Neuro-Ophthalmology Dr. Alberto January 4, 2010.

Slides:



Advertisements
Similar presentations
Fusional vergence.
Advertisements

Mohammad Pakravan MD Associate Professor Labbafinejad Medical Center.
Gregg Lueder & Marlo Galli ( JAAPOS ) Journal of American Association for Peadiatric Ophthalmology and strabismus 2008.
STRABISMUS. Misalignment of the eye(s) may turn in, out, up, or down can be present in one or both eyes cross-eyed, squint. Vergence Duction.
An Overview of the Orthoptist Practical Demonstration The Cover Test
Crossed eyes. Strabismus. Squint. Misaligned eyes. Dr.Ali.A.Taqi.
Exodeviations An exodeviation is a divergent strabismus that can be latent or manifest.
Mahbuba Khondaker PGDO Intern, School of Optometry Aravind Eye Hospital Basics & Classification.
Paediatric Ophthalmology and Strabismus
Bitten by Ophthalmology Professor Helen Danesh-Meyer University of Auckland.
OPTOMETRY VISION SCIENCE. Eyeball Refractive system the basic conditions of clear vision: 1. transparence 2. Imaging on fovea 3. Intact visual pathway.
Midbrain syndromes Idara Eshiet C..
Understanding Amblyopia
Better Health. No Hassles. [Name of Presenter] Children’s Eyes and Vision.
Copyright 2002, Delmar, A division of Thomson Learning Chapter 12 Eyes.
M.R Besharati MD Shahid Sadoughi University
Strabismus for 5 th yr medical students Mutaz Gharaibeh,MD.
Binocular Vision, Fusion, and Accommodation
DONE BY: Kamal Sub-Laban Mahmoud Salman Mustafa Jaber
Strabismus Dr HAN Wei The 1 st Affiliated Hospital, Medical College, Zhejiang University.
Strabismus, Amblyopia & Leukocoria
Extrinsic muscles and Amblyopia The Fourth Affiliated Hospital of China Medical University Ophthalmology Hospital of China Medical University.
Dr. Ajay Dudani, Mumbai Retina Centre
Squint Clinic Hyderabad L. V. Prasad Eye Institute.
SPED 537 ECSE Methods Multiple Disabilities Chapter 4 March 13-14, 2006 Deborah Chen, Ph.D. CSU, Northridge.
CHILD HEALTH SURVEILLANCE Vision Screening & Eye Problems Gordon N Dutton Emeritus Professor of Visual Science Paediatric Ophthalmologist.
Neuro-ophthalmology Dr. Abdullah Al-Amri Ophthalmology Consultant.
AMBLYOPIA/STRABISMUS
Peadiatric ophthalmology in 10 minutes David Kinshuck, Good Hope Hospital Retinopathy of Prematurity Leukocoria……… Examining neonates Amblyopia Squint=Strabismus.
MORNING REPORT KAREN ESTRELLA H. PEDS PGY-2 SBH DEC/2010.
Children’s Eyes and Vision [Name of Presenter] Doctor of Optometry.
Strabismus For Medical Students & GP
Mohamad Abdelzaher MSc
Eye Examination Heather Nelson, RN. Inspection of the Eye eyebrows---size, extension, and texture of hair eyelids---color, edema, lesions, adequate muscle.
Strabismus,Amblyopia& leukocoria
Sheela Evangeline K Co ordinators: Ms. Rizwana Mr. Kabilan
SQUINT SURGERY. The most common aims of surgery on the extraocular muscles are to correct misalignment to improve appearance and, if possible, restore.
ALPHABET PATTERNS.
HETEROPHORIAANDVERGENCEABNORMALITIES. Heterophoria Heterophoria may present clinically with associated visual symptoms, particularly at times of stress.
EXOTROPIA. CONSATANT ( EARLY ONSET ) EXOTROPIA 1- presentation is often at birth. 2- signs -Normal refraction. -Large and constant angle. -DVD may be.
PUPILS Dr. Canan Aslı Yıldırım Ophthalmology. Pupillary Reactions A three-neuron arc Afferent neurons from retinal ganglion cells to pretectal area and.
Advanced Pre-Testing Lynn E. Konkel, MS, CPOT Heart of American – February 2013.
Copyright © 2012 Delmar Cengage Learning. All rights reserved. CHAPTER 31 Sensory Alterations.
VISION SCREENING TRAINING Pre-Test Indicate whether the following statements are True or False: 1. Vision acuity refers to the clarity of vision. 2.
SQUINT Strabismus Introduction:
Vision problems NUR 584 Health Promotion and Clinical Prevention
Vicki Leung, O.D Ventura Blvd, Suite 201 Woodland Hills, CA
Amblyopia and Strabismus
Health Assessment Assessment of eye.
ORTH 140 NORMAL BINOCULAR SINGLE VISION AND MOTOR FUSION
Also known as heterotropia
Evaluation of strabismus
The Eyes! Chapter 14.
Eye movements : Anatomy and physiology
Strabismus Introduction
Congenital SO palsy vs Acquired SO palsy
Consultant Ophthalmologist Ophthalmology department
Neuropsychiatry Module
CHILDHOOD STRABISMUS 1. Examination 2. Esotropia 3. Exotropia
The Visual System Part 1.
Projection in Heterotropia
Chapter 12 Eyes.
Muscular activity of the eyes วัตถุประสงค์ ...
Dr. abdulrhman alsugihi Consultant ophthalmologist
Squint Dr. ABDULRHMAN ALSAGAIHI 015.
Pterygium and Visual Aberrations
Rectus Extraocular Muscle Size and Pulley Location in Concomitant and Pattern Exotropia Hao, Rui, et al. "Rectus extraocular muscle size and pulley location.
The Visual System Part 1.
The pupil and its responses & ophthalmology drugs
eye movement disorders
Presentation transcript:

