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Vision and Driving Anatomy of The Vision and Driving What is Vision Seeing Your Way to Better Client Outcomes The primary sense that we use to acquire information about our environment. Includes Beth Rolland, OTR, CDRS Eye movement Acuity Perception Vision Facts Vision Facts 90% of the information we gather Eye is the only organ in the body comes from the visual system. innervated by both the central and Vision allows us to be anticipatory autonomic nervous systems Central – voluntary movements The visual system is the fastest and (pursuits, saccades, lid opening/closing) most complicated of all sensory systems. Autonomic – involuntary control (pupil constriction and dilation) 50% of all neurologic insults cause visual deficits. Vision Facts The visual system provides the highest level of sensory information processing in the human body and is the most highly integrated of all systems. Anatomy of the It is estimated that 65% of all nerve fiber interactions with the brain have Eye something to do with the visual An Overview information processing system. 1 Anatomy of the Eye Eye Structure & Function Eye parts resemble a camera Sclera - white outer protective coat; the "white of the eye". Cornea - transparent, curved structure in front Iris - colored part seen through the cornea. Pupil - black part in the middle of the iris. Constricts or dilates according to the amount of light passing through. Lens - transparent disc (with both sides being convex) immediately behind the iris and pupil. Eye Structure & Function Eye Structure & Function Rods - more numerous, mostly at outer edge Aqueous humour - transparent fluid respond to low levels of light, peripheral (water consistency) circulates behind cornea and in front of the lens. movement. Vitreous humour – fills the eyeball Cones - far fewer, concentrated in center between lens and retina (like transparent respond to color and details. jelly). Macula - small center of the retina Retina - light-sensitive layer of millions of nerve cells lining back of the eyeball. responsible for central vision—ie: reading. Rod cells – tall, thin Retinal pigment epithelium – dark layer of cells at Cone cells - rounder back of retina Provide oxygen & nutrients to rods/cones. Eye Structure & Function Eye Structure & Function Choroid - large network of blood vessels (behind Retina – the retina) located at the back of the eye and connected transport oxygen & nutrients to retinal pigment to the brain. cells. made up of many millions of light-sensitive cells Optic disc - small yellow oval structure in retina known as photoreceptor cells which transmit nerve cell connections travel from all the rods electrical impulses to the brain to enable sight. and cones. Optic nerve and beyond - "cord" of nerve cell connections that passes from eyeball to destinations throughout brain. 2 Cranial Nerves Cranial Nerve II (cont.) Cranial Nerve II (Optic Nerve) The optic nerve has only a special sensory component Originates at the Retina Visual information enters the eye in the Connected to the specialized receptors form of photons of light in the retina—the rods and cones. Light is converted to electrical signals in the photoreceptors (rods and cones) Exits the back of the eye in the orbit located in the retina Where the optic nerve tract begins. Signals travel optic nerves, chiasm, and tract lateral geniculate nucleus (thalamus) occipital lobe (visual centers) Cranial Nerves Cranial Nerve III (cont.) Cranial Nerve III (Oculamotor Medial Rectus: Nerve) the ocular muscle whose contraction turns the eyeball medially Raises eyelid and controls pupils These muscles are an integral part Drooping eyelid = ptosis Controls several key eye muscles. of how well and how smoothly your These muscles include the following: eyes move. Superior Rectus: the ocular muscle whose contraction turns the eyeball upward and medially Inferior Rectus: the ocular muscle whose contraction turns the eyeball down and medially Cranial Nerves Cranial Nerves Cranial Nerve IV (Trochlear Nerve) Purely motor nerve supplying one muscle: Cranial Nerve VI (Abducens Nerve) Superior oblique: Intorsion- inward rotation of upper part of Lateral Rectus: eye about an axis or a fixed point. Pulls the eye away from the nose Secondary movement-moves eye out and down. Damage to this nerve will result in the Damage results in eye slightly affected eye turning inward (cross elevated in primary gaze position eye) (straight ahead gaze) Intermittent double vision in lateral gaze Effect of esotropia is greater at distance Reading ok, driving a problem 3 Cranial Nerve Summary Nerve Nerve supplies Function Clinical observations CNIII- oculomotor Upper eyelid Eyelid movement Ptosis SR, IR, MR, IO Eyeball movement-up, Exotropia (down&out) Ciliary