Neuro-Ophthalmology

Questions:
1. What is the preferred term for abrupt and temporary vision loss in one eye?
2. What is the most common cause of transient monocular vision loss?
3. What is amaurosis fugax?
4. What is the first step in evaluating transient vision loss?
5. Why is it important to determine whether transient vision loss is unilateral or bilateral?
6. What 3 items are included in the differential diagnosis of transient binocular visual loss?
7. What are the characteristics of an occipital seizure?
8. Are occipital seizures more common in children or adults?
9. What are the characteristics of an occipital transient ischemic attack?

Questions:
10. Other than vascular disease, what 10 conditions can cause transient monocular visual loss?
11. What is Uhthoff’s phenomenon?
12. What conditions should be considered in the absence of an RAPD in cases where the cause of unilateral or asymmetric visual loss is not apparent?
13. What simple clinical test may help in determining if a maculopathy is present where the cause of unilateral or asymmetric visual loss is not apparent?
14. What are five retinal conditions that may mimic optic neuropathies?
15. What is the acquired idiopathic blind spot enlargement syndrome (AIBSE)?
16. What are 4 bilateral retinal conditions that may be difficult to distinguish from bilateral symmetric primary optic neuropathies?
17. What is the fundus appearance early in the course of cone dystrophies?
18. What specific historical items should be sought in cases of unexplained monocular visual acuity loss but with a normal visual field?
19. What exam findings may be found that help confirm the diagnosis of amblyopia?
20. Why should the blood pressure be checked in patients with a history of transient vision loss?
21. What are the findings of the posterior reversible encephalopathy syndrome?

Questions:
1. Does a reduction in visual acuity due to a neurologic problem improve with the patient looking through a pinhole?
2. Can a reduction in the perceived brightness of a white light in one eye compared to the other be an early sign of optic nerve disease?
3. Can a reduction in the perceived saturation or brightness of colors in one eye compared to the other be an early sign of optic nerve disease?
4. Does a relative afferent pupillary defect ipsilateral to visual loss always indicate optic nerve dysfunction?
5. Does normal stereo vision indicate at least 20/20 visual acuity in each eye?
6. What level of vision does a positive response to the optokinetic nystagmus stimulus indicate?
7. What is the most common vascular cause of transient monocular visual loss?
8. What is amaurosis fugax?
9. What are 4 arteries in which reduced blood flow may cause amaurosis fugax?  

Questions:
11. What causes autofluorescence in the fundus?
12. What are the abnormal states of lipofuscin?
13. Do optic nerve drusen cause hyperautofluorescence or hypoautofluorescence?
14. Fluorescein angiography can help differentiate macular from optic nerve related visual loss. True or False?
15. Demonstration of retinal small vessel vasculopathy such as vasculitis is best done with retinal fluorescein angiography. True or False?
16. How is ultrasound helpful in assessing papilledema/pseudopapilledema?
17. What are 7 indications for B-scan echography?

Questions:
1. The visual evoked response is not accurate if the patient fails to cooperate. True or False?
2. The visual evoked response is primarily a function of central visual function. True or False?
3. Visual evoked responses are most useful in evaluating the integrity of the visual pathway in infants and inarticulate adults. True or False?
4. In optic neuropathy, the ERG should be normal. True or False?
5. Full-field ERG is useful in detecting diffuse retinal disease in the setting of generalized or peripheral vision loss. True or False?
6. The ERG is invariably severely depressed by the time patients complain of visual loss due to retinal disease. True or False?
7. Can a patient substantially alter the full-field ERG voluntarily?
8. Can a patient substantially alter the multifocal ERG voluntarily?
9. Multifocal ERGs are extremely helpful in detecting occult focal retinal abnormalities within the macula. True or False?
10. The multifocal ERG simultaneously records locations within the central 30 degrees. True or False?

 Questions:
1. What values indicate an unreliable Humphrey Visual Field?
2. What are the monocular VF defect patterns?
3. What are the bilateral VF defect patterns?
4. A lesion of Wilbrand’s Knee results in what visual field defect?
5. What is the visual field defect of a junctional scotoma?
6. Where is the lesion of a junctional scotoma?
7. What are the findings of a left optic tract lesion?
8. What are the findings of a temporal lobe lesion?
9. What are the findings of a parietal lobe lesion?
10. What are the findings of an occlusion of the posterior cerebral artery?
11. What field defects results from ischemia limited to of the tip of an occipital lobe?
12. What field defect results when a stroke affects the occipital lobe but spares the anterior portion of the occipital lobe?
13. What field defect results when a stroke only affects the anterior portion of the occipital lobe?
14. What are the findings of bilateral occipital lobe lesions?
15. In interpreting a visual field test, what questions should be asked?

Questions:
25. Do metabolic causes of coma usually result in large or small pupils?
26. What is ocular bobbing?
27. What is the likely location of a lesion with ocular bobbing?
28. What is ocular dipping?

Questions:
21. What are 5 clinical settings where OKN testing may be helpful?
22. Why should OKN testing be done in infants suspected of having the infantile nystagmus syndrome (congenital nystagmus)?
23. Where is the lesion likely to be located in a patient with homonymous hemianopia and symmetric OKN?
24. Where is the lesion likely to be located in a patient with homonymous hemianopia and asymmetric OKN response?