Comparative Neuro-Ophthalmology - North Carolina State ...

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Factors Modifying the Pupil and PLR• active = direct adrenergic input frompsychosensory stimulation• passive = supranuclear inhibition ofparasympathetic fibers of CN III- descending, inhibitory pathways from cortex to CNIIInuclei- this inhibition lost with sleep, anesthesia, opiodes,extensive cerebral cortical lesion….resulting in miosis
Evaluating Pupillary Light Reflexes• Evaluate resting pupil size in room and dim light• Evaluate direct and indirect (consensual) PLR withhalogen bulb light source; temporal retina:- in sub-primate mammals, dynamic contraction anisocoria(direct PLR > indirect PLR)- in most submammals, no consensual PLR due tocomplete decussation at chiasm (note pseudo-indirectPLR in birds)• Swinging Flashlight test• High intensity blue light source can help distinguishouter retinal v. inner retinal disorders (ipRGC)
Page 1 and 2: Comparative Neuro-OphthalmologyMich
Page 3: Suggested Reading• Shamir MH, Ofr
Page 6 and 7: AFFERENT ARM OF PLR:• rod/cone ph
Page 9 and 10: • optic nerve fibers convergeat c
Page 11 and 12: LG BodyPTN; R.ColliculusII
Page 13 and 14: Afferent Arm of PLR• pretectal nu
Page 15 and 16: Postganglionic, ParasympatheticCili
Page 17 and 18: Ciliary Body Innervation andAccommo
Page 19: Axon Reflex• stimulation of ophth
Page 23 and 24: Swinging Flashlight Test• “Posi
Page 25 and 26: Dark Adaptation Test• normal = bo
Page 27 and 28: Retinal Chain, Intraocular RetinalG
Page 29 and 30: Unilateral Optic Tract Lesions• s
Page 31 and 32: • ipsilateral dilated pupil• no
Page 33 and 34: ExternalOphthalmoplegia• motor de
Page 35 and 36: Pharmacologic Localization of Lesio
Page 37 and 38: Pharmacologic Testing withParasympa
Page 39 and 40: Efferent Sympathetic Pathway:1st Or
Page 41 and 42: Efferent Sympathetic Pathway: 3rdOr
Page 43 and 44: Horner’s Syndrome• protrusion o
Page 45 and 46: Horner’s Syndrome in Large Animal
Page 47 and 48: Localization of Pupillary Abnormali
Page 49 and 50: Anisicoria: Unilateral Mydriasis•
Page 51 and 52: Anisicoria: Unilateral Mydriasis•
Page 53 and 54: Localizing Horner’s Syndrome with
Page 55 and 56: Bilateral Miosis• Extensive brain

Comparative Neuro-Ophthalmology - North Carolina State ...

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