CO Neuro-Ophthalmic Disorders & Visual Function Testing 2

Question 1

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

Accepted Answer

Left optic tract or cortex

Answer

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

Question 2

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

Accepted Answer

CN III palsy

Answer

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

Question 3

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

Accepted Answer

Relative afferent pupillary defect (RAPD)

Answer

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

Question 4

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

Accepted Answer

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

Answer

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

Question 5

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

Accepted Answer

Junctional scotoma from anterior chiasmal lesion

Answer

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

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