Neuro-ophthalmologic disorders (PEARLS)
NCCPA™ PANCE Eyes, Ears, Nose, and Throat Content Blueprint eye disorders ⇒ neuro-ophthalmologic disorders
Nystagmus (ReelDx) |
Involuntary, jerking movements of the eyes
TX: medications baclofen and gabapentin
- Several therapeutic approaches, such as contact lenses, surgery, and low vision rehabilitation have also been proposed
- Surgery: tenotomy
- Physical therapy
|
Optic neuritis (ReelDx) |
Acute inflammation and demyelination of the optic nerve leading to acute monocular vision loss/blurriness and pain on extraocular movements
- Typically occurs over hours or days
- Associated with multiple sclerosis = MC cause and initial presenting symptoms
- Can also be from ethambutol
DX: Fundoscopy: Inflammation of the optic disc, confirmed by MRI
TX: Corticosteroids (methylprednisone IV)
- Refer to neurology for evaluation of Multiple Sclerosis
|
Papilledema |
Optic disc swelling that is caused by increased intracranial pressure. The swelling is usually bilateral and can occur over a period of hours to weeks
- Causes include malignant hypertension, brain tumor/abscess, meningitis, cerebral hemorrhage, encephalitis, pseudotumor cerebri
- Asymptomatic or may present with transient visual alterations (seconds)
- Bilateral, develops over hours to weeks, the disc appears swollen, margins blurred, obliteration of the vessels, ICP: increased
- Immediate neuroimaging to rule out mass lesion, then CSF analysis
TX: Treat underlying cause |
Back to PANCE Blueprint EENT (7%)