy.
Only get notching with glaucoma. |
|
|
Term
| Name 3 forms of optic neuropathy that can be diagnosed clinically with no further testing |
|
Definition
Optic neuritis
Glaucoma
AION |
|
|
Term
| You suspect an optic neuropathy is not due to a disease that can be diagnosed clinically. Name 6 more tests you can do to narrow down the diagnosis |
|
Definition
Blood pressure
Lumbar puncture
Blood Tests
Temperature
Urine Analysis
Neuroimaging |
|
|
Term
- Suspect syphilis, what blood tests do you run
|
|
Definition
|
|
Term
| Suspect Systemic Lupis erythematosus, which blood test do you run |
|
Definition
|
|
Term
| Suspect sarcoidosis, which blood test do you run |
|
Definition
|
|
Term
| You suspect nutritional optic neuropathy, name 2 blood tests you would want to run |
|
Definition
RBC folate
Serum Vitamin B12 |
|
|
Term
| You suspect renal failure, which blood tests would you run |
|
Definition
|
|
Term
|
Definition
|
|
Term
| 2 specifications to make when ordering MRI |
|
Definition
-Brain and Orbits
-With and without contrast |
|
|
Term
| 4 important aspects of information to be taken from a lumbar puncture |
|
Definition
Opening pressure
CSF biochemistry
CSF microbiology
CSF cytology |
|
|
Term
| Using disc diameters to measure distance between disc and macula, what number indicates nerve hypoplasia |
|
Definition
|
|
Term
T or F
The majority of optic nerve hypoplasia cases are bilateral |
|
Definition
|
|
Term
| The absence of what neural structure is often associated with optic nerve hypoplasia |
|
Definition
| septum pellucidum (separates the 2 hemispheres) |
|
|
Term
| How may optic nerve hypoplasia affect the optic nerve |
|
Definition
| attenuation of intracranial optic nerves or chiasm |
|
|
Term
| Name 3 structures that are commonly abnormal with ON hypoplasia |
|
Definition
Third ventricle
Cerebral hemispheres
Corpus callosum |
|
|
Term
|
Definition
| abnormalities of the 3rd ventricle |
|
|
Term
| 4 types of neurological conditions associated with optic nerve hypoplasia |
|
Definition
Developmental delays
Seizures
Cerebral palsy
Endocrine deficiency |
|
|
Term
| Which optic nerve hypoplasia tends to happen to babies born to insulin-dependent mothers |
|
Definition
|
|
Term
| Which portion of the optic nerve tends to be affected by segmental hypoplasia |
|
Definition
| Superior portion, leading to inferior field loss |
|
|
Term
|
Definition
|
|
Term
| VF results common with megalopapilla |
|
Definition
|
|
Term
| Distance between disc and macula with megalopapilla, in disc diameters |
|
Definition
|
|
Term
Disease?
Center of disc is recessed
white tuft in center
BV come from edge rather than center of disc
Straight vessel pattern |
|
Definition
| Morning Glory disc anomaly |
|
|
Term
| Describe the appearance of blood vessels with morning glory disc anomaly |
|
Definition
Seem to come from edge of disc rather than center
Straight pattern
Seem to have a lot more blood vessels |
|
|
Term
| VA with morning glory disc anomaly |
|
Definition
| Poor, 20/200 to finger counting |
|
|
Term
| 3 complications of morning glory disc anomaly |
|
Definition
Serous retinal detachment
Subretinal neovascularization
Hypoplasia of intracranial vasculature (vessels thin) |
|
|
Term
| Visual field results associated with peripapillary staphyloma |
|
Definition
|
|
Term
| Way to differentiate morning glory from peripapillary staphyloma |
|
Definition
Staphyloma does not have abnormal blood vessel pattern, they appear to come from the center like normal.
