Neuro_Ophthalmology_Presentation.pptx1231

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1. Neuro-Ophthalmology: Key Insights Summarizing the October 2019 Publication Prepared for Educational Purposes

2. Introduction Neuro-ophthalmology bridges neurology and ophthalmology, focusing on vision disorders caused by neurological conditions. This presentation summarizes key topics from the October 2019 Neuro-Ophthalmology publication: - Pupillary Function - Optic Neuropathies - Visual Pathway Disorders - Diagnostic Approaches

3. The Pupil Key Points: - Anatomy: Parasympathetic (miosis) and sympathetic (mydriasis) control - Disorders: Anisocoria, Horner Syndrome, tonic pupil - Examination: Light reflex, near reflex, pharmacologic testing Clinical Tip: Measure pupil size in varying light conditions for accurate diagnosis.

4. Ischemic Optic Neuropathy Types: - Arteritic (associated with giant cell arteritis) - Non-Arteritic (linked to vascular risk factors) Key Features: - Sudden, painless vision loss - Optic disc swelling (in acute phase) Management: - Immediate corticosteroids for arteritic cases - Control vascular risk factors in non-arteritic cases.

5. Optic Neuritis Causes: - Multiple sclerosis - Neuromyelitis optica spectrum disorders (NMOSD) - Myelin oligodendrocyte glycoprotein (MOG) antibody disease Clinical Features: - Pain with eye movement - Vision loss (color desaturation) Treatment: - High-dose IV corticosteroids - Disease-specific immunotherapy for associated conditions.

6. Toxic-Metabolic and Hereditary Optic Neuropathies Toxic-Metabolic Causes: - Alcohol, tobacco, methanol, nutritional deficiencies - Medications (e.g., ethambutol) Hereditary Causes: - Leber Hereditary Optic Neuropathy (LHON) - Dominant optic atrophy Management: - Remove toxic exposures - Supportive therapies, idebenone (for LHON).

7. Idiopathic Intracranial Hypertension (IIH) Overview: - Common in young women with obesity - Presents with headache, papilledema, and visual changes Diagnostic Criteria: - Elevated intracranial pressure on lumbar puncture - Normal brain imaging (except for signs of raised ICP) Management: - Weight loss, acetazolamide - Surgical options: Optic nerve sheath fenestration or shunt.

8. Higher Cortical Visual Disorders Causes: - Stroke, trauma, tumors affecting visual pathways Examples: - Visual agnosia - Balint syndrome (optic ataxia, simultanagnosia) - Hemispatial neglect Historical Context: - Disorders provide insight into brain organization and function.

9. Approach to Diplopia Definition: - Binocular (neurological cause) vs Monocular (ocular cause) Causes: - Cranial nerve palsies (III, IV, VI) - Myasthenia gravis - Thyroid eye disease Diagnostic Steps: - Evaluate eye alignment and movement - Imaging if neurological cause suspected.

10. Nystagmus and Saccadic Intrusions Nystagmus: - Types: Jerk, pendular - Causes: Vestibular dysfunction, cerebellar lesions Saccadic Intrusions: - Examples: Opsoclonus, square wave jerks - Associated with neurodegenerative disorders Management: - Treat underlying cause - Symptom relief with medications or rehabilitation.

11. Imaging in Neuro-Ophthalmology Importance: - Critical for diagnosis and management - Differentiates structural vs functional causes Techniques: - MRI: Visual pathway lesions, demyelination - CT: Bone fractures, acute hemorrhage - OCT: Retinal and optic nerve analysis.

12. Conclusion Neuro-ophthalmology provides vital insights into vision-related neurological disorders. Key Takeaways: - Accurate diagnosis requires understanding anatomy, physiology, and imaging. - Multidisciplinary approach enhances patient outcomes.