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TitleDescriptionType
1 2-37a - Vascular FeaturesWhen looking at the disc, the central retinal artery and vein should be visible. The central retinal artery is usually slightly narrower than the vein. When the central retinal artery goes though the lamina cribrosa, the artery becomes smaller because of diminution of the muscular layer and loss of ...Image
2 2-37b - Vascular FeaturesWhen looking at the disc, the central retinal artery and vein should be visible. The central retinal artery is usually slightly narrower than the vein. When the central retinal artery goes though the lamina cribrosa, the artery becomes smaller because of diminution of the muscular layer and loss of ...Image
3 2-4a - Disc AnatomyThe optic disc appearance is determined by: the size of the eye, the size of the scleral canal, how the nerve is inserted into the globe, the appearance of the lamina cribrosa, where myelination stops, and what is left behind in normal development. Even though this is a disc with a very large cup, i...Image
4 2-53a - Venous PulsationsOn the disc, look for spontaneous venous pulsations. Spontaneous venous pulsations can be seen in the large trunks of veins at the level of the disc margin. They are normally present and seen in 37-90% of normals -- depending on the experience of the examiner and the shape of the disc. The spontaneo...Image
5 2-53b - Venous PulsationsOn the disc, look for spontaneous venous pulsations. Spontaneous venous pulsations can be seen in the large trunks of veins at the level of the disc margin. They are normally present and seen in 37-90% of normals -- depending on the experience of the examiner and the shape of the disc. The spontaneo...Image
6 2-6a - Little Red DiscsImage
7 2-6b - Little Red DiscsImage
8 2-7a - Disc AnatomyThe optic disc appearance is determined by: the size of the eye, the size of the scleral canal, how the nerve is inserted into the globe, the appearance of the lamina cribrosa, where myelination stops, and what is left behind in normal development. Even though this is a disc with a very large cup, i...Image
9 3 Step TestDemonstration of patient examination.Image/MovingImage
10 The 3 Step Test: Looking for a 4th Nerve PalsyDescription of the three step test (3 step test) used when looking for a 4th nerve palsy.Text
11 3-3 - Bergmeister PapillaImage
12 3-31b - Papilledema StagesGrading Papilledema: Stage 0 GRADING PAPILLEDEMA GRADING PAPILLEDEMA We grade papilledema in order to tell us how severe it is. The most sensible grading scheme has been provided by Lars Frisén. STAGE 0: This woman had documented increased intracranial pressure of 340 mm water. Very little if any ...Image
13 3-32b - Papilledema StagesGrading Papilledema: Stage 1 Stage 1 = C shaped blurring of the nasal, superior and inferior borders. Usually the temporal margin is normal. Also notice the chorio-retinal folds (arrows) that eminate toward the macula (m)Image
14 3-33b - Papilledema StagesGrading Papilledema: Stage 2 = Elevation of the disc margin 360 degrees. Since the blood vessels at the disc margin are not swollen or obscured, this disc could be mistaken for pseudo-papilledema.Image
15 3-34c Papilledema StagesGrading Papilledema: Stage 3 Stage 3 = Elevation of the entire disc with partial obscuration of the retinal vessels at the disc margin. Here the vessels are partly obscured and make the development into stage 3 easier to call.Image
16 3-35a - Papilledema StagesGrading Papilledema: Stage 4 Stage 4 = Complete obliteration of the cup and complete obscuration of at least some vessels on the surface of the disc. There may be small dilated capillaries on the disc that resemble telangiectasia. It is not the NFL infarcts or hemorrhages but the obscuration of the ...Image
17 3-36a - Papilledema StagesGrading Papilledema: Stage 5 Stage 5 = Dome-shaped appearance with all vessels being obscured. (Sometimes called "champagne cork" swelling--because of its dome shape.)Image
18 3-4 - Tilted DiscTilted discs are normal variants caused by oblique insertion of the optic nerve to the globe. They can be and frequently are mistaken for papilledema. In this case the superior edge of the disc is tilted and appears elevated. This disc exhibits a nasal inferior tilt.Image
19 3-56a - SarcoidImage
20 3-59a - GliomaThis 45-year-old man presented with vision loss in his right eye; his examination showed severe disc swelling in this eye and vision loss on visual field testing (3-59a). MRI with fat saturation and enhancement and MRI with T2 signals also confirm an enlarged optic nerve. (3-59c) Excisional biopsy o...Image
21 3-59c - GliomaThis 45-year-old man presented with vision loss in his right eye; his examination showed severe disc swelling in this eye and vision loss on visual field testing (3-59a). MRI with fat saturation and enhancement and MRI with T2 signals also confirm an enlarged optic nerve. (3-59c) Excisional biopsy o...Image
