Asymmetries of Dark and Bright Negative Afterimages Are Paralleled by Subcortical on and OFF Poststimulus Responses
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Accommodation in the Holmes-Adie Syndrome by G
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.21.4.290 on 1 November 1958. Downloaded from J. Neurol. Neurosurg. Psychiat., 1958, 21, 290. ACCOMMODATION IN THE HOLMES-ADIE SYNDROME BY G. F. M. RUSSELL From the Neurological Research Unit, the National Hospital, Queen Square, London In 1936, Bramwell suggested that the title response to near and far vision respectively. But it "Holmes-Adie syndrome" be given to the clinical has also been noted that the reaction to convergence complex of a slowly reacting pupil and absent tendon may be remarkably wide in its range, considering reflexes in recognition of the descriptions by Holmes that it often follows a stage of complete paralysis (1931) and Adie (1932). Both authors had empha- (Strasburger, 1902). Not only is the reaction to sized the chief clinical features-dilatation of the convergence well preserved when compared to the pupil, apparent loss of the reaction to light, slow reaction to light, but it may in fact be excessive constriction and relaxation in response to near and (Alajouanine and Morax, 1938; Heersema and distant vision, and partial loss of the tendon reflexes. Moersch, 1939). In assessing the degree of tonicity Although the syndrome had been recognized wholly there are, therefore, two criteria: slowness ofguest. Protected by copyright. or in part many years previously (Strasburger, 1902; pupillary movement and preservation of the range Saenger, 1902; Nonne, 1902; Markus, 1906; Weill of movement. and Reys, 1926), credit must go to Adie for stressing Adler and Scheie (1940) showed that the tonic the benign nature of the disorder and distinguishing pupil constricts after the conjunctival instillation it clearly from neurosyphilis. -
Neuroanatomy Crash Course
Neuroanatomy Crash Course Jens Vikse ∙ Bendik Myhre ∙ Danielle Mellis Nilsson ∙ Karoline Hanevik Illustrated by: Peder Olai Skjeflo Holman Second edition October 2015 The autonomic nervous system ● Division of the autonomic nervous system …………....……………………………..………….…………... 2 ● Effects of parasympathetic and sympathetic stimulation…………………………...……...……………….. 2 ● Parasympathetic ganglia ……………………………………………………………...…………....………….. 4 Cranial nerves ● Cranial nerve reflexes ………………………………………………………………….…………..…………... 7 ● Olfactory nerve (CN I) ………………………………………………………………….…………..…………... 7 ● Optic nerve (CN II) ……………………………………………………………………..…………...………….. 7 ● Pupillary light reflex …………………………………………………………………….…………...………….. 7 ● Visual field defects ……………………………………………...................................…………..………….. 8 ● Eye dynamics …………………………………………………………………………...…………...………….. 8 ● Oculomotor nerve (CN III) ……………………………………………………………...…………..………….. 9 ● Trochlear nerve (CN IV) ………………………………………………………………..…………..………….. 9 ● Trigeminal nerve (CN V) ……………………………………………………................…………..………….. 9 ● Abducens nerve (CN VI) ………………………………………………………………..…………..………….. 9 ● Facial nerve (CN VII) …………………………………………………………………...…………..………….. 10 ● Vestibulocochlear nerve (CN VIII) …………………………………………………….…………...…………. 10 ● Glossopharyngeal nerve (CN IX) …………………………………………….……….…………...………….. 10 ● Vagus nerve (CN X) …………………………………………………………..………..…………...………….. 10 ● Accessory nerve (CN XI) ……………………………………………………...………..…………..………….. 11 ● Hypoglossal nerve (CN XII) …………………………………………………..………..…………...…………. -
Structural Brain Abnormalities in Patients with Primary Open-Angle Glaucoma: a Study with 3T MR Imaging
Glaucoma Structural Brain Abnormalities in Patients with Primary Open-Angle Glaucoma: A Study with 3T MR Imaging Wei W. Chen,1–3 Ningli Wang,1,3 Suping Cai,3,4 Zhijia Fang,5 Man Yu,2 Qizhu Wu,5 Li Tang,2 Bo Guo,2 Yuliang Feng,2 Jost B. Jonas,6 Xiaoming Chen,2 Xuyang Liu,3,4 and Qiyong Gong5 PURPOSE. We examined changes of the central nervous system CONCLUSIONS. In patients with POAG, three-dimensional MRI in patients with advanced primary open-angle glaucoma revealed widespread abnormalities in the central nervous (POAG). system beyond the visual cortex. (Invest Ophthalmol Vis Sci. 2013;54:545–554) DOI:10.1167/iovs.12-9893 METHODS. The clinical observational