Pupils and Reflexes in Ophthalmology
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Questions and Answers

Which muscle is responsible for miosis?

  • Ciliary
  • Sphincter (correct)
  • Pupillary
  • Dilator (radial)

    • Which cranial nerve is responsible for carrying motor impulses from the CNS to the muscles of the iris?

  • Cranial nerve II
  • Cranial nerve V
  • Cranial nerve III (correct)
  • Cranial nerve VII

    • What is the purpose of the swinging flashlight test?

  • To diagnose cranial nerve III palsy
  • To test for afferent pupillary defect (correct)
  • To check for Horner's Syndrome
  • To measure the pupil's response to light

    • What is the result of a lesion anterior to the chiasm?

    <p>Afferent pupillary defect</p> Signup and view all the answers

    What is the function of the Edinger-Westphal nucleus?

    <p>To regulate the pupillary light reflex</p> Signup and view all the answers

    What is the term for the phenomenon of rhythmic fluctuations in pupillary size due to an imbalance between sympathetic and parasympathetic innervation?

    <p>Pupillary hiccup</p> Signup and view all the answers

    What is the term for the measurement of the relative difference in pupillary constriction between the two eyes?

    <p>RAPD</p> Signup and view all the answers

    What is the purpose of using neutral density filters in pupillary testing?

    <p>To quantify the relative afferent pupillary defect</p> Signup and view all the answers

    What is the significance of the direct response being equal to the consensual response?

    <p>The afferent arc is intact</p> Signup and view all the answers

    What should you check if the pupil size difference is larger in dim or bright illumination?

    <p>The near/accommodative reflex</p> Signup and view all the answers

    What is the primary concern in a patient with isolated III CN palsy and pupil involvement?

    <p>Ruling out PCA aneurysm</p> Signup and view all the answers

    What is the recommended course of action for a patient with pupil-sparing isolated III CN palsy and a history of diabetes or hypertension?

    <p>Close monitoring for pupillary involvement</p> Signup and view all the answers

    At what age should a patient with pupillary sparing isolated III CN palsy be referred for neurotesting, regardless of underlying medical conditions?

    <p>50 years old</p> Signup and view all the answers

    What is the typical resolution time for most ischemic causes of isolated III CN palsy?

    <p>90 days</p> Signup and view all the answers

    What is the recommended follow-up time for a patient with isolated III CN palsy and a history of vascular disease?

    <p>5-7 days</p> Signup and view all the answers

    What should be suspected in a patient with isolated III CN palsy and a history of giant cell arteritis?

    <p>Vascular disease affecting CN III central fibers</p> Signup and view all the answers

    In children under 10 years old, what is the recommended course of action for isolated III CN palsy, regardless of pupillary involvement?

    <p>Ordering neurotesting immediately</p> Signup and view all the answers

    What type of anisocoria is characterized by being equal in dim and bright illumination, without ptosis?

    <p>Physiological anisocoria</p> Signup and view all the answers

    What is the name of the condition in which the light reflex is absent or abnormal, but the near response is intact?

    <p>Argyll Robertson Pupil</p> Signup and view all the answers

    Which of the following substances can cause mydriasis of up to 8 mm?

    <p>Tropicamide</p> Signup and view all the answers

    What is the name of the condition characterized by unilateral or bilateral tonically reacting pupils developing in otherwise healthy patients?

    <p>Adie's Tonic Pupil</p> Signup and view all the answers

    What is the name of the substance used to treat hemorrhoids and also has a non-clinical use to decrease eye bags?

    <p>Phenylephrine</p> Signup and view all the answers

    What is the name of the condition caused by an afferent defect, essentially a 'blind eye'?

    <p>Amaurotic pupil</p> Signup and view all the answers

    What is the purpose of instilling dilute Pilocarpine 0.125% in the eyes?

    <p>To diagnose Adie's Tonic Pupil</p> Signup and view all the answers

    What is the mechanism of action of apraclonidine in diagnosing Horner's Syndrome?

    <p>It acts on the delayed sensitivity of alpha 1 receptors in the dilator muscle.</p> Signup and view all the answers

    What is the purpose of pharmacologic diagnostic testing in anisocoria?

    <p>To differentiate between physiologic anisocoria and Horner's Syndrome.</p> Signup and view all the answers

    What is the characteristic pupillary response in Horner's Syndrome?

    <p>Anisocoria with the affected eye being smaller.</p> Signup and view all the answers

    What is the purpose of hydroxyamphetamine testing?

    <p>To differentiate between central and preganglionic lesions.</p> Signup and view all the answers

    What is the most common cause of isolated III CN palsy with pupil involvement?

    <p>Posterior communicating artery aneurysm.</p> Signup and view all the answers

    What is the mechanism of action of cocaine in diagnosing Horner's Syndrome?

    <p>It blocks the reuptake of norepinephrine at the neuroeffector junction.</p> Signup and view all the answers

    What is the significance of a negative hydroxyamphetamine test result?

    <p>It indicates a postganglionic lesion.</p> Signup and view all the answers

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