22 3-5b - Myelinated Nerve FibersMyelinated nerve fibers are frequently confused with papilledema. The feathery edge of the myelinated fibers that conceal the disc and vessel should provide the clue. These myelinated nerve fibers make the disc look blurred.Image
23 3-60a - MeningiomaThis 35 year old woman presented with slowly progressive loss of central acuity to 20/30. 3-60a: Her visual field shows progressive restriction over time. 3-60b: Her disc was chronically swollen, with refractile bodies on the disc surface. 3-60d: The CT axial scan showed an enlarged calcified optic...Image
24 3-60b - MeningiomaThis 35 year old woman presented with slowly progressive loss of central acuity to 20/30. 3-60a: Her visual field shows progressive restriction over time. 3-60b: Her disc was chronically swollen, with refractile bodies on the disc surface. 3-60d: The CT axial scan showed an enlarged calcified optic...Image
25 3-60d - MeningiomaThis 35 year old woman presented with slowly progressive loss of central acuity to 20/30. 3-60a: Her visual field shows progressive restriction over time. 3-60b: Her disc was chronically swollen, with refractile bodies on the disc surface. 3-60d: The CT axial scan showed an enlarged calcified optic...Image
26 3-64a - Shunt Vessels (CRVO)This man with a chronic CRVO and retino-choroidal collaterals developed AION and his collaterals disappeared. CRVO with retinochoroidal collaterals is almost always associated with multiple peripheral dot and blot hemorrhages as well as nerve fiber layer infarcts of various ages. Notice the retino-c...Image
27 3-65 - Shunt Vessels (Glaucoma)Chronic end-stage glaucoma produces high pressure that interferes with venous drainage from the disc and broad smooth venous collaterals drain the disc centrifugally to the disc margin where they drain.Image
28 3-66a - Shunt Vessels (Post-papilledema)The retino-choroidal collaterals seen with chronic papilledema begin with a "Hairnet" of telangiectasias that gradually winnow down to one or more large collateral tortuous draining channel. The presence of these vessels is evidence of long standing disc swelling. When the CSF pressure is lowered, t...Image
29 3-66d - Shunt Vessels (Post-papilledema)The retino-choroidal collaterals seen with chronic papilledema begin with a "Hairnet" of telangiectasias that gradually winnow down to one or more large collateral tortuous draining channel. The presence of these vessels is evidence of long standing disc swelling. When the CSF pressure is lowered, t...Image
30 4-35 - Cupped Optic NerveAtrophic Glaucoma Atrophic glaucomatous discs show thinning of the neuro-retinal rim, "saucerization" (which is shallow cupping), evidence of peripapillary atrophy, and pallor of the very narrow neuroretinal rim. Notice that there is severe atrophy of the nerve fiber layer.Image
31 4-52b - Dominant Optic NeuropathyA son presented with bilateral optic atrophy of unknown etiology after he failed a school visual exam. When looking for dominant optic atrophy, look at the parents. Mother was examined to find similar kind of atrophy. 4-52a mother, 4-52b son.Image
32 4-54a -Optic Neuropathy, Ischemic: PosteriorImage
33 4-54b - Optic Neuropathy, Ischemic: PosteriorImage
34 4-60a - Dominant Optic NeuropathyA son presented with bilateral optic atrophy of unknown etiology after he failed a school visual exam. When looking for dominant optic atrophy, look at the parents. Mother was examined to find similar kind of atrophy. 4-60a mother, 4-60b son.Image
35 A-scan TechniqueThis video describes and demonstrates the A-scan examination technique for examination of the eye using ultrasonography.Image/MovingImage
36 Abducting (Dissociated) NystagmusExample of a patient with abducting (dissociated) nystagmus. Patient has a subtle internuclear ophthalmoplegia. Right eye has right-beating jerk nystagmus, with smaller oscillations in the left eye. Disease/Diagnosis: Abducting NystagmusImage/MovingImage
37 Aberrant Regeneration of the LidPatient with left third nerve palsy demonstrates anisocoria and mild vertical gaze limitation and aberrant movement of the left upper lid. Patient is instructed through all gaze positions. Left upper lid does not descend during downgaze but retracts instead.Image/MovingImage
38 Aberrant Regeneration of the Right PupilAberrant regeneration of the right pupil in a man with a large intracavernous sinus meningioma causing a pupil-involving, incomplete third cranial nerve palsy. His pupil is round when he gazes straight ahead (top). When he tries to rotate the eye medially, the pupil constricts, but a segment of the ...Image
39 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
40 Aberrant Regeneration of the ThirdPatient with a right third nerve palsy demonstrates ptosis, anisocoria and ophthalmoplegia. During attempted downgaze, the right upper lid flutters back up (aberrant movement) and remains retracted.Image/MovingImage
41 Aberrant Regeneration of the Third and Sixth NervesImage/MovingImage
42 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
