Comparative Neuro-Ophthalmology - North Carolina State ...

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Limitations/Caveats in PharmacologicTesting for Autonomic Disorders• endogenous psychosensory stimulation• control eye• quantity of absorbed drug affected byvolume, corneal epithelium, etc• prior drug action (24 hours minimum)• partial lesions, partial dennervationhypersensitivity• pre-ganglionic lesion, partialhypersensitivity
Pharmacologic Testing withParasympathetic Denervation• hypersensitivity > with ganglionic or postganglionic lesions• pharmacologic testing distinguishes from atropine blockade oriridal disease (atrophy, synechia) and aids in lesion localization:- 0.5% physostigmine (indirect parasympathomimetic, allows buildup ofacetylcholine at synaptic fissure):• postganglionic = no constriction• central/preganglionic = rapid constriction before normal, control eye- 2% pilocarpine (direct parasympathomimetic):• 24 hours post indirect agent testing• confirms lesion is neurologic• postganglionic lesion constricts sooner than normal eye
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 and 20: Axon Reflex• stimulation of ophth
Page 21 and 22: Evaluating Pupillary Light Reflexes
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: Pharmacologic Localization of Lesio
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

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