By Lanning B. Kline, MD

ISBN-10: 161525112X

ISBN-13: 9781615251124

Presents a symptom-driven method of the analysis and therapy of significant neuro-ophthalmic stipulations. With the point of interest at the sufferer, this ebook emphasizes exam and acceptable adjunctive stories, together with a dialogue of diagnostic imaging modalities, and leads the reader throughout the occasionally refined manifestations of neuro-ophthalmic ailment to anatomical localization of lesions and definitive analysis. an summary of the anatomy of visible pathways is followed through many illustrations. final significant revision 2009 2010.

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Extra resources for 2011-2012 Basic and Clinical Science Course, Section 5: Neuro-Ophthalmology (Basic & Clinical Science Course)

Example text

Topograp hic (retinotopic) representation is maintained throughout the optic nerve. Peri pheral retinal receptors are fo un d more peripherally, and the papillomacular bundle travels temporall y and inc reasingly centrall y withi n the nerve. As the optic ner ve enters the optic canal, the dural sheath fuses with the periorbita. It is also surrounded by the annulus of Zinn, which serves as the origin of the 4 rectus muscles and the superior oblique muscle. Within th e canal, the optic nerve is accompa- nied by the ophthalmic arte ry in fe ri orl y and sepa rated from the superior orbital fissure by the optic stru t (the lateral aspect of the lesser wi ng of the sphenoid), which terminates superiorly as the anteri or cli noid.

The ppe is important in visuall y guided reflexive saccades. The SC is d ivided into a superficial (dorsal) and deep (ventral) part. The sensory signal (input from the visual cortex and retina) is main ly processed by the superficial sc. The 1110tor signal originates within the deeper layers (the stratum griscurn profundum and stratum album profundum) th at receive position in formati on frorn the more superficial laye rs. The SC projects contralaterally to multiple locations throllghout the brainstem, most particularl y to the RIP, NRTP, and DLPN.

The supranuclea r pathways also go through the BG (caudate nucleus, putamen nucleus, and substantia nigra pars reticu late). T he BG ap pears to have several roles in the saccadic system, including inhibiting unnecessary reflex ive saccades during fixation and helping in th e control of voluntary saccades. Another important structure involved in the programming of sacca des is the thala mus (i nternal medullary lamina and pulvinar). ,,, and projects onl y to the cortex and BG. Therefore, the thalamus appears to relay messages from the brainstem to the cortical eye fields.

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2011-2012 Basic and Clinical Science Course, Section 5: Neuro-Ophthalmology (Basic & Clinical Science Course) by Lanning B. Kline, MD


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