43 Amsler Grid TestingDemonstration of Amsler Grid examination.Text
44 An Enhancing Bladder Metastasis Involving the Tectum of the MidbrainMagnetic resonance image of an enhancing bladder metastasis involving the tectum of the midbrain of a 56-year-old man who developed double vision resulting from skew deviation and divergence insufficiency. He also had a left-sided relative afferent pupillary defect measuring 1.4 log units but showed...Image
45 Anatomy of the Oculosympathetic PathwayAnatomy of the oculosympathetic pathway. (Maloney WF, Younge BR, Moyer NJ: Evaluation of the causes and accuracy of pharmacologic localization in Horner's syndrome. Am J Ophthalmol 1980;90:394-402, Ophthalmic Publishing Company with permission.)Image
46 Anatomy of the Pupillary Light Reflex PathwayAnatomy of the pupillary light reflex pathway. (Miller NR: Walsh And Hoyt's Clinical Neuro-Ophthalmology, p 421. Vol 2, 4th ed. Baltimore: Williams & Wilkins, 1985, with permission.)Image
47 Anterior Ischemic Optic NeuropathyPPT describing Anterior Ischemic Optic Neuropathy (AION). Covers clinical signs, such as monocular vision loss, swollen nerve, and visual field defects, as well as risk factors.Text
48 Argyll Robertson PupilsArgyll Robertson pupils in an elderly man treated for tabes dorsalis in 1952. His pupils are small and slightly irregular, constrict poorly in response to light stimulation (top), dilate poorly in darkness (middle), but constrict promptly in response to near stimulation (bottom).Image
49 Assessment of an Afferent Pupillary Defect When Only One Iris is FunctionalAssessment of an afferent pupillary defect when only one iris is functional. In this example, a right-sided parasellar tumor is compressing both the optic and oculomotor nerves, causing an optic neuropathy and a pupil-involving third crainial nerve palsy. The pupil on the affected side has both an a...Image
50 B-scan TechniqueThis video describes and demonstrates the B-scan examination technique for examination of the eye using ultrasonography.Image/MovingImage
51 Basal EncephalocelesText
52 Basic Eye Alignment ExamDemonstration of basic eye alignment examination. Includes: a. Tools b. Cover-Uncover and SPCT c. Alternate Cover and APCT d. Maddox Rod TestingImage/MovingImage
53 Basic HeadachePresentation covering an overview of headache and migraine.Text
54 Basic Neurologic ExamDemonstration of a basic neurologic examination.Image/MovingImage
55 Basic Neurologic Exam: CoordinationDemonstration of a coordination examination.Image/MovingImage
56 Basic Neurologic Exam: Cranial NervesDemonstration of a cranial nerve examination.Image/MovingImage
57 Basic Neurologic Exam: Mental StatusDemonstration of a mental status examination.
58 Basic Neurologic Exam: Motor ExaminationDemonstration of a motor examination.Image/MovingImage
59 Basic Neurologic Exam: SensoryDemonstration of a sensory examination.Image/MovingImage
60 Basic Neurologic Exam: Station and GaitDemonstration of a station and gait examination.Image/MovingImage
61 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
62 Benign Episodic Unilateral MydriasisPresentation covering benign episodic mydriasis.Text
63 Bilateral Asynchronous Blepharospasm with Facial and Cervical DystoniaBilateral Asynchronous Blepharospasm with Facial and Cervical Dystonia.Image/MovingImage
64 Bilateral Facial MyokymiaExample of a patient with a brain stem glioma. Shows bilateral facial myokymia.Image/MovingImage
65 Bilateral Internuclear OphthalmoplegiaExample of patient with bilateral internuclear ophthalmoplegia. Patient is led through instructions for direction and distance of gaze.Image/MovingImage
66 Bilateral Iris ColobomasColoboma literally means a "gap"-and can be used to describe any fissure, hole, or gap in the eye. The term most often is used to refer to a congenital gap in the disc, retina, the choroid, and the iris. Colobomas occur because the embryonic fissure fails to fuse. Since the fissure closure begins in...Image
67 Bilateral Iris Colobomas (B)Bilateral iris colobomas. B. Bilateral colobomatous defects of the inferonasal retina (black arrows) are also present, as shown in the right eye.Image
68 Bilateral PtosisVideo of patient with bilateral ptosis.Image/MovingImage
69 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
70 BlepharospasmExample of patient with blepharospasm. Patient is led through instructions for direction of gaze and opening and closing of eyes. Patient is led through same exercises again after receiving indomethacin treatment.Image/MovingImage
71 Blepharospasm with Apraxia of the EyeImage/MovingImage
72 Brainstem TraumaImage/MovingImage
73 Brun's NystagmusObservation of patient with Brun's Nystagmus. Shows patient gazing to the right and the nystagmus beating in the direction of the gaze.Image/MovingImage
74 Central Retinal Artery OcclusionVideo of central retinal artery occlusion.Image/MovingImage
75 Clover-leaf Visual Field DefectsDescription of clover-leaf visual field defects.
76 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...
