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TitleDescriptionType
76 Rebound NystagmusExample of a patient with rebound nystagmus, where the oscillations alternate direction as the patient shifts gaze in different directions. Discussion of relationship to disease and disorders of the cerebellum, including degenerations of the cerebellum, infarction, and demyelination.Image/MovingImage
77 Transillumination - Ciliary Body NeurofibromasExample of transillumination on a patient with neurofibromatosis, but without Lisch nodules. Shows suspected neurofibromas in the ciliary body.Image/MovingImage
78 Upbeat NystagmusExample of a patient with upbeat nystagmus. Shows vertical jerk nystagmus with fast phases in the up direction. Localizes to brain stem, and occurs with strokes, demyelination, and tumors.Image/MovingImage
79 Vestibular NystagmusDiscussion of vestibular nystagmus. Seen with peripheral disorders and central disorders, and in two varieties: spontaneous and positional. Horizontal jerk with small amplitude.Image/MovingImage
80 Voluntary NystagmusExample of patient with voluntary nystagmus. Discussion of how a lack of uniform, patterned movement of the eyes along with associated lid movements suggests that activity is voluntary.Image/MovingImage
81 Wall-Eyed Bilateral Internuclear Ophthalmoplegia (WEBINO)Example of patient with horizontal binocular diplopia. Demonstration of exam, which shows alternating exotropia in cover test. As patient follows object, right eye does not pass the midline as the object moves to the left, while left eye go slightly past the midline, but does not abduct completely. ...Image/MovingImage
82 Aberrant Regeneration of the Seventh NerveExamples of patients with aberrant regeneration of the seventh nerve. First example is a patient with contractions around the mouth and dimpling, demonstrated with slow and rapid eye blinking. Second example shows contraction around nose with eye blink.Image/MovingImage
83 Aberrant Regeneration of Third Nerve, Bilaterally (1 degree OD, 2 Digrees OS)Example of patient with bilateral aberrancy of the third nerve. Shows lids popping up (synkinetic) with adduction. Patient had bilateral internal carotid artery aneurisms with third nerve compression.Image/MovingImage
84 Binocular Pendular NystagmusExample of a patient with binocular pendular nystagmus. Patient has somewhat dissociated nystagmus, with nystagmus seen more prominently in the left eye. Patient shows an occasional jerk nystagmus to the right in the right eye. Left eye oscillations are mostly pendular.Image/MovingImage
85 Congenital NystagmusExample of patients with congenital nystagmus. First patient's nystagmus are mostly jerk and not pendular. Second patient's nystagmus are mostly pendular. Both patients show a uniform horizontal oscillation. Second patient also shows differences in frequency of oscillations depending on gaze, includ...Image/MovingImage
86 Monocular Pendular NystagmusExample of a patient with monocular pendular nystagmus, with discussion of situations in which this condition is seen: acquired disorder of the visual-sensory pathway, and acquired disorder of the brain stem (e.g. multiple sclerosis).Image/MovingImage
87 Normal Light Reflex without RAPDThis clip demonstrates the examination of the Relative Afferent Pupillary Defect (RAPD.) Demonstration of gauging the size of the pupil in light, testing light reflexes, swinging flashlight test for optic nerve abnormality.Image/MovingImage
88 Ocular Lateropulsion (Wallenberg's Syndrome)Example of patient with ocular lateropulsion. Patient also has central Horner syndrome and nystagmus in right gaze. When shifting gaze back to forward, eyes overshoot their mark. Eyes laterally deviate to the right upon opening.Image/MovingImage
89 Ocular MyastheniaExample of patient with myasthenia gravis. Demonstration of tensilon test. Patient shown to have bilateral ptosis, bilateral duction deficits, and left hypertropia. Discussion of techniques to observe subtle changes, such as bringing in a neutral observer or taking still photographs. Shows split-scr...Image/MovingImage
90 Paradoxical Constriction of Pupils to Darkness (Flynn Phenomenon)Example of patients both with and without paradoxical constriction of pupils. Observed in many congenital retinal disorders, such as achromatopsia, congenital stationary night-blindness, and Leber's congenital amaurosis. Sometimes seen in optic nerve disorders, such as dominant optic atrophy.Image/MovingImage
91 Progressive Supranuclear PalsyExample of patient with progressive supranuclear palsy. Discussion of difference between saccadic movement in supranuclear palsy and nystagmus. Shows saccadic intrusions in forward gaze, pursuit, saccades, and doll's head maneuver.Image/MovingImage
92 See-saw NystagmusExample of a patient with see-saw nystagmus, showing how one eye elevates as the other depresses, with the elevating eye intorting as the depressing eye extorts. Shows vertical oscillations with pendular waveforms. Suggests a large structural lesion in the pericellar region (associated with bi-tempo...Image/MovingImage
93 Transillumination - Lisch NodulesDemonstration of transillumination of the Lisch nodules on a patient with neurofibromatosis. Shows how Lisch nodules that were not very visible in slit-lamp examination are better seen with transillumination, which may therefore be useful in detecting Lisch nodules earlier in children where they are...Image/MovingImage
94 Cochet-Bonnet Esthesiometer (similar to Von Frey Hair) ExamThe Cochet-Bonnet esthesiometer , similar to Von Frey Hair testing, has been used in studies to quantify sensory changes in the trigeminal system, especially the cornea. The device uses a thin fiber to test sensation. The shorter the fiber, the more sensation is felt. The monofilament is applied per...Image/MovingImage
95 Sector Palsies and Light-Near DissociationExample of patient with bilateral Adie's pupils. Exam is performed with a slit-lamp. Shows iris stroma and focal segments of iris sphincter that retain their contractilty. Suggests post-ganglionic parasympathetic denervation.Image/MovingImage
96 Third Nerve Palsy, Pupil InvolvingExample of patient with third nerve palsy. Left eye shows pupilary involvement. Left eye doesn't immediately duct, but abducts well, with impaired superduction. Secondary and primary deviations are demonstrated. Anisocoria is more prominent when light is on, showing a parasympathetic defect to the p...Image/MovingImage
97 Internuclear Ophthalmoplegia (2 Examples)Two examples of patients with internuclear ophthalmoplegia. First patient has a right internuclear ophthalmoplegia. Patient had subacute bacterial endocarditis with a bacterial abscess in the brain stem. Ductions and gaze to the right look good, but when gazing to the left, the right eye does not ad...Image/MovingImage
98 Superior Oblique MyokymiaExample of patients with superior oblique myokymia, a saccadic intrusion. First patient is seen to have intermittent, intorting movements with superimposed slight vertical deviations in right eye. Discussion of disorder as benign, but frequently disabling, as patients experience episodes of diplopia...Image/MovingImage
99 Before TensilonExample of patient with myasthenia gravis. Demonstration of baseline examination, followed by administration of 2mg of tensilon, which is a test dose. Procedure for administration of tensilon test is described, including variations. Patient is then shown after being given 4mg of tensilon, with very ...Image/MovingImage
100 Dilation LagTwo examples of dilation lag (Horner's syndrome). In the first example, the right pupil dilates much faster than the left pupil when the light is turned out. In the second example, the left pupil dilates much faster than the right pupil when the light is turned out. Discussion of methods of document...Image/MovingImage
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