NBEO NBEO Neuro-Optometry & Visual Fields 2

Question 1

Which condition causes disc edema, vision loss, and pain on eye movement, most often in young women?

Accepted Answer

Optic neuritis

Answer

Optic neuritis classically presents in young women with subacute monocular vision loss, periorbital pain worsened by eye movement, and a central scotoma; it is strongly associated with multiple sclerosis.

Question 2

Non-arteritic anterior ischemic optic neuropathy (NAION) most commonly produces which visual field defect?

Accepted Answer

Altitudinal field defect (inferior)

Answer

NAION infarcts the superior or inferior pole of the optic disc, causing an altitudinal (most often inferior) visual field defect that respects the horizontal meridian.

Question 3

Papilledema from raised intracranial pressure typically causes which early visual field defect?

Accepted Answer

Enlarged blind spot

Answer

The earliest visual field defect in papilledema is enlargement of the physiologic blind spot due to peripapillary edema displacing photoreceptors around the disc.

Question 4

Which hereditary optic neuropathy causes bilateral, painless, central vision loss in young males and is associated with mitochondrial DNA mutations?

Accepted Answer

Leber hereditary optic neuropathy (LHON)

Answer

LHON is caused by mitochondrial DNA point mutations and causes sequential bilateral central vision loss in young men due to retinal ganglion cell death.

Question 5

In a patient with a trochlear nerve (CN IV) palsy, which head position reliably worsens vertical diplopia?

Accepted Answer

Ipsilateral head tilt

Answer

The Bielschowsky head tilt test: tilting toward the side of the palsy worsens hypertropia because the affected superior oblique cannot intort, forcing the eye upward.

NBEO - National Board of Examiners in Optometry Practice Test

NBEO - National Board of Examiners in Optometry Practice Test

NBEO NBEO Neuro-Optometry & Visual Fields 2