Essentials of Neuro-ophthalmology PK Mukherjee
INDEX
A
Abducens 36
Abducent nerve 36
Aberrant regeneration of third nerve 45, 187, 195
Abiotrophies 111
Abnormal
color sense 248
head posture 4, 26, 27, 28
Abnormality of lid 4
Absolute scotoma 11
Acephalgic migraine 334
Achromatopsia 20, 112, 337, 338
Acidophil adenoma 123
Acoustic neuroma 220
syndrome 219
Acquired
central nystagmus 346
labyrinthine 345
nystagmus 343
ocular nystagmus 344
swelling of optic nerve head 74
Acute
chiasmitis 7
episodes 245
ischemic optic neuritis 110
neuritic phase 100
ophthalmoplegia 264
papillitis 7
retrobulbar neuritis 102
Addison's disease 81
Adherence syndrome 271
Adie's
pupil 156, 158
syndrome 9
Adult craniopharyngioma 128
Afferent
pupillary
defect 120, 126, 153
reaction 134
reflex 95
somatic 56
visual signs and symptoms 4
Agraphia 22
Albinism 337, 338
Alexia 22
Altitude scotoma 13
Altitudinal
lower field 91
pallor 109, 110
Alzheimer's disease 22
Amaurosis 20
fugax 6, 20, 90, 138, 304
Amaurotic pupil 152
Amblyopia 8
Anemia 81
Anesthesia dolorosa 212
Aneurysm of internal carotid systems 131
Anhydrosis 31
Aniridia 337, 338
Annulus of Zinn 52, 211
Anterior
chiasma 124
clinoid 129
communicating artery aneurysm 300
half of skull 56
inferior cerebellar artery 54, 218
ischemic optic
neuritis 7
neuropathy 90
knee of Willebrand's 68
medullary velum 51
visual pathway migraine 332
wall of sella turcica 117
Antibiotics 278
Anticholinergic drugs 177
Anticholinesterase drugs 174, 278
Antineoplastic 278
Aortic
aneurysm 91
leak 91
Apex of
lung 170
petrous bone 54
Applied anatomy of
abducent nerve 52
facial nerve 60
oculomotor nerve 39
trigeminal nerve 56
trochlear nerve 47
Apraxia 22, 177
Aqueductal stenosis 81
Arcuate scotomas 13
Argyll-Robertson pupil 157
Arterial
diseases 293
lesions of neuro-ophthalmic interest 294
obstructive
diseases 302
disorders 302
Arteriosclerosis 93
Arteritic ischemic optic neuropathy 90, 94
Arteritis 3
in herpes zoster 90
Ascending degeneration 108
Asphyxia 138
Atherosclerosis 3
Atrophic phase 112
Atypical myasthenia 272
Autofluorescence 73
Autoimmune disease 171, 184
Autosomal dominant 112
Axial neuritis 83
B
Bacteria 88
Barbiturates 98
Basal
ganglion 242, 249
lesions 191
Basilar
artery 133, 285
migraine 333
stroke 184
lesions 219
migraine 333
part 43, 52, 54
Basophil adenomas 123
Battle's signs 221
Behr's
neuropathy 8
optic neuropathy 111
recessive optic neuropathy 112
Bell's
palsy 33, 180, 229, 233, 238
phenomenon 236
Benedict's
dorsal syndrome 190
syndrome 191, 245
Benign
blepharospasm 176
congenital tumors 127
hamartomas 115
intracranial hypertension 3, 81
Bicker staff migraine 333
Bielchowsky test 205
Bilateral
ophthalmoplegia 262
ptosis 167
recurrent facial palsy 184
simultaneous optic neuritis 7
transient loss of vision 21
Binocular
diplopia 23
field defects 13
gross loss 141
loss of vision 129
Bitemporal hemianopia 95, 120, 124, 128
Bjerrum screen 14
Blepharoclonus 5, 35
Blepharospasm 5, 34, 175
Blepharospasm of
neuro-ophthalmic importance 34
neuro-ophthalmic interest 176
Blood supply 288
Blood supply to
chiasma 291
lateral geniculate body 292
optic
nerve head 288
radiation 292
tract 291
various part of brain 293
visual cortex 292
Blood
borne infection 83
vessels 150
Blow out fracture 271
Botulin toxin 242
Botulinum toxin 174, 242
Botulism 9
Bow tie atrophy 109, 110
Brain 346
abscess 79, 319
tumor 319
Brainstem 21, 103, 170
lesion 21, 91
stroke 34
Branches of trigeminal nerve 60
Brown syndrome 209, 268, 271
C
Calcification of aneurysm 132
Caloric test for vestibular nystagmus 341
Carbamazepine 177
Cardiac conduction defect 112
Cardiovascular diseases 79
Carotid
cavernous fistula 132, 298
ophthalmic artery aneurysm 299
system 285, 296
Causes of
acute
headache 323
unilateral loss of vision 7
bilateral
facial palsy 34, 234
ophthalmoplegia 262
central lesions 211
chronic headache 323
disk swelling 100
gradual unilateral diminished vision 8
isolated seventh nerve palsy 34
lid retraction 186
