Pupil Testing in the Optometric Practice Tamara Petrosyan O.D
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AD Singh1, PA Rundle1, a Berry-Brincat1, MA Parsons2 and and Accommodation Were Considered Normal
Tadpole pupil KL Koay et al 93 5 Currie ZI, Rennie IG, Talbot JF. Retinal vascular changes associated with transpupillary thermotherapy for choroidal melanomas. Retina 2000; 20: 620–626. 6 Shields CL, Cater J, Shields JA, Singh AD, Santos MCM, Carvalho C. Combination of clinical factors predictive of growth of small choroidal melanocytic tumors. Arch Ophthalmol 2000; 118: 360–364. 7 Journee-de Korver JG, Oosterhuis JA, de Wolff-Rouendaal D, Kemme H. Histopathological findings in human choroidal melanomas after transpupillary thermotherapy. Br J Ophthalmol 1997; 81: 234–239. 8 Anonymous. Histopathologic characteristics of uveal melanomas in eyes enucleated from the Collaborative Ocular Melanoma Study. COMS report no. 6. Am J Figure 1 Ophthalmol 1998; 125: 745–766. Tadpole-shaped pupil. 9 Diaz CE, Capone Jr A, Grossniklaus HE. Clinicopathologic findings in recurrent choroidal melanoma after transpupillary thermotherapy. Ophthalmology 1998; 105: 1419–1424. periocular sensation. The symptom occurred 10 Singh AD, Eagle Jr RC, Shields CL, Shields JA. Enucleation sporadically, sometimes with several weeks in between following transpupillary thermotherapy of choroidal episodes, but occasionally happening several times on melanoma :clinicopathologic correlations. Arch Ophthalmol the same day. There were no other visual symptoms and (in press). 11 Seregard S, Landau I. Transpupillary thermotherapy as an no significant past ocular history. General health was adjunct to ruthenium plaque radiotherapy for choroidal good and no regular medications were taken. melanoma. Acta Ophthalmologica Scand 2001; 79: 19–22. On examination, visual acuity was normal bilaterally. 12 Keunen JE, Journee-de Korver JG, Oosterhuis JA. There was a 1 mm right ptosis with mild anisocoria, the Transpupillary thermotherapy of choroidal melanoma with right pupil being 1 mm smaller in normal room or without brachytherapy: a dilemma. -
Permeability of the Retina and RPE-Choroid-Sclera to Three Ophthalmic Drugs and the Associated Factors
pharmaceutics Article Permeability of the Retina and RPE-Choroid-Sclera to Three Ophthalmic Drugs and the Associated Factors Hyeong Min Kim 1,†, Hyounkoo Han 2,†, Hye Kyoung Hong 1, Ji Hyun Park 1, Kyu Hyung Park 1, Hyuncheol Kim 2,* and Se Joon Woo 1,* 1 Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea; [email protected] (H.M.K.); [email protected] (H.K.H.); [email protected] (J.H.P.); [email protected] (K.H.P.) 2 Department of Chemical and Biomolecular Engineering, Sogang University, Seoul 04107, Korea; [email protected] * Correspondence: [email protected] (H.K.); [email protected] (S.J.W.); Tel.: +82-2-705-8922 (H.K.); +82-31-787-7377 (S.J.W.); Fax: +82-2-3273-0331 (H.K.); +82-31-787-4057 (S.J.W.) † These authors contributed equally to this work. Abstract: In this study, Retina-RPE-Choroid-Sclera (RCS) and RPE-Choroid-Sclera (CS) were prepared by scraping them off neural retina, and using the Ussing chamber we measured the average time– concentration values in the acceptor chamber across five isolated rabbit tissues for each drug molecule. We determined the outward direction permeability of the RCS and CS and calculated the neural retina permeability. The permeability coefficients of RCS and CS were as follows: ganciclovir, 13.78 ± 5.82 and 23.22 ± 9.74; brimonidine, 15.34 ± 7.64 and 31.56 ± 12.46; bevacizumab, 0.0136 ± 0.0059 and 0.0612 ± 0.0264 (×10−6 cm/s). -
Pupillary Disorders LAURA J
13 Pupillary Disorders LAURA J. BALCER Pupillary disorders usually fall into one of three major cat- cortex generally do not affect pupillary size or reactivity. egories: (1) abnormally shaped pupils, (2) abnormal pupillary Efferent parasympathetic fibers, arising from the Edinger– reaction to light, or (3) unequally sized pupils (anisocoria). Westphal nucleus, exit the midbrain within the third nerve Occasionally pupillary abnormalities are isolated findings, (efferent arc). Within the subarachnoid portion of the third but in many cases they are manifestations of more serious nerve, pupillary fibers tend to run on the external surface, intracranial pathology. making them more vulnerable to compression or infiltration The pupillary examination is discussed in detail in and less susceptible to vascular insult. Within the anterior Chapter 2. Pupillary neuroanatomy and physiology are cavernous sinus, the third nerve divides into two portions. reviewed here, and then the various pupillary disorders, The pupillary fibers follow the inferior division into the