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VISUAL FIELD DEFECTS
OCULAR REFLEXES
Clinical correlation
• Loss of vision in one half
of the visual field (Rt or
Lt) is termed as
hemianopia.
• Homonymous
hemianopia: Loss of
vision in the same halves
of the visual field.
• Heteronymous
Hemianopia: Loss of
vision in the different
halves of the visual field.
3
Pupillary Light Reflex
• When the amount of
light entering the eyes
increases, the pupils
constrict.
• Functions to help the
eye adapt extremely
rapidly to changing light
conditions.
• Direct light reflex:
same pupil constricts
• indirect (consensual)
light reflex: pupil of the
opposite eye constricts
Two type of light reflex
• Direct light reflex
• Constriction of pupil of the eye in which the light is
directed is called direct light reflex
• Consensual light reflex (In direct)
• Constriction of pupil of the other eye is called
consensual light reflex
Pathways of direct and indirect light
reflexes (v.imp.)
BY Muhammad Ramzan Ul
Rehman Nishtar Ken
14
Pupillary light reflex
Direct
Consensual
Extrinsic Eye Muscles
Inferior rectus Inferior oblique
Medial
rectus
Superior
rectus
Superior
oblique
Lateral
rectus
(cut)
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
• Superior rectus
• Rotates eye up and
medially
• Inferior rectus
• Rotates eye down
and medially
• Medial rectus
• Rotates eye
medially
16
Extrinsic Eye Muscles
Inferior rectus Inferior oblique
Medial
rectus
Superior
rectus
Superior
oblique
Lateral
rectus
(cut)
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
• Lateral rectus
• Rotates eye
laterally
• Superior oblique
• Rotates eye down
and laterally
• Inferior oblique
• Rotates eye up and
laterally
17
Medial and lateral
recti move eyes side
to side
Superior and inferior
recti move eyes up
and down
Superior and inferior
obliques rotate the
eyes
Extra ocular muscles
Nerve Supply
Figure 51-7; Guyton & Hall
18
Accommodation
• It is the ability of the
eye to keep the image
focused on the retina
(as the distance
between the eyes & the
object varies)
19
AccommodationAccommodation
NEAR RESPONSE or accomodation
for near vision
• The three components of near response
are:
1. accommodation,
2. convergence of the eyeballs &
3. Pupillary constriction
Pathway of Convergence
Reflex
ACCCOMODATION REFLEX
• When the eyes are
focussed from a distant to
near object, three
reactions take place
• 1. Constriction of pupils
• 2. thickening of lens due to
contraction of ciliary
muscles
• 3. Convergence of both eye
balls
These three reactions
together constitute
Accommodation or near
reflex
Accommodation
reflex
Visual Acuity
• Acuteness or clearness of vision
• It is the degree to which the details
and contours of objects are perceived
• It is defined in terms of the minimum
separable (shortest) distance by which
two lines can be separated and still be
perceived as two lines
• Thus the minimum separable in a
normal individual corresponds to a
visual angle of about 1 minute
• Clinically Snellen’s charts are used to
determine visual acuity
METHOD FOR STATING VISUAL
ACUITY
• Chart for testing eyes
consists of letters of
different sizes placed
20 feet ( 6 meters)
away from the person
being tested.
• Person is said to have
normal vision if he can
see the letters from the
distance of 20 feet or 6
meters. so he have
vision of 20/20 or 6/6
26
CONFRONTATION METHOD TO TEST
THE FIELD OF VISION
27
perimetry
Lister’s perimeter
• Perimetry maps and
quantifies the visual field,
especially at the extreme
periphery of the visual
field.
28
GOLDMAN’S PERIMETRY
29
Physiologic blind spot: In
all perimetry charts, a
blind spot caused by lack
of rods and cones in the
retina over the optic disc
is found about 15
degrees lateral to the
central point of vision, as
shown in the figure.
• Scotoma
A blind spot in any other
portion of the visual field
30

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Visual field defects and light reflex

  • 2. Clinical correlation • Loss of vision in one half of the visual field (Rt or Lt) is termed as hemianopia. • Homonymous hemianopia: Loss of vision in the same halves of the visual field. • Heteronymous Hemianopia: Loss of vision in the different halves of the visual field.
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  • 11. Pupillary Light Reflex • When the amount of light entering the eyes increases, the pupils constrict. • Functions to help the eye adapt extremely rapidly to changing light conditions. • Direct light reflex: same pupil constricts • indirect (consensual) light reflex: pupil of the opposite eye constricts
  • 12. Two type of light reflex • Direct light reflex • Constriction of pupil of the eye in which the light is directed is called direct light reflex • Consensual light reflex (In direct) • Constriction of pupil of the other eye is called consensual light reflex
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  • 14. Pathways of direct and indirect light reflexes (v.imp.) BY Muhammad Ramzan Ul Rehman Nishtar Ken 14
  • 16. Extrinsic Eye Muscles Inferior rectus Inferior oblique Medial rectus Superior rectus Superior oblique Lateral rectus (cut) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • Superior rectus • Rotates eye up and medially • Inferior rectus • Rotates eye down and medially • Medial rectus • Rotates eye medially 16
  • 17. Extrinsic Eye Muscles Inferior rectus Inferior oblique Medial rectus Superior rectus Superior oblique Lateral rectus (cut) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • Lateral rectus • Rotates eye laterally • Superior oblique • Rotates eye down and laterally • Inferior oblique • Rotates eye up and laterally 17
  • 18. Medial and lateral recti move eyes side to side Superior and inferior recti move eyes up and down Superior and inferior obliques rotate the eyes Extra ocular muscles Nerve Supply Figure 51-7; Guyton & Hall 18
  • 19. Accommodation • It is the ability of the eye to keep the image focused on the retina (as the distance between the eyes & the object varies) 19
  • 21. NEAR RESPONSE or accomodation for near vision • The three components of near response are: 1. accommodation, 2. convergence of the eyeballs & 3. Pupillary constriction
  • 23. ACCCOMODATION REFLEX • When the eyes are focussed from a distant to near object, three reactions take place • 1. Constriction of pupils • 2. thickening of lens due to contraction of ciliary muscles • 3. Convergence of both eye balls These three reactions together constitute Accommodation or near reflex
  • 25. Visual Acuity • Acuteness or clearness of vision • It is the degree to which the details and contours of objects are perceived • It is defined in terms of the minimum separable (shortest) distance by which two lines can be separated and still be perceived as two lines • Thus the minimum separable in a normal individual corresponds to a visual angle of about 1 minute • Clinically Snellen’s charts are used to determine visual acuity
  • 26. METHOD FOR STATING VISUAL ACUITY • Chart for testing eyes consists of letters of different sizes placed 20 feet ( 6 meters) away from the person being tested. • Person is said to have normal vision if he can see the letters from the distance of 20 feet or 6 meters. so he have vision of 20/20 or 6/6 26
  • 27. CONFRONTATION METHOD TO TEST THE FIELD OF VISION 27
  • 28. perimetry Lister’s perimeter • Perimetry maps and quantifies the visual field, especially at the extreme periphery of the visual field. 28
  • 30. Physiologic blind spot: In all perimetry charts, a blind spot caused by lack of rods and cones in the retina over the optic disc is found about 15 degrees lateral to the central point of vision, as shown in the figure. • Scotoma A blind spot in any other portion of the visual field 30

Notas del editor

  1. Affeerent fibers from MR via III n. To Mesencephalic nuclei of 5th n To convergence center in Tectal or Pre Tectal region From convergence center to EW nucleus Efferent fibers travel along the III n. Relay in accessory ganglion Reaches the sphincter pupillae