31 Questions
Which muscle is responsible for miosis?
Sphincter
Which cranial nerve is responsible for carrying motor impulses from the CNS to the muscles of the iris?
Cranial nerve III
What is the purpose of the swinging flashlight test?
To test for afferent pupillary defect
What is the result of a lesion anterior to the chiasm?
Afferent pupillary defect
What is the function of the Edinger-Westphal nucleus?
To regulate the pupillary light reflex
What is the term for the phenomenon of rhythmic fluctuations in pupillary size due to an imbalance between sympathetic and parasympathetic innervation?
Pupillary hiccup
What is the term for the measurement of the relative difference in pupillary constriction between the two eyes?
RAPD
What is the purpose of using neutral density filters in pupillary testing?
To quantify the relative afferent pupillary defect
What is the significance of the direct response being equal to the consensual response?
The afferent arc is intact
What should you check if the pupil size difference is larger in dim or bright illumination?
The near/accommodative reflex
What is the primary concern in a patient with isolated III CN palsy and pupil involvement?
Ruling out PCA aneurysm
What is the recommended course of action for a patient with pupil-sparing isolated III CN palsy and a history of diabetes or hypertension?
Close monitoring for pupillary involvement
At what age should a patient with pupillary sparing isolated III CN palsy be referred for neurotesting, regardless of underlying medical conditions?
50 years old
What is the typical resolution time for most ischemic causes of isolated III CN palsy?
90 days
What is the recommended follow-up time for a patient with isolated III CN palsy and a history of vascular disease?
5-7 days
What should be suspected in a patient with isolated III CN palsy and a history of giant cell arteritis?
Vascular disease affecting CN III central fibers
In children under 10 years old, what is the recommended course of action for isolated III CN palsy, regardless of pupillary involvement?
Ordering neurotesting immediately
What type of anisocoria is characterized by being equal in dim and bright illumination, without ptosis?
Physiological anisocoria
What is the name of the condition in which the light reflex is absent or abnormal, but the near response is intact?
Argyll Robertson Pupil
Which of the following substances can cause mydriasis of up to 8 mm?
Tropicamide
What is the name of the condition characterized by unilateral or bilateral tonically reacting pupils developing in otherwise healthy patients?
Adie's Tonic Pupil
What is the name of the substance used to treat hemorrhoids and also has a non-clinical use to decrease eye bags?
Phenylephrine
What is the name of the condition caused by an afferent defect, essentially a 'blind eye'?
Amaurotic pupil
What is the purpose of instilling dilute Pilocarpine 0.125% in the eyes?
To diagnose Adie's Tonic Pupil
What is the mechanism of action of apraclonidine in diagnosing Horner's Syndrome?
It acts on the delayed sensitivity of alpha 1 receptors in the dilator muscle.
What is the purpose of pharmacologic diagnostic testing in anisocoria?
To differentiate between physiologic anisocoria and Horner's Syndrome.
What is the characteristic pupillary response in Horner's Syndrome?
Anisocoria with the affected eye being smaller.
What is the purpose of hydroxyamphetamine testing?
To differentiate between central and preganglionic lesions.
What is the most common cause of isolated III CN palsy with pupil involvement?
Posterior communicating artery aneurysm.
What is the mechanism of action of cocaine in diagnosing Horner's Syndrome?
It blocks the reuptake of norepinephrine at the neuroeffector junction.
What is the significance of a negative hydroxyamphetamine test result?
It indicates a postganglionic lesion.
Test your knowledge of pupils and reflexes in ophthalmology, including the afferent arc, direct and consensual responses, and pupil size evaluation. Learn how to diagnose and interpret various pupil conditions. Evaluate your understanding of ophthalmology concepts.
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