orbit, grouped roughly into one of the three listed categories, are where they then synapse at the ciliary ganglion, which lies discussed. in the posterior part of the orbit between the optic nerve and lateral rectus muscle (Fig. 13.3). The ciliary ganglion issues postganglionic cholinergic short ciliary nerves, which Neuroanatomy and Physiology initially travel to the globe with the nerve to the inferior oblique muscle, then between the sclera and choroid, to The major functions of the pupil are to vary the quantity of innervate the ciliary body and iris sphincter muscle. Fibers light reaching the retina, to minimize the spherical aberra- to the ciliary body outnumber those to the iris sphincter tions of the peripheral cornea and lens, and to increase the muscle by 30 : 1. -
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. -
Sclera and Retina Suturing Techniques 9 Kirk H
Chapter 9 Sclera and Retina Suturing Techniques 9 Kirk H. Packo and Sohail J. Hasan Key Points 9. 1 Introduction Surgical Indications • Vitrectomy Discussion of ophthalmic microsurgical suturing tech- – Infusion line niques as they apply to retinal surgery warrants atten- – Sclerotomies tion to two main categories of operations: vitrectomy – Conjunctival closure and scleral buckling. Th is chapter reviews the surgical – Ancillary techniques indications, basic instrumentation, surgical tech- • Scleral buckles niques, and complications associated with suturing – Encircling bands techniques in vitrectomy and scleral buckle surgery. A – Meridional elements brief discussion of future advances in retinal surgery Instrumentation appears at the end of this chapter. • Vitrectomy – Instruments – Sutures 9.2 • Scleral buckles Surgical Indications – Instruments – Sutures Surgical Technique 9.2.1 • Vitrectomy Vitrectomy – Suturing the infusion line in place – Closing sclerotomies Typically, there are three indications for suturing dur- • Scleral buckles ing vitrectomy surgery: placement of the infusion can- – Rectus muscle fi xation sutures nula, closure of sclerotomy, and the conjunctival clo- – Suturing encircling elements to the sclera sure. A variety of ancillary suturing techniques may be – Suturing meridional elements to the sclera employed during vitrectomy, including the external – Closing sclerotomy drainage sites securing of a lens ring for contact lens visualization, • Closure of the conjunctiva placement of transconjunctival or scleral fi xation su- Complications tures to manipulate the eye, and transscleral suturing • General complications of dislocated intraocular lenses. Some suturing tech- – Break in sterile technique with suture nee- niques such as iris dilation sutures and transretinal su- dles tures in giant tear repairs have now been replaced with – Breaking sutures other non–suturing techniques, such as the use of per- – Inappropriate knot creation fl uorocarbon liquids. -
The Pupillary Light Reflex in the Critically Ill Patient
light must be high for the iris to be seen, which reduces Editorials the step increase induced by the penlight).6 If the pupillary light reflex amplitude is less than 0.3 mm and the maximum constriction velocity is less than 1 mm/s, the reflex is unable to be detected using a The pupillary light reflex in penlight.6 In conscious patients with Holmes-Adie and Argyll-Robertson pupils with ‘absent’ pupillary light the critically ill patient reflexes, small light reflexes have been detected using infrared pupillometry.7 Also in post-resuscitation non- brain dead critically ill patients with ‘absent’ pupillary The pupillary response to light is controlled by the reflexes, the reflex has been demonstrated using a autonomic nervous system. The direct pupillary light portable infrared pupillometer.6 reflex refers to miosis that occurs in the stimulated eye; In this issue of Critical Care and Resuscitation, the consensual pupillary light reflex refers to miosis that Thomas8 describes a case of Guillain Barré syndrome occurs in the other eye. The reflex has a latent period presenting with weakness and fixed dilated pupils who with length of the period, amplitude of the response, and subsequently became ‘locked in’ with absence of any the speed of the pupillary constriction dependent on the clinical response to external stimuli. A positive brain intensity of the stimulus employed.1 For the reflex to be stem auditory evoked response was used to indicate truly tested, an intense stimulus and close observation normal brain stem function. In another recent report, a are required. The reflex has afferent, efferent and central case of ‘reversible fixed dilated pupils’ was associated connections; therefore non-response to light (i.e. -
What's the Connection?
