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Neuro-ophthalmology Question of the Week: Anisocoria Greater in Darkness

November 30, 2016 By

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Question:
A patient presents with 1 mm of anisocoria with the left pupil being larger. Your examination of the pupils reveals: 1. each pupil reacted briskly to light, 2. the swinging flashlight test was normal, 3. the anisocoria was greater in a very dim room, and 4. at 15 seconds after dimming the room lights the right eye has not completed its dilation.

Which of the following possibilities should be considered?

  1. Adie’s pupil
  2. Horner’s syndrome
  3. Chemical blockade
  4. Iris sphincter damage

Neuro-ophthalmology Question of the Week: Anisocoria – One Pupil Sluggish to Light Stimulus

November 23, 2016 By

Question: A patient presents with anisocoria. Examination of the pupils reveals that the right pupil reacted briskly to light, whereas the larger left pupil was very sluggishly reactive.

Which of the following possibilities should be considered?

  1. Adie’s pupil
  2. 3rd nerve palsy
  3. Chemical blockade
  4. Iris sphincter damage

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Neuro-ophthalmology Question of the Week: Anisocoria Causes

November 16, 2016 By

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Question: Which of the following may cause anisocoria?

1. Normal physiology
2. A deficit of sympathetic innervation
3. A deficit of parasympathetic innervation
4. 3rd nerve paresis
5. Trauma
6. Congenital anomalies
7. Pharmacologic agents
8. Exposure to plant material

Neuro-ophthalmology Question of the Week: Emergency Department Evaluation of Anisocoria

November 9, 2016 By

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Question:

Describe the appropriate steps to take in the emergency department when evaluating  anisocoria.

Neuro-ophthalmology Question of the Week: Emergency Department Evaluation of Ptosis

November 2, 2016 By

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a. Photograph of the patient showing right partial ptosis. The left lid shows compensatory lid retraction because of equal innervation of the levator palpabrae superioris (Herring’s law).
b. Post tensilon test: Note the improvement in ptosis.

Question: Describe the appropriate steps to take  in the emergency department when evaluating  ptosis of recent onset.

Neuro-ophthalmology Question of the Week: Emergency Department Evaluation of Bilateral Disc Edema

October 26, 2016 By

Question: Describe the appropriate steps to take in the emergency department when evaluating bilaterally swollen discs.

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Neuro-ophthalmology Question of the Week: Emergency Department Evaluation of Diplopia

October 19, 2016 By

Question: Describe the appropriate steps to take in evaluating diplopia in the emergency department.

Neuro-ophthalmology Questions of the Week: Anisocoria-Horner Syndrome Value of Imaging

October 12, 2016 By

Questions:

  1. When the etiology of Horner syndrome is not known at the initial neuro-ophthalmologic examination, but sufficient information is obtained to allow targeted imaging, how often is an etiology discovered?
    a. In about 90%
    b. In about 60%
    c. In about 30%
    d. In about 10%
  1. When the etiology of Horner syndrome is not known at the initial neuro-ophthalmologic examination, and sufficient information is not obtained to allow targeted imaging, how often is an etiology discovered?
    a. In about 90%
    b. In about 60%
    c. In about 30%
    d. In about 10%
  1. What are the two most common causes of Horner syndrome when the cause is not known at the time of presentation and clinical information is sufficient to permit a inferred targeted imaging evaluation?
    a. Apical lung malignancy
    b. Carotid artery dissection
    c. Cavernous sinus lesion
    d. Thyroid malignancy

Neuro-ophthalmology Question of the Week: Emergency Department Evaluation of Visual Field Defects

October 5, 2016 By

Question: Describe the appropriate steps to take in evaluating visual field loss in the emergency department.

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Neuro-ophthalmology Question of the Week: Emergency Department Evaluation of Monocular Sustained Vision Loss

September 28, 2016 By

Question: Describe the appropriate steps to take in evaluating sustained monocular vision loss in the emergency department.

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