Comparative Neuro-Ophthalmology - North Carolina State ...

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Pharmacologic Testing• 6% cocaine…blocks reuptake of norepinephrine- no mydriasis confirms Horner’s syndrome• 1% hydroxyamphetamine…causesnorepinephrine release- postganglionic = no or incomplete mydriasis- preganglionic = normal mydriasis• 10% phenylephrine- hypersensitivity with postganglionic- mydriasis in 5-8 minutes- retraction of nictitans and resolution of ptosis alsooccurs
Localization of Pupillary Abnormalities• rule out psychosensory stimulation• rule out oculopupillary/axon reflexes• rule out non-neurologic disorders- mechanical or structural iris abnormalities- pharmacologic blockade• if neurologic disorder, define effects on:- pupillary diameter or shape- response to dark adaptation testing- pupillary light reflex- vision (if afferent arm lesion prior to LBG)• funduscopic exam, complete neurologic exam
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 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: Horner’s Syndrome in Large Animal
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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