Questions:
29. In a comatose patient, you observe dysconjugate horizontal eye movements when the head is rotated from side to side. What does this suggest?
30. What is the most common cause of unilateral proptosis?
31. What is the most common cause of bilateral proptosis?
32. Which is the most commonly involved extraocular muscle in thyroid eye disease?
33. What is the differential diagnosis of enlarged extraocular muscles?
34. On CT or MRI, which condition spares the insertions of the extraocular muscles, thyroid eye disease or idiopathic orbital inflammation (orbital pseudotumor)?
35. What 4 features differentiate idiopathic orbital inflammation (orbital pseudotumor) from thyroid eye disease?
36. When should a biopsy be done in a patient with presumed “myositis”
37. What tests should be done in all patients over age 50 with transient or permanent diplopia?
38. What is the Silent Sinus Syndrome?
39. What is the Kearns-Sayre syndrome?
40. What are 5 mitochondrial diseases that can have ophthalmoplegia?
41. What are the features of Myotonic Dystrophy?
42. What are 5 features of Oculopharyngeal Dystrophy?
43. What 3 conditions other than paresis or restriction should be considered in any adult with new-onset transient or permanent ocular misalignment?
44. What may induce myasthenia gravis or make it worse?
45. What is the mechanism of action of edrophonium?
46. What are the side effects of the Tensilon test?
47. What does the development of lid retraction in a patient with Myasthenia suggest?
Archives for November 2019
Neuro-ophthalmology Illustrated Chapter 13 – Diplopia 3 – Binocular Diplopia
Neuro-ophthalmology Illustrated Chapter 13 – Diplopia 2 – Assessment
Questions:
13. How is Bell’s phenomenon checked in normal patients?
14. What is the localization of the lesion in a patient when Bell’s phenomenon is preserved despite an upgaze paresis?
15. What is the localizing value of abnormal eye movements that are overcome by oculocephalic maneuvers?
16. What symptom is usually noted by a patient with convergence insufficiency?
17. A patient presents with a history of the onset of diplopia 3 weeks ago. What should be the first characteristic of the diplopia determined?
18. Your exam confirms that a patient has binocular diplopia, but on exam the extraocular movements appear full. What must be present?
19. Your exam confirms that a patient has patient binocular diplopia, but on exam the extraocular movements appear full. What tests will be helpful in demonstrating the misalignment?
20. What will the cross-cover test detect that the cover-uncover test will not detect?
21. When is a phoria pathologic and not physiologic?
22. Is the 3-step-test useful in horizontal or vertical binocular diplopia?
23. What reflex is involved in the third step of the 3-step-test?
24. With the red Maddox rod placed between a light source and the eye, what does the eye see?
25. Why would one perform the double Maddox Rod test?
26. When are the Hirschberg and Krimsky tests useful?
27. How is the Hirschberg test performed?
28. How is the Krimsky test performed?
Neuro-ophthalmology Illustrated Chapter 13 – Diplopia 1 – Basics
Questions:
1. What 5 anatomical components involved in eye movement can cause binocular diplopia?
2. What holds the image steady during brief head movements?
3. What holds the image steady during sustained head movements?
4. What is Sherrington’s law?
5. What is Hering’s Law?
6. What 2 processes cause most incomitant strabismus?
7. What is the primary deviation in incomitant strabismus?
8. What is the secondary deviation in incomitant strabismus?
9. Is the primary or secondary deviation larger in incomitant strabismus?
10. Does a phoria or a tropia have more value in localizing the defect in a patient with new-onset binocular diplopia?
11. What is the difference between the terms “ocular motor” and “oculomotor”?
12. What 3 techniques can help determine if an ocular misalignment is due to a restriction or paresis?
Neuro-ophthalmology Illustrated Chapter 12 – The Pupil 5
Questions:
42. What is a tadpole pupil?
43. What are 6 causes of light-near dissociation?
44. What is the Argyll Robertson pupil and where is its lesion located
45. What is the mechanism in light-near dissociation due to Argyll Robertson pupils?
46. Where is the lesion in a patient with light-near dissociation due to Adie tonic pupil?
47. What is the mechanism in light-near dissociation due to aberrant regeneration of the 3rd nerve?
48. What is the mechanism in light-near dissociation due to severe vision loss?
49. What is the mechanism in light-near dissociation due to laser panretinal photocoagulation or cryotherapy?
50. Where is the lesion in a patient with light-near dissociation due to peripheral neuropathy?