The cup will still be excavated in both |
|
|
Term
| Which portion of optic disc are more affected in colobomatous optic disc |
|
Definition
| Superior will look normal, inferior will look abnormal |
|
|
Term
| 3 Complications of Colobomatous Optic Disc |
|
Definition
Serous macular detachment
Rhegmatogenous retinal detachment
Multi-systemic genetic disorders |
|
|
Term
| Common complication of a congenital optic pit |
|
Definition
| Serous macular edema (in 52%) |
|
|
Term
| Visual field defect associated with congenital tilted disc |
|
Definition
| Bilateral superior temporal defects |
|
|
Term
| Congenital Tilted Discs need to be differentiated from what neurological condition |
|
Definition
| Pituitary tumour- given the superior temporal VF defect |
|
|
Term
| How may the VF defects of tilted disc be differentiated from a pituitary tumour |
|
Definition
| Those from tilted disc will not respect the midline, those from a tumour will. |
|
|
Term
| 3 complications from tilted disc |
|
Definition
Myopic astigmatism
Neovascularization
Serous retinal detachment |
|
|
Term
| Common white pattern that follows NFL and has scalloped borders that end in a fan-shape |
|
Definition
| Myelinated nerve fiber layer |
|
|
Term
True or false
The majority of myelinated nerve fiber layer cases are bilateral
|
|
Definition
|
|
Term
| Name some good tests for visualizing disc drusen |
|
Definition
B ultrasound
OCT
slit lamp-red free
CT-unneccesary to do just for disc drusen |
|
|
Term
| Calcified axonal debris that appear as round, irregular, whitish/yellow globs generally at disc margin |
|
Definition
|
|
Term
| 2 types of disc drusen and which causes more VF defects |
|
Definition
Buried and Visible
More likely to cause defects when visible |
|
|
Term
| VF defects associated with optic disc drusen |
|
Definition
Inferior/Inferior nasal arcuate defects
Concentric constriction
Enlarged blind spot |
|
|
Term
Pseudopapilledema vs. optic disc edema
Location of elevation |
|
Definition
Pseudo-confined to disc
Edema-elevated NFL |
|
|
Term
Pseudopapilledema vs. Optic Disc Edema
Apperance of NFL |
|
Definition
Pseudo-sharp NFL
Edema-obscured NFL |
|
|
Term
Pseudopapilledema vs. Optic Disc Edema
Disc vasculature |
|
Definition
| Anomalous in pseudo but normal in edema |
|
|
Term
Pseudopapilledema vs. Optic Disc Edema
Presence of exudates
|
|
Definition
None in pseudo
Exudates and cotton wool spots in Edema |
|
|
Term
Pseudopapilledema vs. Optic Disc Edema
Presence of venous congestion |
|
Definition
None in pseudo
Venous congestion in Edema |
|
|
Term
Pseudopapilledema vs. Optic Disc Edema
Presence of circumpapillary light reflex |
|
Definition
| present in pseudo, not present in edema |
|
|
Term
Pseudopapilledema vs. Optic Disc Edema
Presence of Spontaneous Venous Pulsation |
|
Definition
| Absent with edema, may or may not have it with pseudo |
|
|
Term
|
Definition
| about 80% of people have it |
|
|
Term
| 4 Complications of Optic Disc Drusen |
|
Definition
Pre/peri papillary hemorrhages
ischemic optic neuropathy
retinal vascular occlusion
peripapillary subretinal neo |
|
|
Term
| How is disc drusen managed? |
|
Definition
| Just monitored for VF changes, possibly given brimonidine for neuroprotection |
|
|
Term
| Normal result for lumbar puncture |
|
Definition
|
|
Term
| 3 descriptions of patients most commonly diagnosed with Intracranial Idiopathic Hypertension |
|
Definition
Obesity
Women
Child-bearing age |
|
|
Term
| Name for condition that matches Idiopathic Intracranial Hypertension but with a known cause |
|
Definition
|
|
Term
| Name 5 Metabolic/Systemic Symptoms known to cause pseudotumour cerebri |
|
Definition
Pregnancy
