Ten mistakes to avoid while testing for RAPD
Introduction: A relative afferent pupillary defect (RAPD) is an important sign that detects a lesion in the afferent pathway of light reflex. It is seen in unilateral or asymmetric bilateral lesions of the retina and optic nerve upto but not involving the chiasm. It has been noted though, even in lesions of optic tract and pretectal afferent fibres of dorsal mid brain. Although the test requires b...Read More
Visual Fields in Neuro-Ophthalmology : 10 Pearls for the Postgraduates
1. Is there something we can do before ordering a visual field in neuro-ophthalmology? Confrontation visual field testing is an important clinical examination, especially when it comes to neuro-ophthalmology cases. A simple test can give us clues as to what may be the underlying cause of patients’ symptoms. The test is done presuming the visual field of the examiner is normal. Both the patient and...Read More
Papilledema- A Ready Reckoner for Postgraduates
Introduction Papilledema is used to describe optic disc edema resulting from increased intracranial pressure while disc edema could be due to any cause. While disc edema can be unilateral or bilateral, papilledema is usually bilateral, however, it can be asymmetric, to begin with. Another important differential of true papilledema is pseudo papilledema which is seen in conditions like a small hype...Read More
Learn from the Masters: Clinical Highlights in Neuro-ophthalmology
Neuro-ophthalmology is a unique subspecialty of ophthalmology and neurology where there is a complex interaction of neurologic and systemic disorders in the visual system. Neuro-ophthalmic conditions are not only about vision-threatening but sometimes life-threatening too! It needs the most comprehensive examination from ophthalmic, neurologic, and medical viewpoint. The trick lies with a systemat...Read More
Ten Tips for Management of Nystagmus
Nystagmus is defined as an involuntary rhythmic oscillation of one or both the eyes. Clinical assessment and eye movement recordings are important to diagnose and classify nystagmus. It is essential to have patience while examining a child, as anxiety often increases nystagmus. 1.Classification Physiological eye movements have to be differentiated from pathological eye movements. The older etiolog...Read More
Understanding Optic Disc Pallor- Shades of White
Introduction The optic nerve consists of approximately 1.2 million axons that arise from the retinal ganglion cells and acquire myelin sheath proximal to lamina cribrosa. These axons do not have the capacity to regenerate. The normal optic disc is pink in color due to the fact that light entering the optic disc is conducted along the transparent nerve fibers and they diffuse among columns of glial...Read More
Evaluation of a case of Diplopia
What is diplopia or double vision? Diplopia or double vision by definition is the simultaneous perception of two images of a single object that may be displaced in any direction. Other terms could be blurred vision, shadowing, or confusion. Is it uniocular or binocular diplopia? The first step to evaluate diplopia is to differentiate between uniocular and binocular diplopias as the management vari...Read More