VISION

Objective
• To discuss the visual pathway, its parts &
connections and relationship with the optic
reflexes
• Develops from the optic cup, an
outgrowth of the diencephalon
• Retina : rods and cones
• Fovea centralis : specialized region in
macula for high visual acuity; highest cone
density
• Rods- rhodopsin Cones -iodopsin
– isomerization leading to hyperpolarization
 RETINA
• Contains 5 cell types
1. amacrine cell *
2. bipolar cell
3. receptor cell (rods and cones)
4. ganglion cell
5. horizontal cell *

*inhibitory, uses GABA

Optic nerve
 GANGLION CELLS OF THE
RETINA
• Axons converge to form the optic disc
• Becomes myelinated as the optic nerve
• Optic nerve optic chiasm

LGB,
superior optic tracts
colliculus,
pretectal area
LATERAL GENICULATE BODY
• Inputs are arranged in an ORDERLY
TOPOGRAPHIC PATTERN
• Receives the contralateral visual field
• central visual field represented more
extensively
• each layer in the LGB receives inputs
from one eye only (3 layers for
ipsilateral, 3 layers for contralateral)
 SUPERIOR COLLICULUS
• Receives direct visual input from optic
tracts from the visual cortex
• Projects to the pons (tectopontine) and to
the spinal cord (tectospinal)
Tectopontine cerebellum
Tectospinal reflex control of
head & neck
• Participates in eye movement control by
connections with RF
 PRE-TECTAL AREA
• Site for mediation of pupillary reflexes
• Receives input from optic tract
• Fibers project to the Edinger-Westphal
nucleus
 PRIMARY VISUAL CORTEX
(Brodmann’s area 17)
• Primary visual receptive area
• Also called “striate area” (contains
Gennari’s line)
• Surrounds the calcarine fissure/sulcus
• Cuneus - above the fissure
• Lingual gyrus - below the fissure
TOPOGRAPHIC ARRANGEMENT
IN THE CORTEX
• SUPERIOR visual field projects to
INFERIOR part of cortex
• LEFT projects to the RIGHT
• CENTRAL projects to the POSTERIOR
• PERIPHERAL projects to the ANTERIOR
 BRODMANN AREA 18 & 19
• also called VISUAL ASSOCIATION
AREAS
• regions for visual perception or visual
sensory processing
• also play a role in visually guided
saccades, ocular pursuit movements,
accomodation and convergence
OPTIC REFLEXES AND EYE
MOVEMENTS
 LIGHT REFLEX
• DIRECT LIGHT REFLEX
Pupil constricts promptly when light is
flashed into the eye and dilates when
removed.
• Follows the usual visual pathway, BUT,
instead to the LGB, it goes to the superior
colliculus and end in the PRETECTAL
AREA
 DIRECT LIGHT REFLEX
• From the pretectal area, connects to the
E-W nucleus

• E-W nucleus connects with the CILIARY

GANGLION ------> CONSTRICTS Iris
muscles
CONSENSUAL LIGHT REFLEX
• Constriction of the contralateral eye

• Accomplished by crossing connections in

the light reflex pathway at level of
pretectum
CROSSING
OVER
INTACT DIRECT &
CONSENSUAL
 ABSENT DIRECT &
CONSENSUAL REFLEX
 NO DIRECT/CONSENSUAL
REFLEX ON AFFECTED EYE
 REFLEXES OF NEAR-POINT
REACTION
• When eyes are directed to an object close
to the face, 3 reflexes occur :
1. CONVERGENCE
2. ACCOMODATION
3. PUPILLARY CONSTRICTION
 CONVERGENCE
• Medial rectus muscles contract to move
both eyes to the midline so the image
remains focused on the fovea
• IF non-functioning, DIPLOPIA results
 ACCOMODATION
• Lenses are thickened by contraction of its
ciliary muscles; also maintains a focused
image on the fovea
• Ciliary muscles are innervated by
parasympathetic neurons in the ciliary
ganglion
 PUPILLARY CONSTRICTION
• Pupils are narrowed as an AID to regulate
the DEPTH of focus
• Separate from the light reflex
 CLINICAL CONDITIONS
• ADIE’S TONIC PUPIL
Unilateral dilated pupil (assoc. with
absent deep tendon reflexes)
Minimal constriction to light, and
pathologically slow re-dilatation
 CLINICAL CONDITIONS
• ARGYLL ROBERTSON PUPIL
Prostitute eye (accommodates but
does not react)
Damage to the ciliary ganglion or iris is
implicated (probably syphilis)
 VISUAL FIXATION
• Four visual subsystems act to VISUALIZE
AN OBJECT IN THE FOVEA AND KEEP
IT THERE AS THE OBJECT OR THE
VIEWER MOVES
1. Saccadic
2. Pursuit
3. Vergence
4. Vestibulo-ocular
SACCADIC EYE MOVEMENTS
• Saccades = fast conjugate eye
movements to track a MOVING OBJECT
• Voluntary saccades initiated by the
parieto-occipital cortex and visual cortex,
and by Brodmann’s area 8
• Involuntary saccades initiated by
brainstem (e.g. REM, fast phase of
nystagmus)
 SACCADES
• HORIZONTAL GAZE
The contralateral pontine
paramedian reticular formation (PPRF)
is an integral part.
Visual inputs
(contra)
Cortices----->sup. colliculus--->PPRF---
CN III <------MLF <---------CN VI <-----
(ipsi MR) (contra LR)
 SACCADES
• UPWARD GAZE

contra PPRF-----> riMLF ----->interstitial

nucleus
CNIII<------post. commisure<----of Cajal
(ipsi)

SR(contra) and IO (ipsi)

 SACCADES
• DOWNWARD GAZE
Same with upward gaze, except the IR
(CN III) and SO (CN IV) are innervated
 PURSUIT EYE MOVEMENTS
• Maintains fixation on slowly MOVING
OBJECTS
HORIZONTAL PURSUIT
Visual inputs----->parieto-occipital--
CN VI<------cerebellar vermis<----pons<
& III (ipsi)
VERTICAL PURSUIT - (unknown)
• If pursuit fails, saccades will substitute
 VESTIBULO-OCULAR
MOVEMENTS
• Prevents image from moving away from
the fovea during HEAD MOVEMENTS
• Pathway from medulla to midbrain
• Receives inputs from the semicircular
canals to the vestibular nuclei
• Vestibular nuclei reaches CN VI & III
(horizontal) and CN IV & III (vertical)
 VERGENCE EYE
MOVEMENTS
• Allows continual presence of the image of
interest on the fovea as the object moves
closer or farther away
• Signals come from bilateral parieto-
occipital cortex to the midbrain, then to CN
III and VI
THANK YOU.