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Describe Conjunctiva
Conjunctiva is
translucent and clear.
The pink color of
palpebral conjunctiva
is due to underlying
vascular bed. White
Sclera is seen through
bulbar conjunctiva
Note conjunctival reflection
Note anterior and
posterior chamber.
Note ciliary body and
lens connection
Diagnosis
Sub conjunctival
hemorrhage.
Sharply demarcated.
Afferent pathway for visual
acuity?
Retina-Optic nerve-Optic
chiasma-Optic
radiation-Occiptal lobe
visual cortex.
Note fovea as center for visual
field. Locate site for blind spot in
retina
Center of optic disc has
no retinal receptors
and leads to blind
spot.
Pathway for light reflex?
Afferent: Retina-optic
nerve-mid brain
Efferent: Both oculo
motor nerves
Note direct and consensual light
reflex
Sorry the pupillary
contraction on right is
not visible
Note the pathway for pupillary
contraction
Direct reflex on right
Consensual reflex on left
Note the pathway for light reflex
Is this light reflex normal?
Yes.
Note direct and
consensual light reflex
Is this light reflex normal?
Afferent path on left eye
is abnormal.
Which muscles are in action?
Right lateral rectus and
left medial rectus.
Gaze is conjugate.
Which nerves are in action?
Right abducens (right
lateral rectus) and
left oculomotor nerve
(left medial rectus).
Gaze is conjugate.
Which nerves are in action
Oculomotor nerves.
Superior rectus in
action. Gaze is
conjugate.
Which cranial nerves are in
action?
Both oculomotor nerves
Inferior recti in action
Identify the ocular muscles
Levator palpabrae
supreioris
Superior rectus
Inferior recrtus
Appreciate position of ocular
muscles
Superior oblique:
Trochlear nerve
Lateral rectus: Abducens
nerve
Oculomotor supplies the
rest
Ocular muscles influenced by
sympathetic system
Levator palpabrae
superioris
Iris muscle
Muscle in floor of orbit
Is the technique appropriate?
No.
You should look at left
fundus with your left
eye.
Identify artery and vein
Artery is narrow with
light reflex
Vein is thicker than
artery and is red
Diagnosis
Leukemic infiltration
Diagnosis
Macroglobunemia
Source for tears?
• Lacrimal gland
• Meibonian glands
• Conjunctival glands
Drained by puncta into
lacrimal sac and on to
nasolacrimal duct into
nose.
Note pathway for aqueous humor
Your right eye compared to
subject’s left eye
Normal mono-ocular field of
vision
80-90 degrees temporal.
45 degrees medial.
Limited by nose
Eye brows limit upward
field
Anticipate the visual field defects
with lesions marked.
Blind rught eye
Bitempral hemianopsia
Homonymous
hemianopsia
Describe and locate the lesion for
each visual field defect
Left upper retna
Left optic nerve
Chiasma
Right optic tract
Right optic radiation
Right optic radiation