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The first 25 slides, exactly as they appear. The full deck has 84 content slides.
Ophthalmology
Examination of a Neuro ophthalmic Case
Built from Khurana — Neuro-Ophthalmology
What’s inside
3 sections · 84 slides
Overview
- What does a neuro-ophthalmic examination mean?
- Six ways a neuro-ophthalmic problem presents
- Roadmap of this topic
Approach to Visual Loss
Transient loss versus lasting visual impairment
- Two broad kinds of visual loss
- Transient visual loss (TVL): why it matters
- The vocabulary of transient visual loss
- Causes of TVL: the two big buckets
- History in TVL: age and background first
- History in TVL: the pattern of the attack
- Examining the patient with one-eyed TVL
- Investigations in transient visual loss
- Non-ischemic TVL: the clinical pictures
- Ischemic TVL and the carotid artery
- Retinal emboli: reading their origin from their look
- Stroke risk and the vascular work-up
- Treatment of ischemic TVL
- Lasting visual impairment: the puzzle
- The five families of visual impairment
- Flow chart for assessing visual impairment
- Step 1: the pinhole and stenopeic slit test
- Limits of the pinhole — read it with caution
- The swinging flashlight test: detecting RAPD
- How to do the swinging flashlight test
- Reading the swinging flashlight test
- Interpreting the presence of an RAPD
- RAPD: retinal causes, and what its absence means
- Quantifying and grading the RAPD
- Optic nerve head and colour vision testing
- Colour saturation and brightness tests
- Contrast sensitivity testing
- Visual fields: the confrontation test
- Confrontation test: refinements and its place
- Automated visual fields: the key neuro test
- Tests for macular disease: the Amsler grid
- More macular tests: photostress, ERG, angiography
- Tests for amblyopia
- When is neuroimaging essential?
- MRI: the investigation of choice
- CT: when it beats MRI
- Summary flow chart for a patient with visual loss
- Summary: the logic of unexplained visual loss
Approach to Diplopia
Localising the cause of double vision
- What is diplopia, and why take it seriously?
- Monocular diplopia: the fault is in the eye
- Optical causes of monocular diplopia
- Binocular diplopia: seven links from eye to brain
- Common causes of binocular diplopia, by site
- Supranuclear gaze palsies
- Internuclear ophthalmoplegia (INO): what it is
- INO: clinical features
- INO: diagnosis and related syndromes
- Skew deviation and the ocular tilt reaction
- Convergence and divergence disorders
- Clinical evaluation of diplopia: the history
- Features of diplopia: onset and timing
- Features of diplopia: how the images separate
- Associated symptoms that localise the lesion
- Diurnal variation and palinopsia
- Hand-held pinhole device for visual acuity
- General examination in diplopia
- Periorbital swelling
- Proptosis — forward displacement of the globe
- Enophthalmos — backward displacement of the globe
- Eyelid retraction and lid lag
- Globe, orbit and eyelid examination
- Cardinal positions of gaze and their muscles
- Extraocular muscle examination
- Forced duction and active force generation tests
- Measuring the deviation
- Maddox rod test interpretations
- The Maddox rod test
- The cranial nerves — sensory and motor
- Brainstem examination
- The oculocephalic (doll's-eye) reflex
- Supranuclear pathway examination
- Investigations in diplopia
- Fresnel prism spectacles
- Botulinum toxin type A for chemodenervation
- Treatment of diplopia
- Key takeaways
- References
- Neuro-Ophthalmology