2.  To measure the Visual Acuity
 To Examine Pupillary Reactions
 To test the functions of Extra Ocular
muscles
 To Evaluate the Visual Fields
 To Inspect the optic nerve head

3.  Identifying life threatening or vision
threatening neurological disorders
 Other systemic diseases

4.  Visual Acuity testing
 Visual Field testing
 Pupillary Reactions
 Ocular-motility testing
 Opthalmoscopy

5.  One’s visual acuity is an
indication of the clarity or
clearness of one’s vision
 Word “acuity” is derived from
Latin acuitas, which means
sharpness.
 Snellen’s Chart

6.  Visual field defects affect Central Vision
 Gross confrontation field testing.
 Amsler grid test

7.  Swinging flash light test
 Dysfunction of Sympathetic
& Parasympathetic System.
 Optic nerve dysfunction

12.  To examine the occular
fundus

14. Aneurysm compressing upon
CN3
Temporal lobe Herniation compressing
CN3

16. Argyll Robertson Pupil

18.  Causes: Cerebral Aneurysms, Vaso-
occlusive disease, HTN, DM, Trauma
& Brain tumors

19.  Cause: Close head trauma, Small vessel
dieases, HTN, DM
 Vertical Diplopia
 Downward gaze difficulty
 Tilting of head

20.  Cause: Head Trauma,
Small vessel disease,
Viral infection, Increase in
ICP
 Loss of abduction
 Horizontal diplopia
 Greatest separation of
gaze towards the affected
side

21.  CN V
 CN VII
 CN VIII

22.  Autoimmune condition
 Interefering Neuromuscular transmission
 Edrophonium Chloride/ Tencsilon test
 Ptosis
 Diplopia
 Fatigue
 3rd, 4th, 6th nerve diseases
 Gaze paresis
 Internuclear opthalmoplegia

23.  Lesion of medial longitudinal fasiculus
 Cause:
Small vessel disease Old age
Demyelinating dieases Adults
Pontine Glioma Children

25.  Spontaneous, Rhythmic back and forth
movement of one or both eyes
 Horizontal, Vertical, Rotatory &
Combination
 Indicates Central Nervous system
dysfunction, Multiple sclerosis, Brain
Tumor, Degenration of CNS

28.  Referred as
Pseudopapilledema
 Blurring of disc margin
 Elevated disc substance
 Absence of optic cup
 Spontaneous venous pulsation
 Associated with Hyperopia
 Optic disc drusen

29.  Swelling of optic disc
secondary to increased
ICP
 Causes: Intracranial pressure, Brain tumor
(50%), Pseudotumor cerebri, Severe HTN
 Bilateral & Good central vision
 Characterisitics: Hyperemia of disc,
Tortous vessels, Blurring & Elevation of the
margins, Hemorrhages

30.  Inflammatory edema
of the disc
 Opthalmoscopically
indistinguishable to Papilledema
 Unilateral, Decreases visual acuity,
impaired color vision

31.  Pale, Swollen disc,
Splinter Hemorrhages
 Loss of Acuity &
Visual Field(Altitudinal)
 Predominantly involve Superior &
Inferior field

32.  Transient monocular
visual loss
 Cause: Arterial
Insufficiency

33.  Pallor of the optic disc
 Causes: Previous optic neuritis, long
standing papilledema, Compression by
mass lesion, Small vessel disease, Giant
cell Arthritis, Glaucoma
 Disc appears white
 Decrease Visual Acuity & Visual field loss

34.  Scotoma
 Hemianopia
 Homonymous Hemianopia
 Bitemporal Hemianopia

35.  Testing of both visual acuity & visual field is critical in the
evaluation of abnormal optic disc
 A patient with a unilateral optic nerve lesion should have
equal pupils in ambient light but a positive swinging flash light
test
 Blurred disc margin isn’t diagnostic for pailledema, other sign
n symptoms must be considered
 Chiasmal diseases most likely to cause bitemporal field
defects
 If one of the following is abnormal-pupil, lid position or ocular
motility- look closely for the involvement of the others
 CN V & CN VII should be checked if ocular motility is
abnormal & Cranial nerve palsy is suspected
 Slowly progressive visual loss or CN palsy should prompt
consideration of compressive lesions such as Tumor &
Aneurysms