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Sense of Vision – Part 2

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Sense of Vision – Part 2 Sense of vision – part 2 Visual pathway Disorders of the visual field Pupillary reflex, accommodation reflex Stereoscopic vision Colour vision Successive and simultaneous contrasts Practical tasks 1. Detection of the central visual acuity 2. Reaction of pupils to light and accommodation stimulus 3. Examination of the colour vision by the use of pseudoisochromatic charts 4. Successive and simultaneous contrasts 5. Additive mixing of colours by the use of Maxwell´s discs 6. Stereoscopic vision http://4.bp.blogspot.com/_irl8CO-29xk/SXEXnAPoZ5I/AAAAAAAAAUE/SZ3L7xQ3OSw/S220/180px-CentralScotoma.jpg http://www.dwp.gov.uk/img/visual-fields.gif Disorders of the visual field Blind spot - area in the retina where the optic nerve passes through it - the only physiological scotoma A scotoma - area of the visual field in which vision is deficient or absent (surrounded by an area of normal vision) Scotomas - may be caused by diseases of: 1. the eye – macular degeneration, detachment of retina, cataract 2. optic nerve - e.g. demyelinating process 3. visual cortex – e.g. tumours of the brain http://4.bp.blogspot.com/_irl8CO-29xk/SXEXnAPoZ5I/AAAAAAAAAUE/SZ3L7xQ3OSw/S220/180px-CentralScotoma.jpg http://www.dwp.gov.uk/img/visual-fields.gif Disorders of the visual field Blurred central vision - Tunnel vision (in tumours of hypophysis) (in macular degeneration) Binasal hemianopsia Impaired peripheral vision (in glaucoma) https://en.wikipedia.org/wiki/Macular_degeneration http://pituitary.ucla.edu/images/site/Visual3.3.jpg http://www.eschenbach-optik.com/en/uploads/RTEmagicC_sehhilfen_makula_lesen_06.jpg.jpg http://upload.wikimedia.org/wikipedia/commons/thumb/0/0f/Binasalvf.png/230px-Binasalvf.png https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcTMrOczmELpLZpY8vMuueKE- tmCTvq0y9aGMaWJtHSUE2PCZNZG Glaucoma • progressive optic neuropathies characterized by degeneration of retinal ganglion cells and resulting changes in the optic nerve head. • if untreated may lead to blindness • aqueous humour - secreted by the ciliary epithelium into posterior chamber (behind iris) • circulates through the pupil into the anterior chamber • drained by the canal of Schlemm into venous system • constant pressure 22 mm Hg or less • if aqueous humour is not absorbed - increase of intraocular pressure impedes blood flow to the retina http://upload.wikimedia.org/wikipedia/commons/3/3f/Flow_of_aqueous_humour_eye_EDA02.JPG https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcTMrOczmELpLZpY8vMuueKE-tmCTvq0y9aGMaWJtHSUE2PCZNZG Cataract . normal lens is transparent . cataract - slight or complete opacity of the lens (cloudy lens) - causes obstruction for the passage of light – blurred vision - often related to aging http://cd.hpathy.com/wp-content/uploads/2011/09/cataract.jpg https://encrypted-tbn2.gstatic.com/images?q=tbn:ANd9GcRkAzVaYT1ZGNS7qImsK4dibDosC_bBOwG3pf-Fj1Yq_d1tGR9qTw Visual pathway and its disorders nasal - visual images are inverted as they pass temporal temporal through the lens (nodal point of the optical system of the eye is in lens) - the nasal retina receives rays from the temporal half of the world (hemifield) - the temporal retina receives rays from the nasal half of the world (hemifield) http://www.bioon.com/bioline/neurosci/course/bvis1.gif - visual information leaves the eye by way of the optic nerve (1) -partial crossing of axons at the optic chiasm (2) - nerve fibres from nasal part of retina cross over - temporal fibres remain at the same side - after the chiasm, the axons are called the optic tract (3) - the optic tract terminates in the lateral geniculate nucleus (LGN) - the axons synapse here - LGN axons form optic radiations – terminate in the primary visual cortex, in occipital lobes http://www.bioon.com/bioline/neurosci/course/bvis2.gif Disorders of the visual pathway left eye right eye complete blindness 1 bitemporal hemianopsia 2 (often due to tumours of hypo- physis that com- press the chiasm) 3 homonymous hemianopsia Hemianopsia • heteronymous – contralateral (bitemporal, binasal) • homonymous – homolateral (right, left) http://www.bioon.com/bioline/neurosci/course/bvis2.gif Task: The reaction of pupils to light and accommodation stimulus Introduction • the pupil – an opening located in the centre of the iris • pupillary diameter (2-8 mm) - regulated by tone of small muscles in iris M. sphincter pupillae (circular muscle) – its contraction decreases the diameter of pupil (miosis) – controlled by the parasympathetic NS M. dilator pupillae (radial muscle) – its contraction increases the diameter of pupil (mydriasis) – controlled by the sympathetic NS The pupillary light reflex • reflex that controls the diameter of the pupil, in response to the intensity of light that