Term
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Definition
part of optic nerve visible by ophthalmoscopy
flat, round ring of neural tissue (neuroretina rim) and central depression (physiological cup) |
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Term
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Definition
pinkish color from capillaries
distinct border with surrounding retinal tissue
slightly elevated on nasal side |
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Term
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Definition
round and white
should be no more than 1/2 the diameter of the optic disc
cup:disc ratio |
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Term
| central or centrocecal scotoma |
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Definition
visual deficit in center of visual gield, in the "papillomacular bundle"
toxic/nutritional/metabolic, inflammatory, compressive disorders |
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Term
| arcuate/altitudinal scotoma |
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Definition
deficit gathered around central papillodmacular region
ischemic disorders and papilledema |
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Term
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Definition
deficit in bundled wedge-like pattern (apex at blind spot)
congenital malformations (dysplagias) of the optic nerve |
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Term
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Definition
neuroretinal rim pallor
elevation
excavation of the cup
dysplasia |
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Term
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Definition
rim is white instead of pink
suggests loss of axons - congenital or acquired
takes at least 4 weeks to develop |
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Term
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Definition
underlying pathology of EDEMA
inflammation, ischemia, neoplastic infiltration, increased ICP )padilledema)
congenital variants |
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Term
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Definition
widening and deepening of physiologic cup because of atrophy pf neuroretinal ring
only occurs if the process destroys not only axons but their supporting glial elements
glaucoma; ophthalmic artery occlusion (giant cell arteritis); congenital dysplasia ("coloboma") |
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Term
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Definition
optic discs may be malformed at birth
too small - hypoplastic
excavated - colobomatous
tilted - dysverted
elevations |
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Term
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Definition
optic neuritis
ischemic optic neuropathy
compression by a mass
infiltration by cancer
systemic toxic-nutritional-metabolic disorder
increased ICP
glaucoma |
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Term
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Definition
age 15-45, F>M
subacute monocular vision loss, pain around eye
may be only a manifestation or part of systemic illness, MS
ADP, reduced actuiy, *nerve fiber bundle defect*, optic disc normal or swollen |
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Term
| ischemic optic neuropathy |
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Definition
infarction of optic nerve
arteritic (giant cell) and non-arteritic forms
vision does not recover |
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Term
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Definition
arteritic ischemic optic neuropathy
over age 70, F=M
aches, malaise, jaw claudication, anorexia, poor appetite, anemia
sudden severe visions loos, ADP
elevated sed rate and CRP
positive temporary artery biopsy to make diagnosis; high dose steroids to prevent spread to other eye |
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Term
| non-arteritic ischemic optic neuropathy |
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Definition
10x more common
age over 40, M=F, DB/HTN/smoking, etc
less severe vision loss, compromised vessels, "lacunae" of optic nerve
segmentally swollen optic disc, usually nonprogressive but no recovery |
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Term
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Definition
sudden or slow loss, with or without pain
and age, gender
usually intracranial, affecting chiasm, so visual field defect is HEMIANOPIC
brain imaging crucial
pituitary adenoma, meningioma, pilocytic astrocytoma, aneurysm, cyst |
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Term
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Definition
subacute visual loss, usually severe
may have no other new symptoms
any age or gender, usually known history of cancer
optic disc often looks normal
imaging and LP - meningeal enhancement, pleocytosis, high protein |
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Term
| systemic toxic-nutritional metabolic conditions |
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Definition
slowly progressive, symmetrical vision loss
central of centrocecal scotomas
enthambutal, methanol, alcohol, poor diet
mitochondrial dysfunction: Leber hereditary optic neuropathy
dilated optic disc blood vessels, thickened peripapillary nerve fiber layer
vision loss usually profound and irreversible |
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Term
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Definition
usually binocular but may be asymmetrical
edema initially spares center of disc
visual function relatively preserved (unless chronic)
space-taking mass, meningitis, dural venous sinus thrombosis, cerebral edema, idiopathic intracranial HTN |
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Term
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Definition
4 types:
-primary open angle
-secondary
-angle closure (acute presentation)
-congenital |
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Term
| primary open angle glaucoma |
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Definition
most common form, 2% prevalence world wide
mostly over age 40, M=F
painless, slowly progressive optic disc excavation and visual field loss that spares the papillomacular bundles
impaired aqueous drainage though trabecular meshwork, increased intraocular pressure |
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Term
primary open angle glaucoma
clinical features and treatment |
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Definition
1. pathologic excavation of the optic disc (enlarged cup, effacement of rim) cup:disk 2. elevated intraocular pressure
tx: lower intraocular pressure!
-topical medications
-surgery to improve drainage if meds fail |
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