Archives for July 2017

Neuro-ophthalmology Questions of the Week-Optic Neuropathy Patient Evaluation


1. Are some maculopathies associated with mild optic nerve pallor?
2. Can maculopathies have dyschromatopsia?
3. In evaluating optic neuritis, when should a lumbar puncture for CSF analysis be considered?

(a) Isolated right inflammatory optic neuropathy. There is a large central scotoma seen as diffuse depression on a 24–2 Humphrey visual field test.
(b)Coronal and axial T1-weighted magnetic resonance imaging with fat suppression and contrast showing enhancement of the orbital portion of the right optic nerve(arrow).

Neuro-ophthalmology Question of the Week: Optic Neuropathies Introduction

1. In acute optic neuropathy, how long after onset does the optic nerve head become pale?
2. When is electrophysiologic testing useful in acute optic neuropathies?
3. What does a painful orbital apex syndrome in a diabetic patient suggest?


Neuro-ophthalmology Questions of the Week-Ocular Vascular Disease


  1. What may develop in patients with severe stenosis or occlusion of the ipsilateral common carotid artery or internal carotid artery and poor collateral circulation?
  2. What condition should venous stasis retinopathy, or hypotensive retinopathy, suggest?
  3. What are the symptoms of the ocular ischemic syndrome?
  4. What are signs of the ocular ischemic syndrome?
  5. What is the prognosis of the ocular ischemic syndrome?
  6. What should be ruled-out in a patient who has a rapidly worsening ocular ischemic syndrome?
  7. What should be checked in all patients with headache and bilateral optic nerve swelling?
  8. What 10 classic systemic disorders are associated with retinal vasculitis?
  9. Is radiation retinopathy a chronic, painless, progressive retinal vasculopathy?
  10. Radiation retinopathy may be unilateral or bilateral and occur months or years after radiotherapy. True or False?
  11. Radiation retinopathy is more common in patients with underlying retinal vascular disease (e.g., hypertension or diabetes). True or False?
  12. What are 5 key findings of radiation retinopathy?
  13. What are 6 Complications of radiation retinopathy?
  14. What is the chief feature of Purtscher retinopathy?
  15. What is the significance of bilateral retinal vascular tortuosity?
  16. What are 2 retinal vascular malformations?


Neuro-ophthalmology Questions of the Week-Retinal Ischemia

1. What should be done for a patient with monocular vision loss, not due to nonarteritic anterior ischemic optic neuropathy, arteritic anterior ischemic optic neuropathy, or other ophthalmologic disease, but with branch or central retinal artery occlusions or amaurosis fugax?
2. What should be considered if a central artery is associated with pain?
3. What is the most common cause of ophthalmic artery occlusion?
4. What are the findings from ophthalmic artery occlusion
5. What finding seen in acute central artery occlusion is not seen with acute ophthalmic artery occlusion?
6. What work-up should be done when retinal emboli are found in an asymptomatic patient?
7. What is the appearance of cholesterol emboli?
8. What are common sources for cholesterol emboli?
9. What is the appearance of talc emboli?
10. What condition is associated with talc emboli?
11. In a patient with acute retinal ischemia what tests should be ordered for thrombophilia?


Neuro-ophthalmology Recommended Reading – Seesaw Nystagmus – with video
Recommended by Yaping Joyce Liao, M.D., Ph.D.

A 52-year-old man presented to the emergency department with a 1-year history of headache and reduced visual acuity. Physical examination showed seesaw nystagmus; a …