light near dissociation 156
ocular headaches 325
spastic
miosis 163
mydriasis 163
sudden bilateral loss of central vision 7
trochlear nerve palsy 206
uniocular loss of vision 139
Cavernous
lesion 194
part 43, 52, 55
sinus 49, 311
lesion 160, 222
nerve communicates 52
thrombosis 313
Cells in vitreous 86
Central
branches 287
caudal nucleus 167
field 10
defects 95
gaze palsy 173, 174
lesion 211, 249
retinal
artery 91
vein obstruction 109
scotoma 12, 84, 105
vein
occlusion 91
thrombosis 96
Centrocecal scotoma 105
Cerebellopontine angle 179
syndrome 219
Cerebellum 103
Cerebral
cortex to pontine horizontal gaze centers 38
hemisphere 36
migraine 331
Cerebromacular degeneration 109
Cerebrovascular strokes 3
Cerebrum 249
Cervical
spine 319
sympathetic 167
Characteristics of
afferent pupillary defect 151
consecutive optic atrophy 109
fusiform aneurysms 296
Holmes Adie's pupil 159
horizontal gaze defects 250
Horner's syndrome 159
lesions of
optic radiation 134
pregeniculate path 134
nuclear palsies 31
painful ophthalmoplegia 261
palsy 194
primary optic atrophy 108
saccular aneurysms 296
secondary optic atrophy 109
supranuclear ptosis 168
syndrome 253
Chiasma 114, 115
Chiasmal glioma 116
Childhood craniopharyngioma 128
Chloramphenicol 98
Chloroquine 98
Cholesteatoma 220
Cholinergic crisis 279
Chordoma of clivus 221
Choroidal rupture 110
Chromophobe adenomas 122
Chronic
disease 242
glaucoma 93
granuloma 319
nonprogressive headache 319
ocular hypoxia 305
papilledema 79
progressive
external ophthalmoplegia 174, 263, 271, 279
headache 319
subdural hematoma 319
Ciliary ganglion 46, 148
Circle of Willis 119, 285
Classic migraine 329
Classification of
headache 321
migraine 328
nystagmus 339
optic atrophy 107
Claude Bernard syndrome 188
Claude's syndrome 191, 245
Claudication of jaw 91
Clinical features of
bilateral fourth nerve palsy 203
Devic's neuromyelitis 89
disorders of visual path 67
paralysis of individual muscle 29
recent unilateral fourth nerve 202
Clonazepam 104
Cluster headache 215, 333
Cocaine test 162, 170
Cogan lid twitch 172, 273
Cold test 172
Colder countries 103
Collagen vascular diseases 90, 93
Coller's sign 253
Collier sign 187
Color
blindness 19
Doppler 93
vision 67, 84, 99
Comatose patient 193
Common causes of
isolated third nerve palsy 192
oculofacial pain 213
painful ophthalmoplegia 261
papilledema 79
Common
migraine 328
sites of fusiform aneurysms 296
Commonest
congenital anomaly of disk 72
pituitary tumors 122
type of pituitary tumors 122
Commonly used terms in relation to field defects 10
Complete recovery 104
Compressive
lesions 25
neuropathy 8, 101
optic neuropathies 95
Concomitant squint 129
Conduction defect 153
Congenital
anomalies 3
cataract 337, 338
fourth nerve lesion 204
idiopathic nystagmus 343
neuropathy 112
nystagmus 342
oculomotor palsies 196, 245
optic neuropathy 111
phenomenon 32
pits of optic nerve 74
Congruence 11
Conjugate gaze palsy 89
Conjunctiva 238
Conjunctival shortening syndrome 271
Connection of
fifth nerve nucleus 58
fourth nerve nucleus 51
sixth nerve nucleus 53
third nerve nucleus 42
Consecutive optic atrophy 8, 109
Convergence
reflexes 65
retraction nystagmus 347
Corectopia 143
Cornea 238
Coronary angiographies 138
Cortex 178
Cortical
blindness 7, 136
branches 287
ptosis 168
Corticobulbar tract 62
Corticospinal tract 103, 190, 245
Corticosteroids 175
Counterpart of papillitis 102
Course of
facial nerve 64
fourth nerve 51
third nerve 42
Covering of brain 67
Cranial
anomalies 113
nerve
involvement 89
lesions of lids 166
palsy 103, 244
responsible for headache 320
Craniofacial trauma 96
Craniopharyngioma 127
Cranium 319
C-reactive protein 92
Crocodile tears 184, 240
CT skull 101
Curve round Sylvian aqueduct 51
Cushing syndrome 123
Cyanide metabolism 111
Cyclic oculomotor
palsy 175, 196
spasm 187
Cyclophosphamide 278
Cycloplegia 143
Cyclosporine 278
Cyclotonia 143
Cysticercosis of optic nerve 96
D
Decussate in midbrain 36
Deep-seated cerebral lesion 22