Neuro-Ophthalmology Dr. Alberto January 4, 2010

Picture: Left tonic pupil = greater anisocoria in light illumination Picture: Left tonic pupil = greater anisocoria in light illumination than dark illumination; left eye abnormal

Picture: Right tonic pupil – near response is seen in lower photo

Picture: 12 yr old with recent onset od filated right pupil Picture: 30 minutes after instillation of 0.125% pilocarpine qtt OU. Note lack of effect on normal left eye

Picture: Right congenital Horner’s syndrome: miosis, mild ptosis Picture: Right congenital Horner’s syndrome: miosis, mild ptosis and hypochromic iris. Dim the lights and the normal response of dilation will not be seen.

IDENTIFY A B A: Right eye: ptosis, miosis Horner’s Sydnrome B: Right eye: severe ptosis, mydriasis CN 3 lesion

Picture: Visual fields

Picture: Recti Muscles

Picture: Oblique Muscles

Picture: Yoke Muscles

Picture: Concomitant Strabismus Abnormal eye is left Looking at right  esotropia Looks to the left  not as much but more or less equal in strength

Picture: Inconcomitant Strabismus Looking straight  almost normo( Picture: Inconcomitant Strabismus Looking straight  almost normo(?)phoric Looks to the right  normo(?)phoric Looks to the left  one eye does not move. Inwardly turned left eye.

Exotropia – abnormal is both eyes

Esotropia – abnormal is right eye, temporal side

Pic: Cardinal Positions

Cover Test: Tropias [pic] x 2 Pen light test, one eye already deviated Cover fixating eye, deviated eye will look at the light

Cover –Uncover Test: Esotropias Right eye shows esotropia; covering the left eye, it (right) fixates and reflex is centered; however, on uncovering the left eye it reverts back to esotropia

Cover Test – Phoria [pic] Alignment maintained if both eyes opened Cover Test – Phoria [pic] Alignment maintained if both eyes opened. Cover one eye = break the fusion. Deviating eye moves inwards/outwards. Cover other eye = recovery Sometimes, if you cover both eyes = deviation manifested. Persistence of misalignment when uncovered. Sometimes very subtle As your break fusion, deviation will manifest itself

Latent Exophoria [pic] Delayed May be able to catch deviation for a while

Hirschberg Test [pic[ Number of prism diopters At pupil margin = 5 Margin of cornea = 10-15 Beyond that = about 25 Varying degrees of esotropia show the corneal reflex becoming progressively more temporal

Krimksy Test Measure objectively how many prism diopters we have

Pic of child (Oriental looking)  pseudostrabismus – reflexes are centered; epicanthal fold in Oriental children creates illusion of strabismus

Pic of next child  right hypertropia

Squint Surgery

God Bless!!!