study included 15 patients with bilateral advanced POAG and 15 healthy normal control subjects, matched for age and sex with the study group. Retinal rimary open angle glaucoma (POAG) has been defined nerve fiber layer (RNFL) thickness was measured by optical formerly by intraocular morphologic changes, such as coherence tomography (OCT). Using a 3-dimensional magne- P progressive retinal ganglion cell loss and defects in the retinal tization-prepared rapid gradient-echo sequence (3D–MP-RAGE) nerve fiber layer (RNFL), and by corresponding psychophysical of magnetic resonance imaging (MRI) and optimized voxel- abnormalities, such as visual field loss.1 Recent studies by based morphometry (VBM), we measured the cross-sectional various researchers, however, have suggested that the entire area of the optic nerve and optic chiasm, and the gray matter visual pathway may be involved in glaucoma.2–23 Findings from volume of the brain. -
Cone Contributions to Signals for Accommodation and the Relationship to Refractive Error
Vision Research 46 (2006) 3079–3089 www.elsevier.com/locate/visres Cone contributions to signals for accommodation and the relationship to refractive error Frances J. Rucker ¤, Philip B. Kruger Schnurmacher Institute for Vision Research, State University of New York, State College of Optometry, 33 West 42nd Street, New York, NY 10036, USA Received 18 February 2005; received in revised form 7 April 2006 Abstract The accommodation response is sensitive to the chromatic properties of the stimulus, a sensitivity presumed to be related to making use of the longitudinal chromatic aberration of the eye to decode the sign of the defocus. Thus, the relative sensitivity to the long- (L) and middle-wavelength (M) cones may inXuence accommodation and may also be related to an individual’s refractive error. Accommodation was measured continuously while subjects viewed a sine wave grating (2.2 c/d) that had diVerent cone contrast ratios. Seven conditions tested loci that form a circle with equal vector length (0.27) at 0, 22.5, 45, 67.5, 90, 120, 145 deg. An eighth condition produced an empty Weld stimulus (CIE (x,y) co-ordinates (0.4554, 0.3835)). Each of the gratings moved at 0.2 Hz sinusoidally between 1.00 D and 3.00 D for 40 s, while the eVects of longitudinal chromatic aberration were neutralized with an achromatizing lens. Both the mean level of accommo- dation and the gain of the accommodative response, to sinusoidal movements of the stimulus, depended on the relative L and M cone sen- sitivity: Individuals more sensitive to L-cone stimulation showed a higher level of accommodation (p D 0.01; F D 12.05; ANOVA) and dynamic gain was higher for gratings with relatively more L-cone contrast. -
Care of the Patient with Accommodative and Vergence Dysfunction
OPTOMETRIC CLINICAL PRACTICE GUIDELINE Care of the Patient with Accommodative and Vergence Dysfunction OPTOMETRY: THE PRIMARY EYE CARE PROFESSION Doctors of optometry are independent primary health care providers who examine, diagnose, treat, and manage diseases and disorders of the visual system, the eye, and associated structures as well as diagnose related systemic conditions. Optometrists provide more than two-thirds of the primary eye care services in the United States. They are more widely distributed geographically than other eye care providers and are readily accessible for the delivery of eye and vision care services. There are approximately 36,000 full-time-equivalent doctors of optometry currently in practice in the United States. Optometrists practice in more than 6,500 communities across the United States, serving as the sole primary eye care providers in more than 3,500 communities. The mission of the profession of optometry is to fulfill the vision and eye care needs of the public through clinical care, research, and education, all of which enhance the quality of life. OPTOMETRIC CLINICAL PRACTICE GUIDELINE CARE OF THE PATIENT WITH ACCOMMODATIVE AND VERGENCE DYSFUNCTION Reference Guide for Clinicians Prepared by the American Optometric Association Consensus Panel on Care of the Patient with Accommodative and Vergence Dysfunction: Jeffrey S. Cooper, M.S., O.D., Principal Author Carole R. Burns, O.D. Susan A. Cotter, O.D. Kent M. Daum, O.D., Ph.D. John R. Griffin, M.S., O.D. Mitchell M. Scheiman, O.D. Revised by: Jeffrey S. Cooper, M.S., O.D. December 2010 Reviewed by the AOA Clinical Guidelines Coordinating Committee: David A. -
