By Lanning B. Kline, MD
A patient-centered method of the prognosis and remedy of significant neuro-ophthalmic stipulations. targeting very important proposing symptoms, this publication leads the reader throughout the occasionally refined manifestations of neuro-ophthalmic illness to anatomic localization of lesions and definitive prognosis. additionally contains an outline of the anatomy of the visible pathway, directions for engaging in the neuro-ophthalmic exam and applicable use of diagnostic imaging experiences.
Read Online or Download 2008-2009 Basic and Clinical Science Course: Section 5: Neuro-Ophthalmology (Basic and Clinical Science Course 2008-2009) PDF
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Additional resources for 2008-2009 Basic and Clinical Science Course: Section 5: Neuro-Ophthalmology (Basic and Clinical Science Course 2008-2009)
16 . Neuro-Ophthalmology Figure 1-6 Partialcutaway view of vasculatureof optic nerve head. Short posteriorciliaryarteries (PCA) supply centripetal capillary beds of anterior optic nerve head. Central retinal artery (CRA) contribution is restricted to nerve fiber layer capillaries and those of anterior intraorbital optic nerve. Capillary beds at all levels drain into central retinal vein (CRV). ZH = intrascleral circle of Zinn-Haller. RA = recurrent posterior ciliary artery to pial plexus. (Reprintedfrom Kline L8.
Within the canal, the optic nerve is accompanied by the ophthalmic artery inferiorly and separated from the superior orbital fissure by the optic strut (the lateral aspect of the lesser wing of the sphenoid), which terminates superiorly as the anterior clinoid. Medially, the optic nerve is separated from the sphenoid sinus by bone that may be thin or even dehiscent. The canal normally measures approximately 8-10 mm in length and 5-7 mm in width but may be elongated and narrowed by processes that cause bone thickening (fibrous dysplasia, intraosseous meningioma, and so on).
The superior oblique functions as an intorter and abductor but becomes increasinglya depressor as it moves into adduction. The inferior oblique (also inserting posteriorly on the sclera) acts primarily as an extorter and abductor but becomes increasingly an elevator in adduction. The superior muscles (contralaterally innervated superior oblique and superior rectus) are thus intorters, whereas the inferiors (ipsilaterally innervated) are extorters. The obliques are abductors, whereas the vertical rectus muscles are adductors.