Questions:
59. What are the fundus findings of neuroretinitis?
60. When do the retinal abnormalities of neuroretinitis appear in the course of the illness?
61. What is the most common cause of neuroretinitis?
62. How does neuroretinitis affect the risk for multiple sclerosis?
63. What is the blood supply blood to the optic nerve head?
64. What is the blood supply blood to the retrobulbar optic nerve?
65. What is the origin of the short ciliary arteries?
66. What is the origin of the long ciliary arteries?
67. Do emboli usually reach the short or long ciliary arteries?
68. What arteries supply the iris and ciliary body?
69. Is the work-up for ischemic non-arteritic optic neuropathies the same as for a retinal or a cerebral infarction?
70. How much more common is AION than PION?
Neuro-ophthalmology Illustrated Chapter 8 – Optic Neuropathies 5
Neuro-ophthalmology Illustrated Chapter 8 – Optic Neuropathies 4
Questions:
46. How is the diagnosis of neuromyelitis
47. In what setting does acute or subacute disseminated encephalomyelitis (ADEM) develop?
48. What condition may the clinical symptoms and MRI changes of acute or subacute disseminated encephalomyelitis (ADEM) mimic?
49. Is optic neuritis common in secondary and tertiary syphilis?
50. What are the typical findings of optic neuritis in secondary and tertiary syphilis?
51. What is the visual prognosis for adequately treated secondary and tertiary syphilis?
52. How is syphilitic optic neuritis treated?
53. Is syphilitic optic neuritis an uncommon cause of visual loss in patients infected with HIV?
54. What are examples of opportunistic infections invading the CNS that can produce optic neuritis?
55. Is sarcoid optic neuritis always associated with neurosarcoidosis?
56. What does the lumbar puncture often show in sarcoid optic neuritis?
57. What does the MRI typically show in sarcoid optic neuritis?
58. What kind of response to treatment is seen In most cases of sarcoid optic neuritis?
Neuro-ophthalmology Illustrated Chapter 8 – Optic Neuropathies 3
Questions:
36. In idiopathic demyelinating optic neuritis what percentage of cases have pain with eye movements?
37. In idiopathic demyelinating optic neuritis what percentage of cases is a spontaneous improvement is seen within several weeks?
38. In idiopathic demyelinating optic neuritis, what percentage of cases does visual acuity improves spontaneously to at least 20/40 at 6 months?
39. In idiopathic demyelinating optic neuritis, what is the overall risk of multiple sclerosis at 15 years?
40. In idiopathic demyelinating optic neuritis, what is the 15-year risk of multiple sclerosis if the brain MRI is normal?
41. In idiopathic demyelinating optic neuritis, what is the 15-year risk of multiple sclerosis if the brain MRI shows one T2-weighted ovoid > 3 mm in diameter, highly suggestive of multiple sclerosis?
42. In idiopathic demyelinating optic neuritis, what is the 15-year risk of multiple sclerosis if the brain MRI shows at least six T2-weighted white matter lesions suggestive of multiple sclerosis?
43. In a patient with optic neuritis and an abnormal MRI what percentage will not develop multiple sclerosis at 15 years of follow-up?
44. In idiopathic demyelinating optic neuritis, what can a lumbar puncture detect if the cause is multiple sclerosis?
45. In idiopathic demyelinating optic neuritis are oligoclonal bands in the CSF useful if the patient’s MRI has demonstrated findings consistent with multiple sclerosis?
Neuro-ophthalmology Illustrated Chapter 8 – Optic Neuropathies 2
Questions:
18. Is the onset of optic neuritis acute or subacute?
19. Is the onset of most cases of optic neuritis painful or painless?
20. Can the pain precede the vision loss in optic neuropathies?
21. Is the pain from acute optic neuropathy usually exacerbated by eye movement?
22. How long does the loss of central vision progress?
23. What 8 factors should be evaluated in a patient with a suspected recent onset of optic neuritis?
24. Under what circumstances should a lumbar puncture be done in optic neuritis?
25. Is bilateral optic neuritis is more common in children than in adults?
26. In optic neuritis, under what circumstances should an MRI of the spine with contrast be obtained?
27. In optic neuritis, under what circumstances should NMO antibodies be obtained?
28. What are the 5 categories in the classification of optic neuritis?
29. Optic neuritis is associated with what 4 demyelinating conditions?
30. What are examples of bacterial diseases associated with optic neuritis
31. What are examples of viral diseases associated with optic neuritis?
32. What are examples of parasitic diseases associated with optic neuritis? 33. What are examples of fungal diseases associated with optic neuritis?