Hypo-hyperthyroidism
anemia
sleep apnea
systemic hypertension |
|
|
Term
| Name 4 Medications known to cause Pseudotumour cerebri |
|
Definition
Corticosteroids
Tetracyclines
Cyclosporine
Retinoids (vit A and isotretinoin) |
|
|
Term
| Describe the headaches associated with IIH |
|
Definition
pulsatile
worse in am
not localized
worse with straining/coughing/postural changes
improve with lumbar puncture (temporarily) |
|
|
Term
|
Definition
HEADACHES
Nausea & Vomiting
Pulsatile Tinnitus
Dizziness |
|
|
Term
| Visual Symptoms associated with IIH |
|
Definition
Transient Visual obscurations
Horizontal diplopia (CN VI)
Photophobia |
|
|
Term
| Effect of IIH on VA, RAPD and color vision |
|
Definition
|
|
Term
| Effects of IIH on visual field |
|
Definition
Enlarged blind spot (>90%)
arcute, central, paracentral, altitudinal
Overall restriction with late dz |
|
|
Term
Papilledema vs. AION vs. Optic neuritis
Which is bilateral |
|
Definition
| Just papilledema, others are generally unilateral |
|
|
Term
Papilledema vs. AION vs. Optic neuritis
effect on VA |
|
Definition
| Abruptly reduced with AION and ON but spared in papilledema |
|
|
Term
| Visual field defect associated with AION |
|
Definition
|
|
Term
| Visual field defect with Optic neuritis |
|
Definition
|
|
Term
Papilledema vs. Compressive Optic Neuropathy vs. Infiltrative Optic Neuropathy
Laterality |
|
Definition
Papilledema and Infiltrative Optic neuropathy
are bilateral
Compressive optic neuropathy is unilateral |
|
|
Term
Papilledema vs. Compressive Optic Neuropathy vs. Infiltrative Optic Neuropathy
Effect on VA |
|
Definition
Spared in papilledema
Gradual loss in compressive
Abruptly reduced with infiltrative |
|
|
Term
| What symptoms may be associated with infiltrative optic neuropathy |
|
Definition
Unilateral, abrupt VA reduction
Other cranial neuropathies
Generalized depression of VF |
|
|
Term
| Presence of SVP rules out what sign of IIH |
|
Definition
|
|
Term
| What test should never be done before neuroimaging |
|
Definition
|
|
Term
| When doing an MRI with contrast to confirm a suspected case of IIH what do you look for? |
|
Definition
empty sella
Dilation of ON sheath
Flattening of posterior globe |
|
|
Term
| 3 tests to confirm IIH (outside of optometry clinic) |
|
Definition
|
|
Term
| What lumbar puncture results would confirm a case of IIH |
|
Definition
|
|
Term
| When doing MRV to confirm a suspected case of IIH what do you look for? |
|
Definition
Look for thrombosis
and
dissappearance of vessels anywhere along their pathway |
|
|
Term
| 5 methods of managing IIH |
|
Definition
Alleviate symptoms
Eliminate secondary cause
WEIGHT LOSS
medications
surgery |
|
|
Term
| Type and name of medication used to lower ICP |
|
Definition
Oral Carbonic Anhydrase Inhibitor
Acetazolamide 1-4 g/day |
|
|
Term
| 3 MEdications for treating IIH in addition to Acetazolamide |
|
Definition
Methazolamide
Spironolactone
Triamterene |
|
|
Term
| 6 SE of Carbonic anhydrase inhibitors |
|
Definition
Paresthesias
Lethargy
Altered taste
allergy
aplastic anemia
kidney stones |
|
|
Term
| 2 Surgical methods of treating IIH |
|
Definition
Optic nerve sheath decompression
Ventriculoperitoneal/lumbarperitoneal shunt |
|
|
Term
| Name 2 symptoms that if accompanying papilledema will automatically rule out the diagnosis of IIH |
|
Definition
Reduced VA
Visual field defects |
|
|
Term
| What is the presenting sign of MS in 20% of patients |
|
Definition
| Demyelinating optic neuritis |
|
|
Term
| Visual Symptoms of Demyelianting Optic Neuritis |
|
Definition
acute loss in one eye
pain worsened with eye movement
photopsia
|
|
|
Term
| 3 systemic symptoms of MS |
|