falls on the retina of the eye (reflex = involuntary, quick, stereotyped response to stimulus) • greater intensity light - causes myosis (allowing less light in) • lower intensity light - causes mydriasis (allowing more light in) Reflex arc for the pupilary light reflex - light stimulates receptors in retina - signal is transmitted from retina by n. opticus (IIInd,afferent fibres), however 10-15 % of fibres bypass the LGN (leave the primary visual pathway) and terminate in the Edinger-Westphal nuclei on both sides of the midbrain (therefore both eyes react to light at one time) - nerve fibres (efferent, parasympathetic) from the Edinger-Westphal nuclei form the oculomotor nerve (IIIrd) - terminates in m. constrictor pupilae The accommodation reflex Pathway for accommodation reflex - a vision reflex that enables quick transfer of the Receptors: rods and cones focus between near and distant objects Afferent nerve: optic n. Centre: oculomotor nucleus - comprises coordinated changes in Efferent: oculomotor nerve 1. pupil size (miosis when focusing closer) Effector: 2. lens shape (accommodation when focusing closer) 1. constrictor pupillae 3. vergence (convergence of the eyeballs – when 2. ciliary muscles focusing to a close dostance) 3. m. medial rectus far object (parallel) close object (convergence) Task - Procedure - look at the size of the pupil in normal room illuminaton 1. illuminate the eye by a torch and observe the reaction of the pupil, estimate approximately the diameter of the pupil 2. switch the torch off and observe the reaction of the pupil 3. shade the other eye with a hand or a note-book, after illumination of the first eye observe the consensual reaction of pupils 4. stop the illumination of the first eye and observe the consensual reaction of both eyes 5. ask the examinee to focus on your finger that is moving towards the examinees nose – observe size of the pupils and vergence of eyes Result and conclusion • describe your observations for 1 – 5 (or make a drawing) Sclera (outer layer) Retina Vascular layer Pigment layer - the light sensitive tissue lining the inner surface of the eye - cells of retina: 1 1. Receptors • rods A • cones 2 2. Bipolar cells – transmission of AP B from the recptor cells to the ganglion cells 3 3. Ganglion cells • their axons form n. opticus that transmits the signal to CNS A. Horizontal cells – horizontal communication of several rods and cones light B. Amacrine cells – horizontal communication of several ganglion cells Retina - the light sensitive tissue lining the inner surface of the eye - cells of retina: 1 1. Receptors • rods A • cones 2 2. Bipolar cells – transmission of AP B from the receptor cells to the ganglion cells 3 3. Ganglion cells • their axons form n. opticus that transmits the signal to CNS Horizontal cells – horizontal communication of several receptors and bipolar cells Amacrine cells – horizontal communication of several ganglion cells The receptor cells Cones (7 millions) • colour vision - photopic vision • higher threshold – need daylight conditions • high visual acuity • maximum density in fovea centralis • low density outside the fovea Rods (125 milions) • operate in reduced light (scotopic vision) • low threshold for light detection • no well defined image • not present in fovea centralis • maximum in parafoveal region • in direction to peripheral parts of Fovea retina their count rapidly centralis Blind spot decreases - optic nerve disc - no receptors Yellow spot – Fovea centralis • the upper layers of retina are „moved to the side“ - light mainly in the central fovea • the light can more directly reach the receptors • better image resolution • because of the pigment layer behind retina – the yellow spot appears darker in ophtalmoscopy pigment Fovea centralis - best image resolution (ability to recognize details) 1. highest density of receptors 2. highest count of nerve fibres - no convergence Periphery – lower density of receptors, convergence Examination of the central visual acuity Introduction • visual acuity (visus) – ability to see details sharply • the ability of retina to distinguish two close points as separate and not fused into one = minimum separabile • 2 points can be distinguished if 2 sense receptors in retina are stimulated and between them one receptor remains unstimulated • visual acuity depends on receptors of retina – the density of receptors – the angle of observation (angle of light rays) the observed 1´ points • the object you focus on - is imaged in fovea centralis • fovea centralis – the highest density of receptors, therefore the best visual acuity (central visual acuity) • 2 points that are imaged in fovea centralis can be distinguished as 2 if they are observed under visual angle of 1 minute Optotype • serves for examination of visus • Snellen´s optotype – a glass board
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