2008-2009 Basic and Clinical Science Course: Section 5: by Lanning B. Kline, MD

By Lanning B. Kline, MD

A patient-centered method of the prognosis and therapy of significant neuro-ophthalmic stipulations. concentrating on very important featuring signs, this ebook leads the reader during the occasionally sophisticated manifestations of neuro-ophthalmic disorder to anatomic localization of lesions and definitive prognosis. additionally comprises an outline of the anatomy of the visible pathway, instructions for accomplishing the neuro-ophthalmic exam and acceptable use of diagnostic imaging reports.

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Additional info for 2008-2009 Basic and Clinical Science Course: Section 5: Neuro-Ophthalmology (Basic and Clinical Science Course 2008-2009)

Sample text

The retina measures approximately 2500 mm2 in surface area and is between 100 and 250 /lm thick. The choroid, the extremely vascular posterior extension of the uvea, lines the sclera and supports the single-cell-layer retinal pigment epithelium (RPE). The RPE is in direct contact with the retinal receptors and is responsible for metabolic support as well as regeneration of the chromophore II-trans-retinal to the cis form to restore receptor sensitivity. The impulses that make up the optical signal originate in the ganglion cells within the inner retina.

Reproduced with permission from Leigh RJ. Zee OS. The Neurology of Eye Movements. 3rd ed. 1 CHAPTER 1: Neuro-Ophthalmic Anatomy. 39 eyes, a signal to increase firing must be distributed to 1 lateral rectus and the contralateral medial rectus. The lateral rectus is supplied directly through the ipsilateral CN VI. The contralateral medial rectus is stimulated by interneurons that cross in the pons and ascend in the contralateral MLF. Pathology affecting 1 MLF will result in an ipsilateral adduction deficit with attempted contralateral gaze, often accompanied by abducting nystagmus of the contralateral eye (internuclear ophthalmoplegia).

The DLPN projects, mainly contra laterally, to the flocculus, paraflocculus, and ventral uvula of the cerebellum; projections also pass to the dorsal vermis. The flocculus projects to the ipsilateral vestibular nuclei (VN), which in turn project to the contralateral abducens nucleus. Note that the sections of the brain stem are in different planes from those of the cerebral hemispheres. (Reproduced with permission from Leigh RJ, Zee OS. The Neurology of Eye Movements. 3rd ed. ) CHAPTER 1: Neuro-Ophthalmic Anatomy.

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