Definition
Numbness
Vertigo
Loss of balance |
|
|
Term
| 5 Objective Visual signs of Demyelinating Optic Neuritis |
|
Definition
Reduced VA (can still be 20/20 sometimes)
decreased color vision
decreased contrast sensitivity
RAPD
decreased brightness sensation |
|
|
Term
| What portion of Optic neuritis patients have a normal looking disc |
|
Definition
|
|
Term
| Name 5 atypical features whose presence should make you question a diagnosis of optic neuritis |
|
Definition
lack of pain
severe disc edema
peripapillary hemorrhages
macular exudates
Vision of NLP |
|
|
Term
| OCT results in pt with Demyelinating Optic Neuritis |
|
Definition
|
|
Term
| 2 forms of imaging for Demyelinating Optic Neuritis |
|
Definition
|
|
Term
| 2 Best options for medication to treat Demyelinating Optic Neuritis |
|
Definition
IV steroids
No treatment
(both better than oral steroids) |
|
|
Term
| What IV medication may be given to treat Demyelinating Optic Neuritis |
|
Definition
| IV Methylprednisolone 1 g daily for 3 days |
|
|
Term
| Why might a dr still request neuroimaging when they have already confirmed a diagnosis of Demyelinating Optic Neuritis |
|
Definition
| Imaging helps determine prognosis or the chance of developing MS |
|
|
Term
| Correlation between number of brain lesions and chance of progressing to MS |
|
Definition
1 lesion =25%
2 lesions= 50%
3+ lesions =75% |
|
|
Term
| Cause of arteritic vs. non arteritic AION |
|
Definition
Arteritic is caused by GCA, or inflammation of medium sized arteries.
Cause of non-arteritic is mostly idiopathic but is associated with crowded discs and hypoperfusion of the disc. |
|
|
Term
| Another name for Giant cell Arteritis |
|
Definition
|
|
Term
| Describe the onset of NAION |
|
Definition
| Sudden, painless loss of vision upon wakening |
|
|
Term
| Name the 3 types of ischemic optic neuropathy |
|
Definition
AION
PION
Diabetic Papillopathy |
|
|
Term
| What is the most common form of optic neuritis in patients under 40? |
|
Definition
| Demyelinating Optic Neuritis |
|
|
Term
| What is the most common form of optic neuritis in patients over 40 yo |
|
Definition
|
|
Term
| Mean age of onset of NAION |
|
Definition
|
|
Term
| 3 Vasculopathic risk factors for NAION |
|
Definition
Hypertension
Atherosclerosis
Diabetes |
|
|
Term
| What advice should be given to your patient with a crowded disc when they are taking daily blood pressure medication |
|
Definition
| It may be good to recommend that they take their pill only in the morning to avoid the risk of hypoperfusion at night when blood pressure tends to lower. |
|
|
Term
| 2 types of medications associated with NAION |
|
Definition
Amiodarone (arrhythmia)
Erectile dysfunction meds |
|
|
Term
| Name 3 Ocular conditions associated with NAION |
|
Definition
Papilledema
Optic nerve head drusen
Increased IOP
(all things that make the disc more crowded and thus more at risk for hypoperfusion) |
|
|
Term
Radiation
Acute systemic hypotension
Sleep apnea
Are three conditions that are associated with which optic nerve condition |
|
Definition
|
|
Term
| Name 1 differentiating factor between NAION and Demyelinating Optic Neuritis |
|
Definition
|
|
Term
| Three visual defects associated with NAION |
|
Definition
Reduced VA (half are worse than 20/30 to 20/60)
Reduced color vision
Inferior altitudinal visual field defect |
|
|
Term
| For a patient who has experienced sudden loss of vision, name 3 tests that should be done (outside of clinic) and in what order |
|
Definition
ESR and CRP blood tests (STAT)
Neuroimaging if blood tests abnormal
OCT
|
|
|
Term
|
Definition
No treatment for the vision loss, just try to control causative factors.