WHAT’S THE CONNECTION? Sharon Winter Lake Washington High School Directions for Teachers 12033 NE 80th Street Kirkland, WA 98033 SYNOPSIS Students elicit and observe reflex responses and distinguish between types STUDENT PRIOR KNOWL- of reflexes. They then design and conduct experiments to learn more about EDGE reflexes and their control by the nervous system. Before participating in this LEVEL activity students should be able to: Exploration, Concept/Term Introduction Phases ■ Describe the parts of a Application Phase neuron and explain their functions. ■ Distinguish between sensory and motor neurons. Getting Ready ■ Describe briefly the See sidebars for additional information regarding preparation of this lab. organization of the nervous system. Directions for Setting Up the Lab General: INTEGRATION Into the Biology Curriculum ■ Make an “X” on the chalkboard for the teacher-led introduction. ■ Health ■ Photocopy the Directions for Students pages. ■ Biology I, II ■ Human Anatomy and Teacher Background Physiology A reflex is an involuntary neural response to a specific sensory stimulus ■ AP Biology that threatens the survival or homeostatic state of an organism. Reflexes Across the Curriculum exist in the most primitive of species, usually with a protective function for ■ Mathematics animals when they encounter external and internal stimuli. A primitive ■ Physics ■ example of this protective reflex is the gill withdrawal reflex of the sea slug Psychology Aplysia. In humans and other vertebrates, protective reflexes have been OBJECTIVES maintained and expanded in number. Examples are the gag reflex that At the end of this activity, occurs when objects touch the sides students will be able to: or the back of the throat, and the carotid sinus reflex that restores blood ■ Identify common reflexes pressure to normal when baroreceptors detect an increase in blood pressure. -
Affections of Uvea Affections of Uvea
AFFECTIONS OF UVEA AFFECTIONS OF UVEA Anatomy and physiology: • Uvea is the vascular coat of the eye lying beneath the sclera. • It consists of the uvea and uveal tract. • It consists of 3 parts: Iris, the anterior portion; Ciliary body, the middle part; Choroid, the third and the posterior most part. • All the parts of uvea are intimately associated. Iris • It is spongy having the connective tissue stroma, muscular fibers and abundance of vessels and nerves. • It is lined anteriorly by endothelium and posteriorly by a pigmented epithelium. • Its color is because of amount of melanin pigment. Mostly it is brown or golden yellow. • Iris has two muscles; the sphincter which encircles the pupil and has parasympathetic innervation; the dilator which extends from near the sphincter and has sympathetic innervation. • Iris regulates the amount of light admitted to the interior through pupil. • The iris separates the anterior chamber from the posterior chamber of the eye. Ciliary Body: • It extends backward from the base of the iris to the anterior part of the choroid. • It has ciliary muscle and the ciliary processes (70 to 80 in number) which are covered by ciliary epithelium. Choroid: • It is located between the sclera and the retina. • It extends from the ciliaris retinae to the opening of the optic nerve. • It is composed mainly of blood vessels and the pigmented tissue., The pupil • It is circular and regular opening formed by the iris and is larger in dogs in comparison to man. • It contracts or dilates depending upon the light source, due the sphincter and dilator muscles of the iris, respectively. -
A Model of Accommodative-Pupillary Dynamics Stanley Gordon Day Iowa State University
Iowa State University Capstones, Theses and Retrospective Theses and Dissertations Dissertations 1969 A model of accommodative-pupillary dynamics Stanley Gordon Day Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/rtd Part of the Electrical and Electronics Commons Recommended Citation Day, Stanley Gordon, "A model of accommodative-pupillary dynamics " (1969). Retrospective Theses and Dissertations. 4649. https://lib.dr.iastate.edu/rtd/4649 This Dissertation is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Retrospective Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. This dissertation has been microâhned exactly as received 69-15,607 DAY, Stanley Gordon, 1939- A MODEL OF ACCOMMODATIVE-PUPILLARY DYNAMICS. Iowa State University, Ph.D., 1969 Engineering, electrical University Microfilms, Inc., Ann Arbor, Michigan ®Copyright by STANLEY GORDON DAY 1969 A MODEL OF ACCOMMODATIVE-PUPILLARY DYNAMICS by Stanley Gordon Day A Dissertation Submitted to the Graduate Faculty in Partial Fulfillment of The Requirements for the Degree of DOCTOR OF PHILOSOPHY Major Subject : Electrical Engineering Approved: Signature was redacted for privacy. In Charge of Major Work Signature was redacted for privacy. Head of Major Department Signature was redacted for privacy. Dea^ of Gradulate College Iowa State University Of Science and Technology Ames, Iowa 1969 il TABLE OF CONTENTS Page DEDICATION iii INTRODUCTION 1 REVIEW OF LITERATURE 4 EQUIPMENT AND METHODS 22 RESULTS AND DISCUSSION 47 SUÎ4MARY AND CONCLUSIONS 60 BIBLIOGRAPHY 62 ACKNOWLEDGEMENTS 68 APPENDIX 69 i iii DEDICATION This dissertation is dedicated to Sandra R. -
Towards a Chromatic Pupillometry Protocol for Assessing Melanopsin-Driven Post-Illumination Pupil Response in Basic Science and Clinical Investigations