Deficiency of vitamin B12 104
Demyelinating disease 34
Deny blindness 21
Deterioration 6
Deviation 245
Devic's
disease 89
neuromyelitis 8
neuromyelitis optica 89
Diabetes 3, 93
Diabetic
ocular muscle palsy 245
optic neuropathy 100
third nerve palsy 192
Diagnosis of
migraine 334
sixth nerve palsy 223
Differential diagnosis of fourth nerve lesion 207
Diffuse chorioretinitis 109
Diminished
brightness 20
central vision 105
color sense 18, 91
distant vision 5
near vision 4, 8, 26
night vision 20
tear production 180
vision 91, 20, 120, 248
Diphtheria 9
Diplopia 4, 23, 76, 91, 245, 271
Direct trauma 96
Disk drusen 72
Disorders of
basal ganglion 176
chiasma 118
optic nerve 67, 71
parachiasmal structures 121
visual pathway 65
Distal part of optic nerve 68
Dorello's canal 54
Dorsal
horn of spinal cord 58
pons 218
Dorsolateral nucleus 41
Double elevator palsy 269
Downbeat nystagmus 347
Drooping 248
Drug therapy in myasthenia 174
Drusen 3, 77
Drusen of optic
nerve 72, 96
papilla 6
Duane's
retraction syndrome 186, 264, 271
syndrome 263
Duration of diminished vision 6
Dyscoria 143
Dyslexia 22
Dysplasia of disk 73
Dysplastic coloboma 73
Dysthyroid
myopathy 271, 282
status 3
Dystonia 112
Dystrophies 271
E
Eale's disease 101
Early papilledema 72, 76
Eclampsia 6
Edge of tentorium 52
Edinger-Westphal nucleus 39, 41, 147
Edrophonium hydrochloride 276
Efferent
pupillary defects 157
visual symptoms 4
Embedded in lateral wall 52
Empty sella syndrome 127
Encephalitis 3, 250
Enlargement of blind spot 12
Enophthalmos 31
Entrapment of muscle 261
Epilepsy 22
Episodes of amaurosis 124
Essential blepharospasm 34, 176, 242
Ethambutol 98, 99
Evaluation of diplopia 24
Exclusion of diabetes 298
Exophthalmos 5
Extensive photocoagulation 109
External
ear 56
ophthalmoplegia 256
Extraocular
muscle 173
changes 282
palsy 76, 95, 120, 274
Extrapyramidal disease 177
Eyeball 56
F
Facial
asymmetry 5
canal 64, 233
diplegia 184
movement disorder 242
myokymia 35
nerve 36
lesion 229
palsy 62, 232
Fascicular
lesion 190, 218
part 42, 51, 54
Fast deterioration 6
Fatigue tests 171
Features of
classical Argyll-Robertson pupil 157
paralytic and nonparalytic squint 26
pupillary abnormalities 144
Fiber decussate completely 51
Field of vision 10
Fifth cranial nerve 56
First neuron extends 147
Fluctuation of vision 129
Fluorescein
angiography 77, 93
picture 77
Fluroquinolones 98
Foster Kennedy syndrome 117, 131
Four neuron path 147
Fourth nerve palsy 2
Foville's syndrome 218
Fracture of
base of skull 221
orbital wall 261
Frontal
bone 96
lobe 110, 230
tumor 110
Fundus 85, 91, 101
changes 71, 76, 98, 126
in fully developed papilledema 77
fluorescein angiography 92
picture 89, 99, 115
Fungus 88
Fusiform aneurysms of
carotid system 297
vertebrobasilar system 297
G
Ganglion cells of retina 106
Gasserian ganglion 59, 60, 150, 210
Gaze
evoked nystagmus 348
paretic nystagmus 348
General fibrosis syndrome 271
Generalized
myasthenia 274
pallor to primary optic atrophy 106
Geniculate ganglion 64, 179, 180
Geniculo-calcarine path 133
Giant cell arteritis 90, 92
Glioma of
anterior visual path 115, 117
optic nerve 115
Glossodynia 91
Goldmann perimeter 14
Good central vision 76
Gradenigo's syndrome 221
Greater body of ophthalmology 1
Grubber's ligament 54
Guillain-Barre syndrome 34, 184
H
Halogenated hydroxyquinolones 98
Head injury 193
Headache 5, 91, 129, 319, 330
with congested eyes 325
without congested eyes 326
Hearing defect 5
Heavy metals 98
Hemianopia 11
Hemifacial spasm 5, 35, 177, 242
Hemiplegia 5
Hemorrhages 86, 91
Hemorrhagic disorders of neuro-ophthalmic interest 315
Heredofamilial
neuropathy 8
optic
atrophy 110
neuropathy 8
Herings law 167
Herpes zoster 3, 156
infection 240
ophthalmicus 212
Heteronymous field defect 11
Histamine headache 215, 333
Holmes Adie's pupil 158
Homonymous field defect 11
Horizontal gaze
defects 249
palsy 309
Horizontal pendular nystagmus 337
Hormonal replacement 129
Horner's syndrome 31, 131, 160, 161, 166, 170, 179, 221, 310, 333
