neuro-ophthalmology [email protected]
DESCRIPTION
Neuro-ophthalmology [email protected]. a semi-interactive tutorial to be used with the online files; downloaded versions can be downloaded from here into the same folder. They are .exe files and should play on all laptops. Neuro-ophthalmology. - PowerPoint PPT PresentationTRANSCRIPT
Neuro-ophthalmology [email protected]
a semi-interactive tutorial to be used with the online files;
downloaded versions can be downloaded from here into the same folder. They are .exe files and should play on all laptops
Neuro-ophthalmology
Dilated pupil/ptosis/divergent eye= 3rd n palsy Vertical diplopia = 4th nerve palsyOne eye convergent = 6th nerve palsy7th nerve palsyDilated pupil/normal sight = adies pupil Dim vision one eye = optic neuritis (rarely tumour)Field defects
3rd nerve palsy
Common symptoms, 3rd button
3rd nerve palsy
3rd nerve palsy
Online, chronic eye disease, section 3 (3rd ‘?’ down on left) 2mb
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All recti except superior oblique and lateral rectus paralysed
4th nerve palsy
Online, chronic eye disease, section 3 (3rd ‘?’ down on left) 2mb
Folder similar
Superior oblique palsy: vertical diplopia
6th nerve palsyOnline, chronic eye disease, section 3
(3rd ‘?’ down on left) 2mb
Folder similar
Lateral rectus palsy
7th nerve palsy
Try and think, in pairs, 1 minute
Causes
Problems
What is the route of the 7th nerve?
7th nerve palsy
lesions
Bells palsy, possibly herpes simplex
Ramsay-Hunt with rash: herpes zoster
Upper motor neurone…forehead symmetrical
Detailed description
7th nerve palsy
Runs over petrous part of temporal bone…6,7,8th palsy
Herpes zoster: look in ear for vesicles
7th nerve palsy: eye problems
Dry cornea
can ulcerate
Use fluorescein for examination
Lubricate +++
Occasionally suture lids closed.
Serious problem for acoustic neuroma patients
Nystagmus
Involuntary eye movement…
Slow movement is the ‘problem’
Fast is the recovery
If worse looking straight, generally a central lesion
If worse looking to one side, generally vestibular online (section 12, double vision and pupil, 3 top
‘?’right)
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Optic atrophy
Think, again in pairs, about what may cause optic neuritis
Infection, genetic, toxic, vascular, nutritional, other diseases
Optic atrophy, photos
Optic atrophy, causes
Dim sight
Reduced visual field
CausesPernicious anaemia…B12 deficiencyCongenital..eg LebersToxic…methanol, smoking, poor diet
Optic atrophy, case
A 43y woman complains of a mild headache (left forehead). The headache has been present 2 months, and is not getting better.
As you listen she tells you the sight is dim in left eye.Examination confirms red colours in the left eye are
not as bright as when seen with the right eye. CT scan details:
(Further examination may show a pale optic disk and afferent pupillary defect, and visual field defect, but even without these findings a CT scan is needed.)
Field defects
Quiz…with each lesion, what would the field draw the field…in pairs.
AnswersOnline (tiny) folder
Here 1
Here 2
Here 3
Here 4(small, lower
occipital)