TOWARDS A CHROMATIC PUPILLOMETRY PROTOCOL FOR ASSESSING MELANOPSIN-DRIVEN POST-ILLUMINATION PUPIL RESPONSE IN BASIC SCIENCE AND CLINICAL INVESTIGATIONS by Shaobo Lei A thesis submitted in conformity with the requirements for the degree of Master of Science Institute of Medical Science University of Toronto © Copyright by Shaobo Lei 2016 Towards a Chromatic Pupillometry Protocol for Assessing Melanopsin-Driven Post-Illumination Pupil Response in Basic Science and Clinical Investigations Shaobo Lei Master of Science Institute of Medical Science University of Toronto 2016 Abstract The pupillary light reflex (PLR) is mediated by intrinsically photosensitive retinal ganglions cells (ipRGCs), a sub-group of retinal ganglion cells that contain photopigment melanopsin. Melanopsin activation drives a sustained pupil constriction after the offset of light stimulus, this so-called post-illumination pupil response (PIPR) is an in vivo index of melanopsin-driven ipRGC photoactivity. PIPR can be assessed by chromatic pupillometry, but consensus on a standardized PIPR testing protocol has not been reached yet. The purpose of this thesis is to develop an optimized PIPR testing methodology, and to use it to investigate clinical and basic science questions related to melanopsin and ipRGCs. Based on previous pilot work on full-field chromatic pupillometry, a new and repeatable method was developed to measure PIPR induced by hemifield, central-field and full-field light stimulation. This chromatic pupillometry system was then used to investigate a series of basic science and clinical questions related to melanopsin and ipRGCs. ii Acknowledgments I would like to take this opportunity to express my gratitude to a number of people who have helped me to see through this thesis project. -
Asymmetries of Dark and Bright Negative Afterimages Are Paralleled by Subcortical on and OFF Poststimulus Responses
1984 • The Journal of Neuroscience, February 22, 2017 • 37(8):1984–1996 Systems/Circuits Asymmetries of Dark and Bright Negative Afterimages Are Paralleled by Subcortical ON and OFF Poststimulus Responses X Hui Li,1,2 X Xu Liu,1,2 X Ian M. Andolina,1 Xiaohong Li,1 Yiliang Lu,1 Lothar Spillmann,3 and Wei Wang1 1Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China, 2University of Chinese Academy of Sciences, Shanghai 200031, China, and 3Department of Neurology, University of Freiburg, 79085 Freiburg, Germany Humans are more sensitive to luminance decrements than increments, as evidenced by lower thresholds and shorter latencies for dark stimuli. This asymmetry is consistent with results of neurophysiological recordings in dorsal lateral geniculate nucleus (dLGN) and primary visual cortex (V1) of cat and monkey. Specifically, V1 population responses demonstrate that darks elicit higher levels of activation than brights, and the latency of OFF responses in dLGN and V1 is shorter than that of ON responses. The removal of a dark or bright disc often generates the perception of a negative afterimage, and here we ask whether there also exist asymmetries for negative afterimages elicited by dark and bright discs. If so, do the poststimulus responses of subcortical ON and OFF cells parallel such afterimage asymmetries? To test these hypotheses, we performed psychophysical experiments in humans and single-cell/S-potential recordings in cat dLGN. Psychophysically, we found that bright afterimages elicited by luminance decrements are stronger and last longer than dark afterimages elicited by luminance increments of equal sizes. -
The Influence of Pupil Responses on Subjective Brightness Perception
1 The influence of pupil responses on subjective brightness perception I. K. Wardhania, b, C. N. Boehlera, and S. Mathôtb, ∗ aDepartment of Experimental Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium bDepartment of Experimental Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands Abstract When the pupil dilates, the amount of light that falls onto the retina increases as well. However, in daily life, this does not make the world look brighter. Here we asked whether pupil size (resulting from active pupil movement) influences subjective brightness in the absence of indirect cues that, in daily life, support brightness constancy. We measured the subjective brightness of a tester stimulus relative to a referent as a function of pupil size during tester presentation. In Ex- periment 1, we manipulated pupil size through a secondary working-memory task (larger pupils with higher load and after errors). We found some evidence that the tester was perceived as darker, rather than brighter, when pupils were lar- ger. In Experiment 2, we presented a red or blue display (larger pupils following red displays). We again found that the tester was perceived as darker when pu- pils were larger. We speculate that the visual system takes pupil size into account when making brightness judgments. Finally, we highlight the challenges associ- ated with manipulating pupil size. In summary, the current study (as well as a recent pharmacological study on the same topic) are intriguing first steps towards understanding the role of pupil size in brightness perception. Keywords: pupillometry, pupil light reflex, psychosensory pupil reflex, pupil size, luminance, subjective brightness perception ∗Corresponding author.