Huntington's
disease 34, 177
pupil 158, 193
Hydrocephalus 254
Hydroxy amphetamine 162
Hypermetropic eyes 72
Hypertension 3, 93
Hyperviscosity diseases 3
Hypoperfusion of optic disk 93
Hypoplasia 73, 337, 338
Hypotension 138
Hypothalamus 167
Hypoxia 138
I
Ice pack test 274
Immunosuppressive drugs 175, 278
Impaired color sensation 112
Impending central vein thrombosis 101
Inability to close eye 248
Infantile neuropathy 112
Infarction of optic nerve 90
Infection of central nervous system 9
Infectious diseases 3
Inferior petrosal sinus thrombosis 315
Inflammatory cause of ocular headaches 325
Infranuclear defect 36
Infrequent blinking 5
Injecting alcohol 215
Insulin dependent diabetics 100
Intermediate nucleus 41
Internal
capsule 62
carotid 119
ophthalmoplegia 143, 244, 256
Internuclear ophthalmoplegia 103, 173, 174, 250
Interpontine course 64
Intracavernous carotid aneurysms 297
Intracerebral hemorrhage 81, 294, 316
Intracranial aneurysm 294
Intractable headache 127
Intraorbital compressive lesion 95
Intravenous injection 276
Intraventricular hemorrhage 294
Intrinsic tumors 115
Investigations required in third nerve palsy 199
Ipsilateral
control 38
internuclear ophthalmoplegia 202
single muscle 217
subdural hematoma 193
Irregular polygon 285
Ischemic
chiasmal syndrome 306
neuropathy 25
optic
neuritis 7
neuropathy 90
syndrome 304
Isolated
facial palsy 229
partial third nerve palsy 244
total third nerve palsy 244
trunk lesion 192
Isoniazid 98
Isopter 11
IV methylprednisolone 104
J
Jerk nystagmus 338
Junctional scotomas 13, 95, 124
Juvenile myasthenia gravis 275
Juxtapapillary choroiditis 110
K
Kearns-Sayer syndrome 271, 281
Kinetic 14
Kjer's
juvenile
neuropathy 111
optic neuropathy 112
neuropathy 8
L
Lack of lid oculomotor synergies 32
Lacrimal
hyposecretion 229
nucleus 64
Lactic acidosis 271
Lagophthalmos 5, 178, 236
Lambert-Eaton syndrome 271, 277
Larynx 174
Latency in nystagmus 341
Lateral
geniculate body 133
rectus 217
sinus thrombosis 315
Leber's
congenital amaurosis 338
disease 8, 111
hereditary optic neuropathy 99
neuropathy 88
optic neuropathy 111
Leprosy 34
Leprotic facial palsy 184
Lesions of
supranuclear pathway 248
third nerve 189
Less common nucleofascicular lesion 202
Leukemia 81, 115
Levator peripheral superior 166
Level of vision 84
Lid
dyskinesis 196
fatigue 172
jaw synergies 32
myokymia 243
retraction 5, 32, 186
Light
near dissociation 156
reflex 65, 147
Lightening eye movement 349
Localization of fourth nerve lesion 206
Localized chorioretinitis 109
Long
ciliary nerves 150
standing juvenile diabetes 156
Lower
altitudinal field defects 93
division of third nerve 255
motor neuron
facial palsy 180, 232
paralysis 178
pons 52, 58
Lupus erythematosus 81
Lyme disease 34, 234
M
Macular
hypoplasia 338
lesion 22
sparing 14, 18, 136
splitting 14
Maculopathy 19
Malignant
hypertension 8
melanoma 114
Malingering 8, 21, 140
Management of
nystagmus 351
ocular myasthenia 279
optic neuritis 87
papilledema 82
Mania 22
Manipulation of neck 138
Marcus-Gunn
pupil 153
syndrome 175
Massive loss of blood 93
Meckel's cave 210
Medial longitudinal fasciculus 54, 250
Mega dose of steroids 98
MELAS syndrome 271, 281
Melkersson-Rosenthal syndrome 34, 184, 241
Meningioma 220
Meningioma of
intraorbital part 117
neuro-ophthalmic interest 130
Meningitis 3
Ment for tactile sensation 58
Mesencephalic
nucleus 58
root of trigeminal 51
Mestinon 278
Metamorphopsia 22
Methods of field charting 14
Methyl alcohol 7, 98, 99
poisoning 105
Metronidazole 98
Microangiopathy 112
round disk 100
Microvascular ischemia 192
Mid chiasmal lesions 110
Midbrain 62
Fovile's lateral medullary syndrome 160
Middle
cerebral artery 139, 286, 292
aneurysm 300
meningeal artery 210
third sphenoidal 131
Migraine 8, 214
Millard-Gubler syndrome 33, 178, 218, 219, 245
Miners nystagmus 338
Miosis 31, 143
Miotic pupil 143
Mitochrondrial encephalopathy 271
Mixed
adenomas 123
nerve 56, 62
nystagmus 338
Mobius syndrome 34, 217, 241, 268