Take pt off any medication that may be causing it, send to PCP for evaluation
Aspirin |
|
|
Term
| Why is aspirin recommended to NAION pts? |
|
Definition
| Because they are at an increased risk for strokes and heart attacks |
|
|
Term
NAION vs AAION
Which will have cupping? |
|
Definition
|
|
Term
| Rate of progression to bilateral NAION in pts who have it in one eye |
|
Definition
|
|
Term
|
Definition
GIANT CELL ARTERITIS
Polyarteritis nodosa
Wegener's granulomatosus
Systemic Lupus erythematosus
Churg-Strauss
Rheumatoid arthritis |
|
|
Term
|
Definition
|
|
Term
| Systemic symptoms of AAION |
|
Definition
headache on same side as vision loss
jaw claudication
scalp tenderness
flu-type symptoms
|
|
|
Term
| What portinof GCA patients have no symptoms at all? |
|
Definition
|
|
Term
NAION vs AAION
Which has more rapid onset? |
|
Definition
| NAION-it seems sudden cuz they wake up with it |
|
|
Term
| Ocular symptoms of AAION in addition to the vision loss |
|
Definition
Transient visual obscurations
Diplopia |
|
|
Term
| Why might AAION present with diplopia |
|
Definition
| ischemic extraocular muscles cause diplopia to come and go |
|
|
Term
AAION vs. NAION
Which is more likely to be bilateral |
|
Definition
|
|
Term
NAION vs. AAION
Which has worse vision loss? |
|
Definition
AAION
AAION-70-83% worse than 20/200
NAION 75% better than 20/200 |
|
|
Term
| Why may AAION present with low IOP |
|
Definition
| ischemia to ciliary body reduces aqueous production |
|
|
Term
| Most common visual field defect associated with both NAION and AAION |
|
Definition
|
|
Term
| 5 ocular symptoms of AAION |
|
Definition
Vision loss
Decreased color vision
RAPD (if unilateral)
Altitudinal VF defect
Low IOP |
|
|
Term
NAION vs. AAION
Which is associated with a disc at risk? |
|
Definition
|
|
Term
|
Definition
PION
Retinal artery occlusion
Ciliretinal artery occlusion
Peripapillary choroidal ischemia
neovascular glaucoma
EOM/nerve ischemia |
|
|
Term
| 3 Important properties specifically examined in blood tests for AAION |
|
Definition
|
|
Term
| ESR and CRP levels specific for GCA |
|
Definition
>2.45 mg/dL
ESR>47 mm/hr
is 97% specific for GCA |
|
|
Term
| How is platelet count correlated with AAION |
|
Definition
Higher the platelet count the higher the risk of the patient losing vision.
High platelet count is due to thrombocytosis |
|
|
Term
| Name 2 tests done for AAION in addition to blood tests |
|
Definition
Temporal artery biopsy
Fluorescein angiography |
|
|
Term
| Name the first 3 things we worry about when we have a case of AAION in our chair |
|
Definition
Progression to the other eye
Stroke
Myocardial infarction
|
|
|
Term
|
Definition
IV methylprednisone (1g/day 3-5days)
Then oral prednisone 1 mg/kg/day
Low dosde aspirin
Calcium/vit D supplements |
|
|
Term
Chance of AAION progressing to bilateral without treatment
|
|
Definition
HIGH
54-95% w/i hours or days |
|
|
Term
| How long before your patients AAION systemic symptoms will resolve once treatment commences |
|
Definition
|
|
Term
| Prognosis for vision improvement in AAION |
|
Definition
|
|
Term
| Most common cause of inflammatory optic neuritis |
|
Definition
|
|
Term
| 4 Common causes of inflammatory optic neuritis |
|
Definition
Sarcoidosis
Behcets
Sjogren's
Atopic dermatitis |
