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Klopto 1: Plotseling slecht zicht en de papil van Louise van Doorn, Jaar 2, Blok B
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Samenvatting van HC 1 van Klopto met de leerdoelen uitgewerkt.
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Klopto1: Plotseling slecht zicht en de papil
Notatie funduscopie:
Testen:
- Pupilreacties
o Testen van de NII en NIII
- Gezichtsveld
o Testen van de NII en de visuele cortex
- Oogbewegingen
o Testen van de NIII, NIV en NVI
- Kleurzien
o Testen van de NII
o Rode: doorsturen wanneer de uitslag boven de 20% is
- Visus/ contrast
o Testen NII en visuele cortex
- Fundus
o Onderzoek NII
, Nervus opticus
Intraocular part (1-2mm): wat we zien in de fundus
Intraorbital portion (20-30mm):
- De zenuw is langer dan nodig in de orbita
- Speling voor rotatie en rek
Intracanalicular portion (- 10mm)
- Zenuw loopt door het canalis opticus in het os sphenoidale
- Stevig verbonden met de dura en dus gevoelig voor trauma
Intracranial portion (10-15mm): verloop richting chiasma opticum
, Gradatie bij papiloedeem:
- Kijk naar de begrenzing van de papil
- Kijk naar verloop van kleine bloedvaatjes, bij een grotere zwelling verdwijnen deze
Oorzaken unilaterale zwelling papil:
Ontsteking:
- Neuritis optica
- Demyelinisatie
- Ontstekingsoorzaken
o Sarcaoidosis
o Lupus (LSE)
Infecties:
- Syfilis
- Via sinus of orbita infectie
Trauma
Infiltratief
- Lymfoom (lymfeklier kanker (NON) hodgkin
Vasculair
- NAION
- AAION
- Diabetic papillopathy
Compressie orbitale/ craniale lesies
- Agressieve thyroïd orbitopathie
- Optic nerve sheath meningioma
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