Monocular
gross loss 141
field defects 12
Monosymptomatic 138
Morning Glory syndrome 8, 73
Motility disorders 4
Motor
component 56
nucleus 62
root 58
Muller's muscle 31, 166, 167
Multiple
cranial nerve 219
palsy 259
sclerosis 3, 25, 89, 103, 112
Muscle of
face 174, 177
palate 174
Myasthenia 3, 25, 32, 34, 171, 261
crisis 279
gravis 184, 271, 272
like syndromes 271
Myasthenic
crises 279
ptosis 273
Mydriasis 143
Mydriatic pupil 143
Myelitis 89
Myocardial infarction 91
Myoclonus 5
Myogenic
causes of bilateral ophthalmoplegia 263
ptosis 170
Myokymia 5
Myopic astigmatism 73
Myotonic dystrophy 34, 184, 282
N
Nasal cavity 56
Nasopharyngeal tumors 220
Nausea 5
Near reflex 65, 148
Neonatal asphyxia 138
Neostigmine test 276
Nervus intermedius 62
Neuralgia 5
Neuritis phase 111
Neuroblastoma 116
Neurofibroma 115, 220
Neuroimaging 79
Neurological
blepharospasm 241
causes of
diminished near vision 9
lid retraction 33
ptosis 168
symptoms 84
Neuromuscular
junction disorders 271
ptosis 170
Neuromyelitis 103
Neurons of
first order 145
second order 145
third order 145
Neuro-ophthalmic
diseases 271
disorders of lids 166
features of
aneurysms of carotid 297
sixth nerve 217
interest 285
lesions 19
manifestation of
abducens 217
cerebral infarct 303
fifth nerve 210
fourth nerve 202
seventh nerve 229
third nerve 189
mobility disturbance of eye 244
significance 24
Neuro-ophthalmology 1
Neuropathy with diabetes mellitus 111
Nocturnal hypotension 93
Nonarteritic ischemic optic neuropathy 93
Non-neural ophthalmoplegia 264
Nonneurogenic ptosis 171
Nonocular symptoms 5, 130
of neuro-ophthalmic disorders 5
Nonoptical reflex 38
Nontumor enlargement of sella 127
Non-Wallerian degeneration 108
Normal
light reflex 152
pupillary reaction 152
Nothnagel's syndrome 191
Nuclear lesion 31, 189, 218
Nuclei of
seventh nerve 62
trigeminal nerve 56
Nucleus 52
trochlear nerve 50
Nystagmus 4, 26, 90, 103, 112, 115, 126, 173, 337
O
Occipital
lobe ischemia 6
migraine 138
tumors 138
Occlusion of
branch of central retinal artery 110
central retinal vessels 7
Occlusive diseases of
carotid system 304
vertebrobasilar system 306
Ocular
adnexa 56
bobbing 350
causes of swollen disk 82
dysmetria 350
flutter 350
headache 325
hypoxic syndrome 298
management 175
movements 115
myasthenia 273
myoclonus 349
myopathies 279
pain 310
symptoms 3, 4, 91
Oculogyric crisis 351
Oculomotor 36
imbalances 308
nerve 36, 39
palsy 9
Oculopharyngeal dystrophy 282
Oculosympathetic
fibers 298
path 51
Olfactory meningioma 110
Ophthalmic
division 60, 150
migraine 331
nerve 52
retinal circulation 139
Ophthalmoplegia 125
migraine 196, 331
Ophthalmoscopic classification of optic atrophy 108
Ophthalmoscopy 107
Opsoclonus 349
Optic
atrophy 106, 107, 110, 115
atrophy in children 113
canal 97, 116
disk 85
foramen for asymmetry 116
nerve 36, 66, 115
hypoplasia 8
neuritis 7, 83, 89, 103, 111
in children 87
neuropathy 19
in thyroid ocular diseases 101
neuroretinitis 83
radiation 68, 133
sheath meningioma 117
tract 68, 133
tract lesions 110
Optociliary vessels 96
Optokinetic nystagmus 71
Oral
contraceptives 98
prednisone 93
Orbicularis 166, 173, 178, 242
Orbit 49
Orbital
apex syndrome 214
lesions 223
myositis 271
part 44, 52, 55
pseudotumors 261
Orofacial dystonia 177
Oscillopsia 21, 349
Osteoma 220
P
Painful ophthalmoplegia 259
Palinopsia 22
Papilledema 21, 75, 110, 318
Papillitis 72, 83
Papillomacular fibers 102
Papillopathy 100
Papillophlebitis 96, 101
Paracentral scotoma 12
Paradoxical
action 195
lid movement 5
pupil 163
Paralysis of masseters 174
Paralytic
ptosis 168
squint 129
Paranasal sinuses 103
Paraplegia 5, 89
Parasites 88
Parasympathetic
fibers 41
root 46
Paredrine 162, 170
Paretic phase 196
Parinaud's
dorsal midbrain lesion 187
syndrome 156, 253
Parkinson's disease 34, 177, 242
Partial
ophthalmoplegia 255
recovery 104
third nerve palsy 194
Pathogeneses of
migraine 327
optic atrophy 107
Pathological nystagmus 342
Pathway of
light reflex 145
near reflex 148
