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Third Semester Case Base Learning (CBL) – 1 Week 2: 19-03-18 to 24-3-18 2nd Year M.B.B.S MODULE – HEAD AND NECK Theme (Optic Neuritis)

A 22-year-old female presented with pain and visual loss in the left eye for 4 days. On examination visual acuity is restricted to the finger counting. Her left eye cornea conjunctiva and lens are normal; pupil is dilated and non-reacting. On fundoscopy, left fundus shows papilloedema. There was past history of left hemiparesis that recovered completely with a course of steroid injection.

Her pulse, blood pressure and auscultation of heart are normal. Her blood sugar is 120mg/dl.

Her MRI-Brain is showing hyperintense signals in cerebrum, cerebellum and the left optic nerve.


  1. Anatomy:
  2. Describe the course of optic nerve with reference to optic chiasma and optic tract.
  3. What is the location of primary and secondary visual areas in cerebral cortex?
  4. Describe connections of visual areas to different parts of CNS.
  5. What is myelin shealth and what function does it perform?


  1. Biochemistry:
  2. What are the different forms of Vitamin A?
  3. Describe the visual cycle.
  4. What is the function of vitamin A?
  5. What are the disorders caused by vitamin A deficiency?


  1. Community Health Sciences:
  2. What are the causes of blindness in the community?
  3. How would you prevent blindness in the community?



  1. Neurosciences:
  2. Define optic neuritis, multiple sclerosis and demyelination.
  3. What are the symptoms and signs of optic neuritis?
  4. What are signs of multiple sclerosis?
  5. What is the relation of optic neuritis with multiple sclerosis?
  6. What is visual evoked potential (VEP)? What are VEP findings in optic neuritis?
  7. What is the drug treatment of optic neuritis?


  1. Pathology:
  2. What are the infectious and the non-infectious causes of optic neuritis?


  1. Physiology:
  2. Describe the formation of optic nerve fibers.
  3. Learn visual pathway and its related lesions resulting the various types of blindness.
  4. Radiology:


  1. Search MRI scan for multiple sclerosis associated with optic neuritis.


Book References:

  • Neuroanatomy by Snell
  • Neurology Neurosurgery illustrated
  • Robin’s Basic Pathology
  • Guyton Textbook (Major)
  • Ganong Review of Physiology
  • Sherwood text book of Physiology
  • Pathologic Basis of Disease
  • Biochemistry by Lippincott

Web Based Article:

  • Khan Academy
  • YouTube