Embryology, Anatomy, and Physiology of the Afferent Visual Pathway
CHAPTER 1 Embryology, Anatomy, and Physiology of the Afferent Visual Pathway Joseph F. Rizzo III RETINA Physiology Embryology of the Eye and Retina Blood Supply Basic Anatomy and Physiology POSTGENICULATE VISUAL SENSORY PATHWAYS Overview of Retinal Outflow: Parallel Pathways Embryology OPTIC NERVE Anatomy of the Optic Radiations Embryology Blood Supply General Anatomy CORTICAL VISUAL AREAS Optic Nerve Blood Supply Cortical Area V1 Optic Nerve Sheaths Cortical Area V2 Optic Nerve Axons Cortical Areas V3 and V3A OPTIC CHIASM Dorsal and Ventral Visual Streams Embryology Cortical Area V5 Gross Anatomy of the Chiasm and Perichiasmal Region Cortical Area V4 Organization of Nerve Fibers within the Optic Chiasm Area TE Blood Supply Cortical Area V6 OPTIC TRACT OTHER CEREBRAL AREASCONTRIBUTING TO VISUAL LATERAL GENICULATE NUCLEUSPERCEPTION Anatomic and Functional Organization The brain devotes more cells and connections to vision lular, magnocellular, and koniocellular pathways—each of than any other sense or motor function. This chapter presents which contributes to visual processing at the primary visual an overview of the development, anatomy, and physiology cortex. Beyond the primary visual cortex, two streams of of this extremely complex but fascinating system. Of neces- information flow develop: the dorsal stream, primarily for sity, the subject matter is greatly abridged, although special detection of where objects are and for motion perception, attention is given to principles that relate to clinical neuro- and the ventral stream, primarily for detection of what ophthalmology. objects are (including their color, depth, and form). At Light initiates a cascade of cellular responses in the retina every level of the visual system, however, information that begins as a slow, graded response of the photoreceptors among these ‘‘parallel’’ pathways is shared by intercellular, and transforms into a volley of coordinated action potentials thalamic-cortical, and intercortical connections. -
Eye Essentials 5
continuing education 33 Eye essentials 5 Successful participation in each Classification and localisation module of this approved series counts as one credit towards the GOC CET scheme administered by Vantage and of visual field defects one towards the AOI’s scheme. In the last of our features based on the Eye Essential textbooks, Dr Robert Cubbidge describes the visual pathway and its relationship with the visual field. CET module C2354 This article has been adapted and abridged from Visual Fields by Dr THE DIMENSION of the blind spot Robert Cubbidge, is approximately 7.5º high and 5.5º wide part of the new and represents the temporal visual field Eye Essentials projection of the optic nerve, found series. For further approximately 1.5º below and 15º horizon- information, tally from fixation. When interpreting including ordering, please click on visual field defects, knowledge of the the Bookstore link arrangement of nerve fibres in the visual at www.optician pathway is essential. online.net Depending on the site of damage in the visual pathway, characteristic visual field defects are produced (Figure 1). course to the optic nerve as they are not Anatomically, the visual pathway hindered by the papillomacular bundle begins at the photoreceptors which lie in (Figure 2). The nerve fibres from the nasal the outer retina. Here, photons of light are retina do not cross those of the temporal absorbed by the photopigments, which are retina and thereby form a theoretical sensitive to specific regions of the visible vertical line of demarcation which passes electromagnetic spectrum. Light energy through the centre of the fovea. -
Anatomy and Physiology of the Afferent Visual System
