Optic Nerve: Symptoms & Signs in Clinical Medicine

1. SET BY: NOFEL SALEEM ASSWIEL
MEDICAL STUDENT ,ADEN UNIVERSITY
THIRD YEAR 2013/2014
E-mail: Nofel166@gmail.com
@nasswiel
facebook/nasswiel
Symptoms & Signs in Clinical Medicine

4.  Impressions of light >> optic nerve >>
optic chiasma >> optic tracts >> lateral
geniculate bodies >> optic radiation >>
occipital cortex
 optic tracts >> pretectal area (pupillary
Reflex)
 Medial parts of optic tracts
(communication) between optical
system & ocluomotor nuclei.

18. Visual Acuity
 Near vision
- Reading from a book
 Far vision
- Snellen chart.
- Ishihara charts

19. Snellen chart

20. Ishihara charts

21. Ophthalmoscopic Examination
 Retinae
 Optic discs
- Color.
- Margin
- Counter
- Crescent
- Distribution of veins.
Examination of the Eye & Vision - OSCE Guide

22. Normal optic disc

23. Papilloeodema
 Definition ,
hydrostatic Non-inflammatory swelling.
Optic disc or nerve head.
Associated with ↑ Intracranial pressure

24. Papilloeodema
 Causes
1. Raised Intracranial Pressure>
- Space-occupying lesions
- Malignant HTS.
- Chronic carbon-dioxide retention.
-Occlusion of :retinal veins
cavernous sinus
-Other cause.

25. Papilloeodema
 Pathogenesis
 Subarachnoid space.
 Retinal vessel.
 Raised Pressure.
 The inflow & outflow

26. Foster kennedy syndrome
 Seen in patients with frontal lobe /
olfactory lobe tumors, meningiomas of
olfactory groove / sphenoidal wing.
 characterized by
optic atrophy on the side of the tumor
(direct pressure on the nerve)
papilledema on the opposite side
(raised ICT).

27. Papilloeodema
 Engorgement of the veins
 blurring of disk margin.
 Disappearance of blood vessel.

29. Optic Neuritis
 Definition
- Inflammation or demyelination
- At any point of the optic nerve.
 Near the disc >> optic neuritis
 behind the eyeball(lamina cribrosa) >>
retrobulbar neuritis.
 Causes
- Multiple Sclerosis
- Meningitis
- Avitaminosis .

30. Optic Neuritis
 Central scotoma
 Oedematous disc>> less swelling
 Red coloration of the disc
 Inflammatory exudates > cloudy disc

31. Founds Signs of Optic Neuritis

32. Optic Atrophy
 Definition
- Damage of the optic nerve.
 Causes
- Optic Neuritis
- Papilloeodema
- Trauma .
- Glaucoma
- Ischaemia
- Familial

33. Optic Atrophy
 Pallor of the optic
disc.
 Loss of visual
acuity.
-sever optic
neuritis, vascular
occlusion>> Rapid
visual failure.
- Other condition
>> slow &
progressive

34. 1 Hypertensive
2 Diabetic
The Retinopathies

35. Hypertensive Retinopathy
 Classification
- According to
- appearance.
- life prognosis.

36. GRADE I HTR
 Narrowing of the vessel
 Age- related

37. GRADE II HTR
 Marked variation of
the caliber of the
vessel.
 Veins is kinked, the
peripheral caliber is
engorged
 Age- related

38. GRADE III HTR
 Addition of Flame
shaped or round
retinal hemorrhages
& cotton wool spots,
hard exudates.

39. GRADE IV HTR
 All changes of
grade 3
 Addition of
papilloedema
 Increase
hemorrhages and
exudates

40. Diabetic Retinopathy
Definition
 Progressive dysfunction of the retinal blood
vessels caused by chronic hyperglycemia.
 DR can be a complication of diabetes type
1 or diabetes type 2.
 Initially, DR is asymptomatic, if not treated
though it can cause low vision and
blindness.

41. Diabetic Retinopathy
symptoms
Diabetic retinopathy is asymptomatic in early
stages of the disease
As the disease progresses symptoms may include
 Blurred vision
 Floaters
 Fluctuating vision
 Distorted vision
 Dark areas in the vision
 Poor night vision
 Impaired color vision
 Partial or total loss of vision

42. Diabetic Retinopathy
Retina is thickly
with minute red
dots (micro
aneurysms)
Microaneurysms

43. Diabetic Retinopathy
Next :
larger blot & dot
hemorrhages
appear
Then:
waxy-looking
exudates with
harder edges.
Microaneurysms
Hard exudates

44. Diabetic Retinopathy
Larger hemorrhages
appear with
irregular veins.
New-formed
vascular plexuses
.veins loops and
coils(may
protruded into the
vitreous)
Hard exudatesNeovascularization
Blot hemorrhage