Pediatric
migraine 334
myasthenia 275
Pendular nystagmus 20, 337
Periaxial neuritis 83
Perineuritis 83
Periodic alternate nystagmus 348
Peripapillary superficial hemorrhage 101
Peripheral
field 10
lesions 212
Periphlebitis 103
Permanent loss of vision 124
Persistent neonatal myasthenia 275
Pharmacological tests 172
Pharynx 174
Phase of
atrophy 91
edema 91
Phenomenon of Hutchinson's pupil 194
Photophobia 20
Photopsia 22, 91
Picture of papillitis with retinal edema 106
Pie in
floor 14
sky 14
Pilocytic astrocytomas 115
Pituitary
adenomas 122
apoplexy 127
tumors 87, 122
Polio 34
Polymyalgia 91
Polyopia 24
Pons 58, 62, 178, 218, 249
Pontine
horizontal gaze complex 36
lesion 249
paramedian reticular formation 54, 309
Pontomedullary junction 54
Position of fibers of different functions 45
Positional nystagmus 351
Posterior
cerebellar artery 133
cerebral 43
arteries 52, 285, 292
ciliary arteries 90
circulation 93
columns 103
communication artery 132, 300
fossa migraine 333
ischemic neuropathy 90
Postherpetic neuralgia 214
Postinflammatory optic atrophy 8
Postneuritic
atrophy 8
optic atrophy 104
Postpapilledematous optic atrophy 8, 96, 115
Predisposing factors 93
Pregnancy 103
Presbyopia 8
Pretectal
nucleus 147
syndrome 253
Primary optic atrophy 8, 96, 108, 110, 115
Principle sensory nucleus 58
Progressive supranuclear palsy 177, 253
Propioceptive
impulses 36
sensation 58
Proptosis 5, 95, 221, 248
Prostigmine 33
test 172
Pseudo Argyll-Robertson pupil 196
Pseudoneuritis 72
Pseudopapilledema 77
Pseudotumor
cerebri 319
orbit 95
Ptosis 5, 31, 273
Ptosis of
Horner's syndrome 169
third nerve origin 168
Pulmonary emphysema 81
Pupil dyskinesis 196
Pupillary
abnormality 120
anomaly 89
changes in
anterior junctional lesions 155
mid chiasmal lesion 154
neuro-ophthalmic disorders 143
pretectal lesion 155
defect 91
reaction 21, 100
sparing oculomotor palsy 45
Pyramidal track 178
Pyridostigmine 278
Q
Quadrantanopia 11
Quinine 7
R
Raeder's
paratrigeminal 160
neuralgia 215
syndrome 213
Raised intracranial
pressure 6, 221
tension 8
Ramsay-Hunt syndrome 34, 183, 234
Raymond's syndrome 219, 245
Real enophthalmos 170
Rebound nystagmus 348
Red nucleus 191, 245
Reflex blepharospasm 34
Regurgitation of fluid from nose 5
Relation of
chiasma to arteries 119
vision to ophthalmoscopic picture 84
Relative
afferent pupillary reaction 97
position of fibers in visual pathway 68
scotoma 11
Remnants of notocord 221
Retina 65, 86
Retinal migraine 332
Retinitis 103
pigmentosa 109
Retinoblastoma 114
Retinocalcarine 65
Retraction syndrome 271
Retractors 166
Retrobulbar neuritis 83, 102, 103
Retrochiasmal
lesions 133
part 114
Reverse Horner's syndrome 162
Rhabdomyosarcoma 116
Riley-Day syndrome 159
Rostral-dorsal midbrain 187
Rotational test for vestibular nystagmus 341
Round Sylvian aqueduct 249
S
Saccadic movements 38
Scalp tenderness 91
Schilder's disease 81, 113
Schizophrenia 22
Scotoma 9, 11, 91
Second branchial arch 62
Secondary
blepharospasm 177
empty sella syndrome 127
optic atrophy 108, 109
Secretomotor
component 62
nuclei 63
See saw nystagmus 347
Sensory 46, 56
ganglion of trigeminal nerve 60
nucleus 63
root 46
Setting sun appearance 187
Seventh cranial nerve 62
Severe
dyschromatopsia 112
loss of vision 93
Short acting anticholinesterase drug 276
Short posterior ciliary arteries 90
Simple recessive optic neuropathy 112
Sixth
cranial nerve 52
nerve palsy 221
Skeletal muscles 173
Skew deviation 253
Sleep test 274
Slow eye movement 38
Small oval nucleus 52
Smaller subsidiary nucleus 51
Smooth pursuit 38
Snellen's chart 141
Space occupying lesion of brain 3
Sparing of temporal crescent 14
Spasms of pupil 163
Spastic lid retraction 33
Sphenoidal
meningioma 130
ridge meningioma 110
sinusitis 103
Spinal cord 170
tumors 81
Splinter 86
Spontaneous hemorrhage 73
Spread over long area 58
Sprouting of new axons 195
Square wave jerks 350
Squint 4, 26, 271
surgery 175
Star formation 86
Static perimetery 14
Steroids 278