34. What are the examples of post-vaccination optic neuritis?
35. What are the examples of inflammatory disorders associated with optic neuritis?
Neuro-ophthalmology Illustrated Chapter 8 – Optic Neuropathies 1
Questions:
1. What are optic neuropathies with an acute onset and with a normal optic nerve called?
2. What are optic neuropathies with an acute onset and with a swollen optic nerve head called?
3. After the onset of visual loss in a case of optic neuropathy, when does the optic nerve head become pale?
4. When is electrophysiologic testing is useful in acute optic neuropathies?
5. What does a painful orbital apex syndrome in a diabetic patient suggest
6. In addition to the optic nerve what structures pass through the optic canal?
7. What structures pass through the superior orbital fissure?
8. How is color vision typically affected in disease of the optic nerve?
9. How is the pupil typically affected in disease of the optic nerve?
10. How is the
11. How is the ERG typically affected in disease of the optic nerve?
12. How is the Amsler grid typically affected in disease of the optic nerve
13. How is color vision typically affected in disease of the macula?
14. How is the pupil typically affected in disease of the macula?
15. How is the
16. How is the ERG typically affected in disease of the macula?
17. How is the Amsler grid typically affected in disease of the macula?
Neuro-ophthalmology Illustrated Chapter 7 – Retinal Vascular Diseases 3
Questions:
20. Radiation retinopathy a chronic, painless, progressive retinal vasculopathy. True or False?
21. Radiation retinopathy may be unilateral or bilateral and occur months or years after radiotherapy. True or False?
22. Radiation retinopathy is more common in patients with underlying retinal vascular disease (e.g., hypertension or diabetes). True or False?
23. What are 5 key findings of radiation retinopathy?
24. What are 6 complications of radiation retinopathy?
25. What is the chief feature of Purtscher retinopathy?
26. What is the significance of bilateral retinal vascular tortuosity?
27. What are 2 retinal vascular malformations?
Neuro-ophthalmology Illustrated Chapter 7 – Retinal Vascular Diseases 2
Questions:
12. What may develop in patients with severe stenosis or occlusion of the ipsilateral common carotid artery or internal carotid artery and poor collateral circulation?
13. What condition should venous stasis retinopathy, or hypotensive retinopathy, suggest?
14. What are the symptoms of the ocular ischemic syndrome?
15. What are signs of the ocular ischemic syndrome?
16. What is the prognosis of the ocular ischemic syndrome?
17. What should be ruled out in a patient who has a rapidly worsening ocular ischemic syndrome?
18. What should be checked in all patients with headache and bilateral optic nerve swelling?
19. What 10 classic systemic disorders associated with retinal vasculitis?
Neuro-ophthalmology Illustrated Chapter 7 – Retinal Vascular Diseases 1
Questions:
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 diseases, but with branch or central retinal artery occlusions or amaurosis fugax?
2. What causes central artery occlusion 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 that 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 Illustrated Chapter 6 – Transient Visual Loss 3
Questions:
29. What should be done immediately when a patient presents with a recent vascular TMVL?
30. What work-up should be done for transient monocular visual loss thought to be of vascular origin?
31. What should be done emergently in the presence of an acute central retinal artery or branch retinal artery occlusion?
32. What is the chance and timeline of stroke after TMVL in the presence of ipsilateral atheromatous internal carotid stenosis ≥50%?
33. What is the yearly risk of vascular death (myocardial infarction) in patients with TMVL and atheromatous disease? 34. What tests should be done in all patients with transient monocular visual loss over age 50?
Neuro-ophthalmology Illustrated Chapter 6 – Transient Visual Loss 2
Questions:
10. What provides the blood supply to the anterior cerebral hemispheres and to the eyes?
11. What is the blood supply to the occipital lobes?
12. What finding does occlusion of a posterior cerebral artery produce?
13. A patient complains of loss of visual field in one eye, what should be ruled-out on examination?
14. What 5 mechanisms should be considered in the differential diagnosis of transient monocular visual loss?
15. What is the most likely cause of transient visual obscurations (brief blackouts or grey-outs) on change of posture?
16. What is the likely cause of gaze-evoked episodes of transient monocular vision loss?
17. Which ocular diagnoses involving the anterior segment of the eye should be considered when a patient complains of transient monocular blurring of vision?
18. How long does the transient loss of vision last when the cause is retinal emboli?
19. What is the typical length of time of transient monocular vision loss in optic nerve head anomalies?
20. What should be considered in a patient who has eye or brow pain with transient monocular vision loss?
21. What should be considered in a patient who has transient monocular vision loss and neck pain or ipsilateral Horner syndrome?
22. What should be considered in a patient who has transient monocular vision loss and simultaneous contralateral hemisensory or motor findings?
23. What should be considered in a patient who has transient monocular vision loss and presyncope?
24. Will the transient monocular vision loss due to carotid occlusive disease be partial vision loss or complete vision loss?
25. What is the major source of collateral circulation to the eye?
26. What are 5 vascular mechanisms of transient monocular visual loss?
27. Should the presence of emboli in the eye found on a routine exam prompt a workup for their source?
28. How long does the monocular visual loss from spasm of the central retinal artery last?