Muscle down, and medially Diplopia at near Sphincter of Iris Pupil constriction No pupil accomodation CNIV-trochlear Superior obique Eyeball movement- down Hypertropia/phoria and out Vertical diplopia Lateral tilt of head CNVI- abducens Lateral rectus Eyeball movement Esotropia/phoria outwards Diplopia at distance Eye Anatomy Videos Dr. Tim Root https://timroot.com/anatomy-of-the-eye- video/ Anatomy video Neuro-anatomy Functional Vision Hierarchy of Visual Oculamotor Control Adaptation Oculamotor Control (pursuits, Visual Fixation - ability to find target and saccades) hold eyes on it Visual Attention Pursuits – ability to follow a moving target (without head movement) Visual Scanning Saccades – rapid eye movements in any Pattern Recognition direction (without head movement) Visual Memory Visuo-Cognition (perception) Implication for driving: if you can’t see it, you can’t respond to it!; objects are moving in driving Adaptation (thought, reasoning) environment – pedestrians, bicycles, cars 4 Visual Attention Visual Scanning Cognitive component Ability to pick out relevant information in an environment and suppress irrelevant Visual Scanning – ability to find things in information the environment Sustained attention – maintain over time Peripheral Vision – what can be seen on Shifting attention – change focus from one thing to the side without head or eye movement another rapidly Not clear, but brain fills in and seems clear Divided attention – attend to multiple factors at Alerts to movement – prompts saccade or head once (ie: hazards on both right and left side) turn to use central vision for more information Implication for driving: if you are not paying attention, Implication for driving: hazards come from all you will miss things fields; inadequate scan will miss things Visual Fields – Peripheral Pattern Recognition Vision Norms: . Cognitive process that matches information 65 degrees upward from a stimulus with information retrieved 70 degrees downward from memory 60 degrees nasally 90-110 degrees temporally . Allows anticipatory awareness Implication for driving: if you don’t anticipate, you will respond late Visual Memory Visuo-Cognition (perception) Ability to process and interpret meaning from Recollected information about what visual information gained through eye sight one has seen. visual discrimination Mental storage of information visual figure ground – distinguishing object from background Ability to retrieve stored information visual closure – “seeing” the whole from a part visual memory – recalling what you saw visual form constancy – recognizing objects when they are Implication for driving: deficit may lead to turned around difficulty finding your way, finding your visual spatial relationships – where one thing is in relation to car in a lot, remembering what was on the another left when you scan right visual-motor integration – eye/hand coordination 5 Visual Perception Implication for driving: . Poor lane position . Unsure where they are relative to parked cars, lanes . Unable to coordinate steering movements quickly enough to maintain straight path Other Crucial . Improperly placed turns . Unsure where to start turn – especially lefts Vision Skills . Unsure where curve starts for rights . Poor sign recognition (ie: branch over stop sign) . Difficulty driving at night (poor contrast) Visual Acuity Visual Acuity Ability to focus either near or far Includes Contrast Sensitivity Expressed as a fraction Ability to see objects of decreasing contrast rather than size High contrast: black on white, etc. Numerator: testing distance at which stimulus is recognized Low Contrast: grey on white; white on white, etc. Denominator: distance at which letter being viewed could be recognized by a person with normal visual acuity (20/20) Contrast Sensitivity has been linked to crash risk Implication for driving: difficulty driving at night, Implication for driving: state laws for minimum; dusk or dawn; difficulty seeing items against same inability to read signs or see road details color background (green car with green bushes) Contrast Sensitivity Binocular Vision Combining images from each eye into single image. Images must fall precisely on corresponding positions on each retina or double vision will occur. Muscles work together to position eyes properly to focus light on center of each eye, providing clear vision. 6 Binocular and Stereoscopic Binocular Vision Vision Focusing near - eyes move closer together (convergence) Focusing far - the eyes move further apart (divergence) Misalignment of eyes – double vision Double vision usually either near OR far Muscle weakness pulls eye opposite May be in one gaze (ie: far left gaze) May be constant Implication for driving: blurry vision, motion
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