Stilling-Turk-Duane syndrome 264
Stimulation of cervical sympathetic 33
Strabismus fixus 271
Streptomycin 98
Stroke like syndrome 271
Stylomastoid foramen 64
Subarachnoid
hemorrhage 79, 294, 317
spaces 67
Subdural hematoma 2, 79, 193, 318
Superficial exudates 86
Superior
cerebellar arteries 43, 52
cervical ganglion 150
oblique myokymia 207, 350
orbital fissure syndrome 214
rectus 167
sagittal sinus thrombosis 315
salivatory nucleus 63
Supraclinoid carotid artery aneurysms 299
Supranuclear
connections of eye movement 37
fibers 62
gaze anomaly 304, 305
lesion of seventh nerve 167
path 36, 230
ptosis 168
retraction 187
Suprasellar
calcification 129
meningioma 129
Swinging flash light test 153
Swollen
disk 101
hyperemic disk 101
Sylvian aqueduct syndrome 253
Sympathetic
efferent pupillary change 159
ptosis 169
root 47
Symptomatology in neuro-ophthalmic disorders 1
Symptoms of neuro-ophthalmic
disease 3
motility disturbances 245
Symptoms of
papilledema 75
paralytic squint 257
trigeminal 212
Synaptic acetylcholine receptors 272
Syphilis 3
Syphilitic arteritis 90
Systemic
complication of migraine 331
diseases 3
manifestations 75
symptoms 90
T
Tegmentum 191
Telangiectasia 100
near disk 112
vessels 101
Temporal
artery biopsy 92
pallor 109110
Temporomandibular joint 319
Tensilon test 172, 274, 276
Term iridoplegia 143
Terminal ends 167
Terson's syndrome 318
Tests for ptosis 273
Tetanus 9, 34
Tetany 34
Thermal gangliolysis 215
Thiamine 104
Third
cranial nerve 39
neuron 148
Thymectomy 175
Thyroid
disease 3
eye disease 173, 174
myopathy 261
ophthalmopathy 25
orbitopathy 95
Thyrotoxicosis 33
Tinitus 5
Tonic
gaze deviation 253
pupil 158
Topical diagnosis of fourth nerve defect 205
Topographically optic neuritis 83
Total
ophthalmoplegia 244, 254
third nerve palsy 193, 197
Toxic amblyopia 104
Tractus solitarius 63
Transient
ischemic attack 302
neonatal myasthenia 275
visual loss 20
Transverse
myelitis 89
neuritis 83
Trauma 2, 109
Traumatic
fourth nerve palsy 207
optic neuropathy 2, 96
third nerve palsy 194
Trigeminal
nerve 36, 210
neuralgia 214
Trivial injury 97
Trochlear nerve 36
Tuberculosis 3
Tuberculum sella 129
Tumors of
intracanalicular part 114
intracranial parts 114
intraorbital part 114
optic nerve 113
Types of
afferent pupillary changes 152
Duanne's retraction syndrome 266
U
Unilateral
disk edema 96
facial palsy 233
loss of vision 96, 97, 100
Uniocular
diplopia 24
fall of vision 129
loss of vision 91
nystagmus 351
sudden loss of vision 93
Unstable gait 258
Upbeat nystagmus 347
Upper motor neuron paralysis 178
Uvea 325
Uveitis 103
V
Vascular
accident 219
lesions of neuro-ophthalmic interest 285
neuropathy 96
phenomenon 90
Venoms 137
Venous
diseases 294
stasis syndrome 305
Ventral pons 218
Ventromedial nucleus 41
Vertebrobasilar
artery 7, 285
insufficiency 21
system 133, 295, 296
aneurysm 301
Vertical gaze 38
defects 252
palsy 309
Vertical retraction syndrome 271
Vertigo 5, 258
Vestibular
division of eighth nerve 219
nystagmus 345
reflex 38
system 21
Vestibulo-cochlear
nerve 36
ocular nerve 36
Virus 88
Visible part of optic nerve 83
Visual
agnosia 22
aura 21
cortex 17, 22, 65, 68
hallucinations 21
loss 127
path 65, 103
symptoms 4, 76
Vomiting 5, 129
W
Wallenberg's syndrome 160
Wallerian degeneration 108
Weakness in limbs 5
Weber's
syndrome 245
ventral syndrome 191
Wedge pallor 110
Well demarcated dermatomes 211
Wernicke's hemianopic pupil 155
Widening interpalpebral aperture 248
X
X-ray orbit 283
×
Chapter Notes

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1Essentials of Neuro-ophthalmology2
Declaration
Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The authors, editors, contributors and the publishers have, as far as it is possible, taken care to ensure that the information given in this text is accurate and up-to-date. However, readers are strongly advised to confirm that the information, especially with regard to drug dose/usage, complies with current legislation and standards of practice.
