Ophthalmology and Visual Sciences

  • D. Disorders of the Afferent and Efferent Visual Pathways

    I. Diseases of the optic nerve

    Goals:

    1. Diagnose and evaluate patients with optic nerve diseases.

    Topics:

    1. Ischemic optic neuropathy(1) 
      1. Anterior
      2. Posterior
      3. Diabetic papillopathy
    2. Inflammation(1)
      1. Non infectious
      2. Infectious
    3. Compression / Infiltration(1)
    4. Paraneoplastic(2)
    5. Traumatic(1)
    6. Toxic(1)
    7. Nutritional(1)
    8. Metabolic(1)
    9. Hereditary(1)
    10. Congenital(1)
    11. Glaucoma(3)
      1. Classification of glaucoma
      2. Evaluation and basic management of glaucoma
    12. Raised intracranial pressure (papilledema)(1)

    II. Orbital pathology causing neuro-ophthalmic manifestations

    Goals:

    1. Diagnose and evaluate patients with orbital diseases.

    Topics:

    1. Trauma(1)
    2. Mass lesions(1)
      1. Neoplasms
      2. Thyroid orbitopathy
    3. Orbital inflammation(1)
    4. Infection(1)
      3. Orbital cellulitis
      4. Abscess

    III. Diseases of the chiasm

    Goals:

    1. Diagnose and evaluate patients with chiasmal disorders

    Topics:

    1. Chiasmal visual field defects(1)
    2. Compression/infiltration(1)
    3. Inflammation(1)
    4. Trauma(1)
    5. Ischemia/hemorrhage(1)

    IV. Diseases of the retrochiasmal visual pathways

    Goals:

    1. Diagnose and evaluate patients with lesions of the retrochiasmal visual pathways.

    Topics:

    1. Optic tract(1)
    2. Lateral geniculate(1)
    3. Radiations(1)
    4. Calcarine cortex(1)
    5. Association areas(2)
    6. Specialized syndromes
      1. Anton's syndrome (cerebral blindness)(1)
      2. Riddoch's phenomena: Statico-kinetic dissociation(2)
      3. Balint syndrome(2)
      4. Gerstmann syndrome(2)
      5. Cerebral achromatopsia(2)
      6. Alexia without agraphia(2)
      7. Acalculia(3)
      8. Agraphia (with associated alexia)(2)
      9. Agnosias(2)
      10. Visual neglect(2)
      11. L-R confusion(3)
      12. Akinetopsia(3)
      13. Concept of "Blindsight"(3)

    V. Pupillary pathology

    Goals:

    1. Diagnose and evaluate patients with abnormal pupillary reactions.

    Topics:

    1. Normal pupillary responses(1)
    2. Effects of drugs on the pupils(1)
    3. Congenital pupillary abnormalities(2)
      1. Coloboma
      2. Congenital iris strands (embryonic pupillary membrane)
      3. Anterior cleavage syndromes
      4. ICE syndrome (iridocorneal-endothelial adhesion syndrome)
      5. Ectopic pupil
    4. Pupillary changes secondary to ocular diseases(1)
      1. Traumatic, foreign body
      2. Inflammation
      3. Neovascularisation
      4. Ocular surgery, laser
    5. Traumatic pupillary changes(1)
    6. Evaluation and management of anisocoria(1)
    7. Evaluation and management of a large or a small pupil(1)
    8. Evaluation and management of specific pupillary disorders(1):
      1. Tadpole pupil(2)
      2. Argyll-Robertson pupil(1)
      3. Correctopia(2)
      4. Physiologic anisocoria(1)
      5. Horner's syndrome(1)
      6. Third nerve palsy(1)
      7. Afferent pupillary defect(1)
      8. Light near dissociation(1)

    VI. Eye movement systems pathology

    Goals:

    1. Diagnose and evaluate patients with abnormal eye movements.

    Topics:

