By Lanning B. Kline, MD

Presents a symptom-driven method of the prognosis and therapy of significant neuro-ophthalmic stipulations. With the point of interest at the sufferer, this booklet emphasizes exam and applicable adjunctive experiences, together with a dialogue of diagnostic imaging modalities, and leads the reader in the course of the occasionally sophisticated manifestations of neuro-ophthalmic sickness to anatomical localization of lesions and definitive prognosis. an summary of the anatomy of visible pathways is observed by way of many illustrations. final significant revision 2009 2010.

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Extra info for 2011-2012 Basic and Clinical Science Course, Section 5: Neuro-Ophthalmology (Basic & Clinical Science Course)

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The extra length of th e intraorbital optic ner ve allows unimpeded globe rotation as well as CHAPTER 1: Ne uro-Opht halmic Anatomy . 31 axial shifts withi n the orbit. The central retin al artery an d vein travel withi n the anterior 10-12 m l11 of the optic nerve. The centra l reti nal artery supplies only a minor portion of the optic nerve circulation; most of the blood supply comes from pial branches of the surround in g meninges, which is in turn supplied by small branches of the ophthalmic artery (see Fig 1- 10) .

One of th e primary anatomical features of retinal organization in the primate is th e var iab le ratio of photoreceptor cells to ganglion cells. The ra ti o is highest in th e periphery (at more th an 1000:1) and lowest at th e fovea (where a gan glion cell may receive a signal from a single cone). Thi s ratio underlies the in crease in receptor field wi th increasing eccentri city and the maximal spati al resolutio n at the fove a. Ga nglion cell density in the macula is approximate ly 60 times that in the periphery.

T he BG ap pears to have several roles in the saccadic system, including inhibiting unnecessary reflex ive saccades during fixation and helping in th e control of voluntary saccades. Another important structure involved in the programming of sacca des is the thala mus (i nternal medullary lamina and pulvinar). ,,, and projects onl y to the cortex and BG. Therefore, the thalamus appears to relay messages from the brainstem to the cortical eye fields. For clinical disorders of saccadic dysfunction , see Clinical Disorders of the Ocu lar Motor System in Chapter 7.

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