Neuro-Ophthalmic Disorders & Visual Function Testing Flashcards

A patient with a right homonymous hemianopia has damage in which location?

Answer: Left optic tract or cortex

Right homonymous hemianopia results from a lesion of the left visual pathway posterior to the chiasm (optic tract, LGN, or cortex).

Which cranial nerve palsy causes an eye that is 'down and out' with a dilated, non-reactive pupil?

Answer: CN III palsy

A complete CN III palsy causes ptosis, an eye deviated down and out, and a dilated non-reactive pupil due to parasympathetic involvement.

The swinging flashlight test is primarily used to detect which condition?

Answer: Relative afferent pupillary defect (RAPD)

The swinging flashlight test reveals an RAPD by comparing the consensual and direct responses between the two eyes.

In internuclear ophthalmoplegia (INO), which eye movement finding is characteristic?

Answer: Failure of adduction ipsilateral to the lesion with nystagmus of the abducting eye

INO is characterized by impaired adduction of the eye ipsilateral to the MLF lesion and nystagmus of the abducting (contralateral) eye.

A bitemporal hemianopia with a central scotoma in one eye suggests which lesion?

Answer: Junctional scotoma from anterior chiasmal lesion

A junctional scotoma (one central scotoma + contralateral superior temporal defect) indicates a lesion at the junction of the optic nerve and chiasm.

Which visual field defect pattern is most consistent with an occipital lobe lesion?

Answer: Congruous homonymous hemianopia with macular sparing

Occipital lobe lesions produce highly congruous homonymous hemianopias, often with macular sparing due to the dual blood supply of the occipital pole.

Parinaud syndrome (dorsal midbrain syndrome) is characterized by all of the following EXCEPT:

Answer: Absence of the pupillary light reflex with a large, reactive pupil

In Parinaud syndrome, pupils are mid-dilated with light-near dissociation (react to near, not light) and upgaze palsy; pupils are not large and reactive.