Board Certified Ophthalmologist Board Certified Ophthalmologist Neuro-Ophthalmology Questions and Answers 2

Question 1

A 45-year-old patient presents with sudden painless monocular vision loss and a relative afferent pupillary defect.
Fundoscopy reveals a swollen optic disc with peripapillary hemorrhages.
What is the most likely diagnosis?

Accepted Answer

Anterior ischemic optic neuropathy

Answer

Central retinal artery occlusion

Answer

Optic neuritis

Answer

Papilledema

Question 2

Which cranial nerve palsy is most commonly associated with microvascular ischemia in diabetic patients?

Accepted Answer

Sixth nerve palsy

Answer

Third nerve palsy

Answer

Fourth nerve palsy

Answer

Seventh nerve palsy

Question 3

A patient with multiple sclerosis develops bilateral sequential optic neuritis. MRI of the brain shows periventricular white matter lesions. What visual field defect is most characteristic of optic neuritis?

Accepted Answer

Central scotoma

Answer

Bitemporal hemianopia

Answer

Homonymous hemianopia

Answer

Altitudinal field defect

Question 4

A 30-year-old woman presents with transient visual obscurations, bilateral disc edema, and an enlarged blind spot on perimetry. Her BMI is 38. What is the most appropriate initial diagnostic study?

Accepted Answer

MRI brain with MR venography

Answer

Carotid Doppler ultrasound

Answer

Fluorescein angiography

Answer

Electroretinography

Question 5

A patient presents with a complete third nerve palsy including pupil involvement after minor head trauma. CT angiography reveals a 7 mm aneurysm. What is the most likely location of this aneurysm?

Accepted Answer

Posterior communicating artery

Answer

Anterior communicating artery

Answer

Middle cerebral artery bifurcation

Answer

Basilar tip

Question 6

What is the hallmark visual field defect seen in a patient with a lesion at the optic chiasm caused by a pituitary adenoma?

Accepted Answer

Bitemporal hemianopia

Answer

Homonymous hemianopia

Answer

Binasal hemianopia

Answer

Central scotoma