3Essentials of Neuro-ophthalmology
PK Mukherjee MS Former Professor and Head Upgraded Department of Ophthalmology Pandit Jawaharlal Nehru Memorial Medical College Raipur, Chhattisgarh, India
4
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Jitendar P Vij
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Essentials of Neuro-ophthalmology
© 2010, Jaypee Brothers Medical Publishers (P) Ltd
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First Edition: 2010
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5To My Wife and Soul Mate Protima6
Preface
The fascinating subject of neuro-ophthalmology is an enigma that frightens the undergraduates and the postgraduates are initially at ease with cases of neuro-ophthalmology and the general ophthalmologists find them too demanding hence are happy to handover them to neurophysicians or neurosurgeons at the earliest.
Neuro-ophthalmology is not an individual entity, it is very much ophthalmology. It has ramifications in other specialties like neuromedicine, neurosurgery, neuroimaging, oncology and otorhinology.
The riddle of neuro-ophthalmology is not difficult to crack provided the cases are examined by a fixed protocol, avoiding ordering investigations at random. The puzzles of neuro-ophthalmology are easier to solve if the clues in the form of history, clinical examination, etc. are given adequate attention to.
The number of books in neuro-ophthalmology are not too many. Most of those available are huge treatise which are almost classics by themselves. These books create awe in the beginners. The remaining books are too abridged to comprehend. The present book is a veritable “Neuro-ophthalmology Made Easy” meant for both undergraduates and postgraduates.
Management of a neuro-ophthalmic disorder is not always within the domain of ophthalmologists who should be aware of the significance of referring the case to consultants in other specialties. They should be able to decide when and to whom a case should be referred to.
The present book does not deal with systemic management in details, whenever needed only passing references have been given. The systemic management is better left to neurophysicians or neurosurgeons. The surgical procedures too have been left out. They may be read from specific books. Neuroimaging is proving to be a great boon in neuro-ophthalmic disorders. The students are advised to understand finer points of neuroimaging from books exclusively dealing with the subject.
PK Mukherjee7
Acknowledgments
It was virtually impossible for me to write the book without the help from my friends, colleagues and family members.
On the top of the list of my peers, who extended unending help are the members of upgraded Department of Ophthalmology, Pandit Jawaharlal Nehru Memorial Medical College, Raipur, Chhattisgarh, India. They include Professor SL Adile, the present Director Medical Education, Government of Chhattisgarh, Professor and Head of the Department, Dr AK Chandrakar, Professor Dr ML Garg and Dr Nidhi Pandey, Associate Professor of Ophthalmology, all of whom have kept me supplied with unending stream of books and journals. Dr Santosh Patel has been generous enough to provide me maximum number of clinical pictures, who deserves special mention and thanks.
My niece, Dr Nupur Chakravarty, Professor of Ophthalmology, YD Patil Medical College, Mumbai, Dr OP Billore of Rotary Eye Hospital, Navsari, Dr Hetal Yagnik, Dr Sharad Sivasane and Dr Dishant Shant of the same institute as well, have sent me interesting photographs from their collection. Their contribution is acknowledged with gratitude. I am thankful to Dr Anand Saxena for the colored fundus photographs and fundus fluorescein angiography (FFA) used in the book.
I thank Dr Barun K Nayak, Editor of Indian Journal of Ophthalmology, to use some of the photographs published in the journal.
Dr Manik Chatterjee, Associate Professor of Anatomy, Pandit Jawaharlal Nehru Memorial Medical College, Raipur, Chhattisgarh, India was always available to solve my curiosity about intricacies of neuroanatomy. He was polite enough to point out the fallacies in my drawings. I am thankful to him.
I am highly obliged to Padamsri Professor AT Dabke PhD, former Director of Medical Education and Professor of Pediatric for permitting to use his personal library unfettered.
The book may not have seen the light of the day without the help from members of my family. My sons-in-law, Satayadeep Sahukar and Dr Abeer Bandyapadhya, took special interest in locating various references on Internet, drawing the diagrams and arranging them. I am thankful to my daughters, Dr Protibha Mukherjee Sahukar and Dr Preeti Bandyopadhya, for their unending help and suggestions from time to time in their respective specialties.
The real inspiration has been my wife, Protima, who awakened me often from the slumber in which I slipped occasionally.
Sri Maneesh Dandekar of Hypersoft Computers has taken great troubles in deciphering my handwritten manuscript and type them many a times. Sri Bhim Sona of Hypersoft also deserves appreciation for drawings used in the book.
Finally, I extend my thanks to Sri Jitendar P Vij (Chairman and Managing Director), Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, India and members of his team for their constant interest in publishing my humble contribution towards continued medical education.