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ophthalmology causes differential adies clinical physicalexam vision algorithm anisocoria blurry diplopia doublevision encephalopathy loss parinauds pocus syndrome triad ultrasound wernickes
Adie's Pupil What? Unknown nature & benign • Regular and mildly dilated pupil (4-6mm); • Light-near dissociaton;
• Light-near dissociaton ... females Differential Diagnosis ... no light-near dissociation ... Other causes of tonic ... #PhysicalExam #neurology
Parinaud's syndrome What? • Light-near dissociation (tectal pupils) • Convergence retraction nystagmus • Eyelid retraction (Collier's sign)
• Light-near dissociation ... (tectal pupils) ... Convergence retraction nystagmus ... Parinauds #syndrome #neurology ... #diagnosis
Lens Dislocation on Ocular POCUS One of my favorite POCUS diagnoses! Recent study showed POCUS was 99%
Lens Dislocation ... on Ocular POCUS ... favorite POCUS diagnoses ... PratsEM Amazing video ... #Lens #Dislocation
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 Vision Loss - Differential Diagnosis Chronic: - Cornea: Scarring, Edema - Lens: Cataracts
- Differential Diagnosis ... Scarring, Edema - Lens ... Cataracts - Macula: Macular ... Unilateral, Painless: Lens ... Dislocation, Retinal
Adie’s Tonic Pupil on Physical Exam A young female was referred in for a sudden onset anisocoria.
Adie’s Tonic Pupil ... Her ocular exam ... Adie’s tonic pupil ... with light near dissociation ... #clinical #video
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 Blurry Vision - Differential Diagnosis Framework Anatomical Approach to Eye Disease: 1. Lids/Lashes 2. Extraocular Muscles/Motility 3. Conjunctiva/Sclera 4. Cornea 5. Anterior
- Differential Diagnosis ... Ocular Adverse Effects ... dislocation • ... GCA • Adie’s pupil ... #differential #diagnosis
Wernicke's Encephalopathy CLINICAL TRIAD: only seen in 1/4 pts W.E. is often under diagnosed 1. ENCEPHALOPATHY
is often under diagnosed ... DYSFUNCTION (29%) Nystagmus ... , Light near dissociation ... , Nonreactive pupils ... #triad #neurology
Diplopia - Double Vision - Differential Diagnosis Algorithm Clinical Pearls: • Diplopia is almost always binocular. •
- Differential Diagnosis ... • Neurologic ... Error • Cataract/Lens ... Dislocation • ... large/unreactive pupil
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