Handbook of Clinical Neurology, Vol. 102 (3rd series) Neuro-ophthalmology C. Kennard and R.J. Leigh, Editors # 2011 Elsevier B.V. All rights reserved Chapter 1 Anatomy and physiology of the afferent visual system SASHANK PRASAD 1* AND STEVEN L. GALETTA 2 1Division of Neuro-ophthalmology, Department of Neurology, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, USA 2Neuro-ophthalmology Division, Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA INTRODUCTION light without distortion (Maurice, 1970). The tear–air interface and cornea contribute more to the focusing Visual processing poses an enormous computational of light than the lens does; unlike the lens, however, the challenge for the brain, which has evolved highly focusing power of the cornea is fixed. The ciliary mus- organized and efficient neural systems to meet these cles dynamically adjust the shape of the lens in order demands. In primates, approximately 55% of the cortex to focus light optimally from varying distances upon is specialized for visual processing (compared to 3% for the retina (accommodation). The total amount of light auditory processing and 11% for somatosensory pro- reaching the retina is controlled by regulation of the cessing) (Felleman and Van Essen, 1991). Over the past pupil aperture. Ultimately, the visual image becomes several decades there has been an explosion in scientific projected upside-down and backwards on to the retina understanding of these complex pathways and net- (Fishman, 1973). works. Detailed knowledge of the anatomy of the visual The majority of the blood supply to structures of the system, in combination with skilled examination, allows eye arrives via the ophthalmic artery, which is the first precise localization of neuropathological processes. -
Pupils and Near Vision
PUPILS AND NEAR VISION Akilesh Gokul PhD Research Fellow Department of Ophthalmology Iris Anatomy Two muscles: • Radially oriented dilator (actually a myo-epithelium) - like the spokes of a wagon wheel • Sphincter/constrictor Pupillary Reflex • Size of pupil determined by balance between parasympathetic and sympathetic input • Parasympathetic constricts the pupil via sphincter muscle • Sympathetic dilates the pupil via dilator muscle • Response to light mediated by parasympathetic; • Increased innervation = pupil constriction • Decreased innervation = pupil dilation Parasympathetic Pathway 1. Three major divisions of neurons: • Afferent division 2. • Interneuron division • Efferent division Near response: • Convergence 3. • Accommodation • Pupillary constriction Pupil Light Parasympathetic – Afferent Pathway 1. • Retinal ganglion cells travel via the optic nerve leaving the optic tracts 2. before the LGB, and synapse in the pre-tectal nucleus. 3. Pupil Light Parasympathetic – Efferent Pathway 1. • Pre-tectal nucleus nerve fibres partially decussate to innervate both Edinger- 2. Westphal (EW) nuclei. • E-W nucleus to ipsilateral ciliary ganglion. Fibres travel via inferior division of III cranial nerve to ciliary ganglion via nerve to inferior oblique muscle. 3. • Ciliary ganglion via short ciliary nerves to innervate sphincter pupillae muscle. Near response: 1. Increased accommodation Pupil 2. Convergence 3. Pupillary constriction Sympathetic pathway • From hypothalamus uncrossed fibres 1. down brainstem to terminate in ciliospinal centre -
I. Multiple Mechanisms of Accommodation A. Variable Axial Length B
Mechanics, Aging and Neurological Control of accommodation: I. Multiple Mechanisms of Accommodation A. Variable axial length B. Corneal Power C. Lenticular power D. Pupil size E. Lenticular refractive index gradient (isoindical surfaces) II. Anatomy A. Lens B. Capsule C. Zonules D. Ciliary Body E. Index gradient III. Autonomic innervation IV. Amplitude of accommodation and age A. Functional presbyopia B. Absolute presbyopia C. Treatment Bifocals Monovision Surgically implanted prosthesis Course title - (VS217) Oculomotor functions and neurology Instructor - Clifton Schor GSI: James O’Shea, Michael Oliver & Aleks Polosukhina Schedule of lectures, exams and laboratories : Lecture hours 10-11:30 Tu Th; 5 min break at 11:00 Labs Friday the first 3 weeks Examination Schedule : Quizes: January 29; February 28 Midterm: February 14: Final March 13 Power point lecture slides are available on a CD Resources: text books, reader , website, handouts Class Website: Reader. Website http://schorlab.berkeley.edu Click courses 117 class page name VS117 password Hering,1 First Week: read chapters 16-18 See lecture outline in syllabus Labs begin this Friday, January 25 Course Goals Near