1. Neuro-ophthalmology, part 2 pupils david.kinshuck@goodhope.nhs.uk
Common pupil abnormalities
Show the problems, explain the anatomy briefly, ..so you may remember
Present, a few questions as we go, then a mini-break for a tiny quiz
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2. 1st animation Watch I will describe what is happening You describe
Where is the problem, and why?
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3. 1st animation Watch I will describe what is happening You describe
Where is the problem, and why?
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4. Light reflex pathway Healthy 13/04/2019
slide1.asp
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slide1.asp

5. Right optic nerve disease
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6. Right optic nerve disease
Animation..left
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7. Right optic nerve disease
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8. 2nd animation Watch I will describe what is happening You describe
Where is the problem, and why?
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9. Pupils do respond to accomodation
Right adies
Pupils do respond to accomodation
(slowly)
slide1.asp
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10. 3rd pupil problem Watch Describe the signs
Where is the problem, and why?
                                                                   
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11. Another case Watch Describe the signs Where is the problem, and why?
slide1.asp
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12. pathway Horners 13/04/2019 www.ophthalmic.hyperguides.com
slide1.asp
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13. 4th type of problem
What is going on here?
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14. 3rd Nerve palsy
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15. 3rd Nerve palsy…young person
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16. Other pupil problems…eye disease
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17. Possible diagnosis (1) (2) (3)
Pupils mini-quiz
R>L left pupil
Possible diagnosis (1) (2) (3)
Describe 3 eye signs that may clarify diagnosis
Diagnosis
3. Young patient..?
4. Old patient…?
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18. Questions
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19. Some serious causes..part of a third nerve..aneursym; horners
Summary
APD…afferent defect (eg optic nerve)…light in good eye, both pupils respond
Adies…(efferent)…one pupil does not respond wherever light shone (but other pupil responds to light in both eyes)
Some serious causes..part of a third nerve..aneursym; horners
Diagnostic dilemmas
Exam cases
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