|
|
Term
| Symptoms of Inflammatory Optic Neuritis |
|
Definition
Progressive vision loss
headache/eye pain |
|
|
Term
| 2 Most common signs of sarcoidosis |
|
Definition
|
|
Term
| Given the most common causes, name tests for diagnosing Inflammatory Optic Neuritis |
|
Definition
ACE
Chest X ray
Gallium scanning
Lacrimal gland/conj biopsy
|
|
|
Term
| Treatment of Inflammatory Optic Neuritis |
|
Definition
| Corticosteroids and other immunosuppressive agents |
|
|
Term
| Prognosis of Inflammatory ON |
|
Definition
| Responds quickly to treatment and 72-90% resolve completely |
|
|
Term
| Noninfectious inflammatory stage of syphillis |
|
Definition
|
|
Term
| Name a parasite that can cause inflammatory optic neuritis |
|
Definition
|
|
Term
| 3 Ocular signs of neurosyphillis |
|
Definition
Severe VA reduction
Optic Neuritis
Cells in vitreous |
|
|
Term
| 5 Serologic tests to order when suspecting Syphillis |
|
Definition
Venereal Disease Research Laboratory
Rapid Plasma Reagin
T. pallidum hemagglutination assay
Fluorescent Treponemal Antibody absorption
HIV |
|
|
Term
| 2 aspects of treatment of Syphillis |
|
Definition
IV penicillin
Repeat VDRL to assess response |
|
|
Term
| Symptoms of Cat-Scratch disease |
|
Definition
|
|
Term
| Signs of Cat scratch disease |
|
Definition
Lymphadenopathy
Neuroretinitis (5%)
Increased antibody titer in serology
Conjunctivitis/Uveitis |
|
|
Term
| Adult treatment of cat scratch disease |
|
Definition
Oral
Ciprofloxacin
Doxycycline |
|
|
Term
| Treatment of Cat Scratch for children |
|
Definition
|
|
Term
| Approx how long should the papillitis take to resolve in cat scratch dz |
|
Definition
|
|
Term
|
Definition
Erythema migrans
Fever
Fatigue
myalgia
(flu-like)
|
|
|
Term
| Optic nerve involvement in Lyme dz |
|
Definition
Anterior/Retrobulbar optic neuritis
Papilledema |
|
|
Term
| serological testing for Lyme dz |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Define Parainfectious Optic Neuritis |
|
Definition
| ON occurring 1-3 weeks after viral infection |
|
|
Term
| Age group most commonly affected by parainfectious ON |
|
Definition
|
|
Term
| CSF analysis in Parainfectious Optic Neuritis |
|
Definition
Lymphocytic pleocytosis
Elevated protein |
|
|
Term
| What is seen on neuroimaging of parainfectious ON |
|
Definition
| Enlargement/Enhancement of optic nerves |
|
|
Term
| Visual prognosis of Parainfectious Optic Neuritis |
|
Definition
|
|
Term
| Approx when does Post-vaccination ON occur? |
|
Definition
| 1-3 weeks after vaccination |
|
|
Term
| Treatment for Post-vaccination ON |
|
Definition
| No treatment, spontaneous recovery |
|
|
Term
| Symptoms of an Optic Nerve Meningioma |
|
Definition
Slow, progressive vision loss
No pain
Headache
diplopia
Proptosis
TVO, esp. with change of gaze |
|
|
Term
| Visual field defects in optic nerve meningioma |
|
Definition
Enlarged blind spot
Reduced mean deviation
generalized constriction |
|
|
Term
| Visual signs of optic nerve meningioma |
|
Definition
Color visin deficiency
RAPD
Proptosis
Limited EOM
Visual field defects |
|
|
Term
| When are choroidal folds a sign to be concerned about and when are they not. |
|
Definition
If the folds are circumferential to the disc they could indicate there is something pressing behind the disc.
