PHYSIOLOGY OF EYE

BY
DR. MUDASSAR ALI ROOMI (MBBS, M. Phil.)

Neurophysiology of Vision

the visual system/pathway consists of: theretina Theoptic nerve Theoptic chiasma Theoptic tract Thelateral geniculate body Theoptic radiation Thevisual cortex Thevisual association cortex

Visual Pathways to the Brain

optic nerve
axons of ganglion cells of the retina

optic chiasm
At optic chiasma, all fibers from the nasal halves of the retina cross to the opposite side

crossed fibers join fibers from the opposite temporal retina to form the optic tracts
These fibers synapse in the dorsal lateral geniculate nucleus (LGN) from LGN to primary visual cortex by way of the optic radiation (geniculocalcarine tract)

Visual pathways to the brain

Lesions of the optic pathway

LESION OF OPTIC RADIATION OR GENICULOCALCARINE TRACT

Homonymous contralateral hemianopia with macular sparing. Macular sparing occurs because lesion of visual cortex don't destroy all neurons that represent the macula.

PITUITARY TUMOR MAY COMPRESS ON OPTIC CHIASMA AND CAN CAUSE BITEMPORAL HEMIANOPIA
BITEMPORAL HEMIANOPIA

BITEMPORAL HEMIANOPIA

BINASAL HEMIANOPIA

Lateral Geniculate Nucleus

High degree of spatial fidility Layers II, III and V receive temporal fibers Layers I, IV and VI receive nasal fibers Layer I & II receive Y neurons Layerr II & VI receive X cells

Primary Visual Cortex????

Area 17 located in the occipital lobe in the calcarine fissure region extending to the pole large representation in visual cortex for the macula (region for highest visual acuity) receives the primary visual input

Secondary Visual Areas

visual association cortex (area 18, 19) responsible for analyzing the visual information area for 3 dimensional position, gross form, and motion area for color analysis

Retinal Projections to Subcortical Regions

suprachiasmatic nucleus of the hypothalamus control of circadian rhythms?? pretectal nuclei pupillary light reflex accommodation of the lens superior colliculus rapid directional movement of both eyes

The Autonomic Nerves to the Eyes

The Autonomic Nerves to the Eyes

The eye is innervated by both parasympathetic and sympathetic neurons. Parasympathetic fibers arise in the EdingerWestphal nucleus, pass in the 3rd cranial nerve to the ciliary ganglion.
Postganglionic fibers excite the ciliary muscle and sphincter of the iris.

Sympathetic fibers originate in the intermediolateral horn cells of the superior cervical ganglion.

Postganglionic fibers spread along the corotid artery and eventually innervate the radial fibers of the iris.

Pupillary Light Reflexes

If a light is shone directly into one eye, its pupil constricts. This response is known as the direct pupillary response. The pupil of the other eye also constricts, and this is known as the consensual response.

PUPILLARY REFLEXES

Fig. 16.07

Pupillary Light Reflex

When the amount of light entering the eyes increases, the pupils constrict. Functions to help the eye adapt extremely rapidly to changing light conditions. Direct light reflex: same pupil constricts indirect (consensual) light reflex: pupil of the opposite eye constricts

Pathways of direct and indirect light reflexes (v.imp.)

Control of Pupillary Diameter

miosis: decreasing of pupillary aperture due to stimulation of parasympathetic nerves that excite the pupillary sphincter muscle mydriasis: dilation of pupillary aperture due to stimulation of sympathetic nerves that excite the radial fibers of the iris

ARGYLL ROBERTSON PUPIL.

Pupil that fails to respond to light but does respond to accommodation and is very small in size. It is an important diagnostic sign of CNS disease (syphilis).

HORNERS SYNDROME
The sympathetic nerves to the eye are occasionally interrupted . Interruption occurs in cervical sympathetic chain.

HORNERS SYNDROME
One pupil remains persistently constricted to a smaller diameter than the pupil of the opposite eye (miosis) Drooping of Upper eyelid (ptosis) Blood vessels on the corresponding side of the face & head become persistently dilated (flushing of face) Sweating cant occur on the affected side of the face (anhydrosis)

CONFRONTATION METHOD TO TEST THE FIELD OF VISION

perimetry
Listers perimeter

Perimetry maps and quantifies the visual field, especially at the extreme periphery of the visual field.

GOLDMANS PERIMETRY

Physiologic blind spot: In all perimetry charts, a blind spot caused by lack of rods and cones in the retina over the optic disc is found about 15 degrees lateral to the central point of vision, as shown in the figure. Scotoma A blind spot in any other portion of the visual field

Fields of Vision
nasal field located on the temporal side of the retina temporal field located on the nasal side of the retina interruption of the visual pathway at different points leads to very specific visual field defects blind spot located about 15 degrees lateral to the central point of vision no rods or cones in this area, called the optic disc, exit point for axons of the ganglion cells