Response - Current developments in optometry Myopia control – environmental, surgical, pharmaceutical and genetic Presbyopia treatment – amelioration and prosthetic treatment Developmental disorders (amblyopia and strabismus) Reading disorders Ergonomics- computers and sports vision Virtual reality and personal computer eye-ware Neurology screening- Primary care gate keeper neurology, systemic, endocrines, metabolic, muscular skeletal systems. Mechanics, Aging and Neurological Control of accommodation : I. Five Mechanisms of Accommodation A. Variable axial length B. Corneal Power and astigmatism C. Lenticular power D. Pupil size & Aberrations E. Lenticular refractive index gradient (isoindical surfaces) II. -
Cranial Nerves II, III, IV & VI (Optic, Oculomotor, Trochlear, & Abducens)
Cranial Nerves II, III, IV & VI (Optic, Oculomotor, Trochlear, & Abducens) Lecture (13) ▪ Important ▪ Doctors Notes Please check our Editing File ▪ Notes/Extra explanation ه هذا العمل مب ين بشكل أسا يس عىل عمل دفعة 436 مع المراجعة { َوَم نْ يَ َت َو َ ّكْ عَ َلْ ا َّْلل فَهُ َوْ َحْ سْ ُ ُُْ} والتدقيق وإضافة المﻻحظات وﻻ يغ ين عن المصدر اﻷسا يس للمذاكرة ▪ Objectives At the end of the lecture, students should be able to: ✓ List the cranial nuclei related to occulomotor, trochlear, and abducent nerves in the brain stem. ✓ Describe the type and site of each nucleus. ✓ Describe the site of emergence and course of these 3 nerves. ✓ Describe the important relations of oculomotor, trochlear, and abducent nerves in the orbit ✓ List the orbital muscles supplied by each of these 3 nerves. ✓ Describe the effect of lesion of each of these 3 nerves. ✓ Describe the optic nerve and visual pathway. Recall the how these nerves exit from the brain stem: Optic (does not exit from brain stem) Occulomotor: ventral midbrain (medial aspect of crus cerebri) Trochlear: dorsal midbrain (caudal to inferior colliculus) Abducent: ventral Pons (junction b/w pons & pyramid) Brain (Ventral view) Brain stem (Lateral view) Extra-Ocular Muscles 7 muscles: (ترفع جفن العين) .Levator palpebrae superioris 1- Origin: from the roof of the orbit (4) Recti muscles: *Rectus: ماشي على ( Superior rectus (upward and medially 2- الصراط (Inferior rectus (downward and medially 3- المستقيم 4- Medial rectus (medial) (medial) 5- Lateral rectus (lateral) How to remember the 2 فحركته muscles not supplied by نفس اسمه -اسمها عكس وظيفتها- :Oblique muscles (2) 6- Superior oblique (downward and laterally) Oblique: CN3? Superior oblique goes -1 منحرفOrigin: from the roof of the orbit 7- Inferior oblique (upward and laterally) up (superior) and turns around (oblique) a notch يمشي Origin: from the anterior floor or pulley and its supply is عكس كﻻمه NB. -
Diseases of the Vitreous, Retina and Optic Nerve
Diseases of the Vitreous, Retina and Optic Nerve University of Florida Normal dog fundic appearance tapetum- reflective area of the superior X fundus optic disk retinal vessels nontapetum Cat Dog Tapetal fundus color dependent on age, breed and coat color blue until 6 to 10 wks 4, 8, 13, 18 wks Tapetal fundus cellular layer of the choroid variable boundary with the nontapetum area centralis (cone rich) – visual streak: RGCs no melanin in tapetal RPE nontapetal color depends on the degree of RPE and iris pigmentation choroidal vessels (orange) may be visible Retinal vasculature usually 3 or 4 major venules – form a circle (not always complete) on the optic disk surface up to 20 arterioles – may be tortuous Optic disk variable amount of myelin pale pink in color physiological pit ± pigmented ring Normal fundic variations Cat – circular optic disk lacks myelin – 3 major venules leave the disk edge with 3 major arterioles – Tapetum is usually yellow or green in color Normal fundic variations horse – 30-60 small blood vessels extend a short distance from the disk edge – oval optic disk – Stars of Winslow – fibrous tapetum Vitreal opacities Vitreal degeneration from inflammation, trauma, senile changes may predispose to retinal detachment leukocytes hemorrhage – resolution over months asteroid hyalosis – calcium-lipid complexes Choroidal coloboma Equatorial staphyloma: Australian Shepherds Progressive Retinal Atrophy (PRA) in the dog inherited retinal photoreceptor dysplasia or degeneration PRA: progressive loss of night