    1. Vestibular ocular system(2)
    2. Optokinetic nystagmus(2)
    3. Saccades(2)
    4. Pursuit(2)
    5. Convergence(2)
    6. Divergence(2)
    7. Specific ocular motor syndromes:
      1. Cranial nerve palsies(1) 
          1. Third, fourth and sixth
      2. Supranuclear palsies(1) 
          1. Internuclear ophthalmoplegia 
          2. One and half syndrome 
          3. Horizontal gaze palsy 
          4. Monocular elevation deficit 
          5. Vertical gaze palsy 
          6. Skew deviation 
          7. Ocular tilt reaction(2)
      3. Ocular motor apraxia(2) 
          1. Spasm of the near triad(1) 
          2. Convergence insufficiency(1) 
          3. Divergence insufficiency(1) 
          4. Decompensation of phorias(1) 
          5. Restriction syndromes(1) 
          6. Ocular neuromyotonia(2) 
          7. Cyclic oculomotor paresis(2)
    8. Classical brain stem syndromes(3)
      1. Foville
      2. Millard-Gubler
      3. Duane's syndrome
      4. Möbius syndrome
      5. Locked In syndrome
      6. Nothnagel
      7. Benedickt
      8. Weber
      9. Claude syndrome
      10. Wallenberg syndrome
      11. Syndrome of the anterior inferior cerebellar artery
    9. Ocular motility disturbance by location(1)
      1. Medulla
      2. Pons
      3. Mesencephalon
      4. Dorsal mid brain syndrome
      5. Cerebellar pathology

    VII. Nystagmus and disorders of ocular stability

    Goals:

    1. Diagnose and evaluate patients with ocular oscillations.
    2. Recognize the localizing nystagmus.

    Topics:

    1. Jerk nystagmus(1)
    2. Pendular nystagmus(1)
    3. Congenital vs acquired nystagmus(1)
    4. Central vs peripheral nystagmus(1)
    5. Specific types of nystagmus and their localizing value(1)
      1. Down beat nystagmus
      2. Upbeat nystagmus
      3. Rebound nystagmus
      4. Brun's nystagmus
      5. Periodic alternating
      6. Convergence retraction nystagmus
      7. See saw nystagmus
      8. Divergence nystagmus
      9. Sensory nystagmus
      10. Congenital motor nystagmus
      11. Spasmus nutans
    6. Induced nystagmus(2)
      1. Valsalva
      2. Sounds (Tullio's phenomena)
      3. Calorics: hot or cold water in ear(1)
    7. Ocular oscillations(1)
      1. Superior oblique myokymia
      2. Square wave jerks
      3. Opsoclonus
      4. Flutter
      5. Ocular bobbing
      6. Oculopalatal myoclonus
      7. Oculomasticatory myorhythmia

    VIII. Eyelid position abnormalities

    Goals:

    1. Diagnose and manage patients with eyelid position abnormalities.

    Topics:

    1. Eyelid retraction.(1)
    2. Ptosis(1)
      1. Pseudoptosis(3)
      2. Congenital(2)
      3. With elevator palsy(2)
      4. Marcus Gunn Jaw Wink(2)
      5. Blepharophimosis(3)
      6. Levator dehiscence(2)
      7. Myopathic(1)
      8. Neuro-muscular transmission(1)
      9. Neuropathic(1) 
          1. Cortical 
          2. Apraxia of eyelid opening 
          3. Third nerve dysfunction 
          4. Horner's syndrome
      10. Blepharospasm(1)
    3. Eyelid nystagmus(2)

    IX. Facial nerve dysfunction

    Goals:

    1. Diagnose and evaluate patients with facial nerve dysfunction.
    2. Treat patients with blepharospasm and hemifacial spasm

    Topics:

    1. Central and peripheral facial palsy(1)
    2. Blepharospasm(1)
    3. Hemifacial spasm(1)
    4. Facial myokymia(2)
    5. Oculomasticatory myorhythmia (Whipple's)(3)
    6. Facial tics(3)
    7. Facial myotonia(3)