By Lanning B. Kline, MD
A patient-centered method of the prognosis and remedy of significant neuro-ophthalmic stipulations. targeting very important offering signs, this e-book leads the reader throughout the occasionally sophisticated manifestations of neuro-ophthalmic sickness to anatomic localization of lesions and definitive analysis. additionally comprises an summary of the anatomy of the visible pathway, instructions for undertaking 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)
PartA reprintedfromKline LB. Optic Nerve Disorders. ) Monograph 10. San Francisco. American Academy of Ophthalmology; 1996. that some of the nasal fibers (nasal within the macula) enter the disc on its temporal side (papillomacular bundle). Focal loss of the nerve fiber layer may be seen as grooves or slits or as reflections paralleling the retinal arterioles where the internal limiting membrane drapes over the vessels, whereas diffuse nerve fiber layer loss is often more difficult to detect and brings the retinal vessels into sharp relief.
Most of the axons that originated in the retinal ganglion cells terminate within the lateral geniculate. The lateral geniculate is located in the posterior thalamus below and lateral to the pulvinar and above the lateral recess of the ambient cistern. This peaked, mushroomshaped structure is divided into 6 levels. The 4 superior levels are the terminus of parvocellular axons, which are the ganglion cells with smaller receptive fields that are responsible for mediating maximal spatial resolution and color perception.
The j1occulonodular lobe plus parts of the paraj10cculus make up the vestibulocerebellum. Two additional 40 . Neuro-Ophthalmology Upward E e Movements Downward E e Movements PC PC riMLF riMLF INC INC Midbrain CN III CN III o CNIV CNIV Pons Medulla y-group vn vn Figure '-20 Anatomic schemes for the synthesis of upward and downward movements (in red). From the vertical semicircular canals, primary afferents on the vestibular nerve (vn) synapse in the vestibular nuclei (VN) and ascend into the medial longitudinal fasciculus (MLF) and brachium conjunctivum (not shown) to contact neurons in the trochlear nucleus (CN IV), oculomotor nucleus (CN III), and interstitial nucleus of Cajal (/NC).