However, if they are in straight lines they could just be due to refractive error. |
|
|
Term
| 4 situations when radiotherapy is considered as treatment for ON meningioma |
|
Definition
Lesion extending intracranially
threatens vision in other eye
disfiguring proptosis
progressive vision loss |
|
|
Term
| Treatment of ON Meningioma |
|
Definition
| Radiotherapy, but only when the benefits outweigh the damage caused by radiation |
|
|
Term
| Most common optic nerve tumor |
|
Definition
|
|
Term
| By what time are 90% of optic nerve gliomas discovered |
|
Definition
| by end of second decade, but majority are under 10 when diagnosed |
|
|
Term
| Glioma more common in adults or children? |
|
Definition
|
|
Term
| Prognosis for adult optic nerve glioma |
|
Definition
| Results in blindness and death in a short time (10 months) due to metastasis |
|
|
Term
| 3 Symptoms of Optic Nerve Glioma |
|
Definition
Diplopia
Proptosis
Vision loss |
|
|
Term
| Signs of Optic Nerve Glioma |
|
Definition
Proptosis (94%)
Swollen optic disc
Atrophic optic disc
Optociliary shunt vessels
retinal striae
increased hyperopia |
|
|
Term
| Prognosis of Optic Nerve Glioma in children |
|
Definition
| Good prognosis, benign and stable |
|
|
Term
| Symptoms of Optic Neuropathy with Thyroid Eye Disease |
|
Definition
Bilateral, symmetric, gradual vision loss
Tearing
Irritation
photophobia
Eyelid puffiness
Transient diplopia
|
|
|
Term
| Where may you find localized hyperemia in Optic neuropathy with TED |
|
Definition
| Conjunctival hyperemia over horizontal rectus insertions |
|
|
Term
| Corneal signs of Optic neuropathy with TED |
|
Definition
Superior Limbic Keratoconjunctivitis
Punctate epithelial erosions |
|
|
Term
| Appearance of disc when compressed in TED |
|
Definition
In half of patients:
Swelling
Hyperemia
Pallor
Increased cupping
|
|
|
Term
4 substances analysed (outside of antibodies) in serology tests for thyroid eye dz
|
|
Definition
T4
T3
TSH
TRH (Thyrotropin releasing hormone) |
|
|
Term
| Management of Optic Neuropathy from TED |
|
Definition
Corticosteroids
Immunosuppressives
Orbital decompression
Radiation
Cessation of smoking
Control hormones |
|
|
Term
| 6 Causes of Toxic/Metabolic Optic Neuropathy |
|
Definition
Nutrition
Vitamin B12 deficiency
Cigarette smoking
Alcohol consumption
Exposure to toxins
Medications |
|
|
Term
| Name a Tuberculosis medication known to cause toxic optic neuropathy |
|
Definition
|
|
Term
Name 2 vitamins specifically tested for with toxic/metabolic optic neuropathy
|
|
Definition
|
|
Term
| Which cause of toxic optic neuropathy has the most severe affect on vision, causing nearly complete blindness |
|
Definition
|
|
Term
| Management of toxic/metabolic optic neuropathy |
|
Definition
Hydroxycobalamin Injection
Removal of causative agent |
|
|
Term
| Age range and gender most affected by LHON |
|
Definition
|
|
Term
| Name some factors that may increase the risk of expressing genes for LHON |
|
Definition
Other mutations
Smoking
Alcohol
Crowded disc |
|
|
Term
| Visual symptoms/signs of LHON |
|
Definition
Painless, bilateral, symmetric visual acuity loss -->20/200
Reduced color vision
Central/ceco central defects, spares periphery
|
|
|
Term
True or False
Both glaucoma and LHON can cause cupping |
|
Definition
|
|
Term
| Which gender passes on the mutated gene that causes LHON |
|
Definition
| Women pass it on, men do not |
|
|
Term
True or False
All LHON cases have the same visual prognosis regardless of the causative mutation |
|
Definition
| False, some mutations have a better prognosis than others |
|
|
Term
| The most common HEREDITARY optic neuropathy |
|
Definition
| Autosomal Dominant Optic Atrophy |
|
|
Term
| average age of onset of autosomal dominant optic atrophy |
|
Definition
|
|
Term
| Symptomso f Autosomal Dominant Optic Atrophy |
|
Definition
|
|
Term
| Visual acuity range of Autosomal Dominant optic Atrophy |
|
Definition
20/20 to 20/800
However 40% are better than 20/60 |
|
|
Term
| Treatment of autosomal dominant optic atrophy |
|
Definition
|
|
Term
T or F
Prognosis of Autosomal Dominant Optic Atrophy is proportional to initial vision loss |
|
Definition
|
|
Term
| Most common cause of traumatic optic neuropathy |
|
Definition
| Motor vehicle and bicycle accidents |
|
|
Term
|
Definition
| The escape of blood from ruptured vessels into subcutaneous tissues, hemorrhagic spot, larger than petechia |
|
|
Term
| Name 7 signs of ocular trauma |
|
Definition
Orbital rim fracture
Hyphema
Blood in vitreous
Commotio retinae
Angle recession
Dislocated lens
Resistance to retropulsion |
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