77 Cogan's Lid TwitchExample of a patient with Cogan's lid twitch, with discussion of how to detect it in an exam.Image/MovingImage
78 Cogan's Lid TwitchImage/MovingImage
79 Color Vision TestingDemonstration of color vision examination.Text
80 Cone DystrophyPPT covering Cone Dystrophy - An inherited degeneration that presents between 10 - 30 years of age. Symptoms are decreased visual acuity, poor color vision, and sometimes light sensitivity.Text
81 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
82 Congenital NystagmusPatient with congenital nystagmus (no audio)Image/MovingImage
83 Congenital Ocular Motor ApraxiaTwo examples of congenital ocular motor apraxia. Patients have trouble initiating saccades, and compensate with head movement. Discussion of how to distinguish this condition from simply not seeing well.Image/MovingImage
84 Convergence Retraction Nystagmus (Parinaud's Syndrome)Examples of patients with convergence retraction nystagmus. Shows saccadic oscillations in patients looking upwards and following downwards moving targets. Also shows a side-view of the retracting movements of the globes.Image/MovingImage
85 The Course of the Postganglionic Segment of the Oculosympathetic Fibers from the Internal Carotid ArteryThe course of the postganglionic segment of the oculosympathetic fibers from the internal carotid artery (ICA) to the orbit is depicted as a dotted line. Note that they briefly join the abducens nerve (cranial nerve VI) before joining the nasociliary branch of the of the ophthalmic division of the t...Image
86 CPEOPatient with Chronic Progressive External Ophthalmoplegia (CPEO)Image/MovingImage
87 Cyclic Oculomotor PalsyExample of patient with cyclic oculomotor palsy.Image/MovingImage
88 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
89 Dissection of the Carotid Artery
90 Dissociated NystagmusExample of a patient with dissociated nystagmus. Demonstrates difference in movements between each eye.Image/MovingImage
91 Documenting the Neuro-ophthalmic Patient: External PhotographyDescription of documenting the neuro-ophthalmic patient using external photography. This covers pupils and extra ocular muscles.
92 Downbeat NystagmusExample of patients with downbeating jerk nystagmus. Demonstrates how oscillations grow more prominent when the patient gazes down or laterally. Discusses some causes, including Arnold-Chiari malformation, infarction, and demyelination.Image/MovingImage
93 Downbeat NystagmusExample of patient with downbeat nystagmus. Patient is led through instructions of where to gaze. (no audio)Image/MovingImage
94 Downbeat NystagmusExample of patient with downbeat nystagmus. Patient is led through instructions of where to gaze.Image/MovingImage
95 Duane's Retraction Syndrome Type 1: Lid RetractionExample of patients with Duane's Retraction Syndrome, Type 1. Description of components of Duane's Syndrome: limitation of abduction, variable limitation of adduction, and palpebral fissure narrowing and globe retraction with attempted adduction. Type 1 includes limited or absent abduction with norm...Image/MovingImage
96 Duane's Retraction Syndrome Type 3Example of a patient with Type 3 Duane's Retraction Syndrome, as well as bilateral Duane's Syndrome. Shows limitation of abduction in both eyes and adduction in the left eye. Also shows side-view of globe retraction in abduction.Image/MovingImage
97 Duane's SyndromeExample of patient with Duane's Syndrome. Patient is led through instructions for pursuit.Image/MovingImage
98 Duane's Syndrome Type 1Clip of patient with Duane's Syndrome Type I. Presented at the Neurology Grand Rounds in Fall 2011 at the University of Utah. Presentation can be found in this collection at: Why Don't You See Double? http://content.lib.utah.edu/u?/EHSL-Moran-Neuro-opth,132 Disease/Diagnosis: Duane's Syndrome Type ...Image/MovingImage
99 Duane's Syndrome Type 2: Aberrant Regeneration of the Third and Sixth NervesExample of a patient with Type 2 Duane's Syndrome. Demonstrates limitation of adduction in left eye with normal abduction. Discussion of limited pathological cases.Image/MovingImage
100 Duane's Syndrome Type 3Clip of patient with Duane's Syndrome Type III. Presented at the Neurology Grand Rounds in Fall 2011 at the University of Utah. Presentation can be found in this collection at: Why Don't You See Double? http://content.lib.utah.edu/u?/EHSL-Moran-Neuro-opth,132 Disease/Diagnosis: Duane's Syndrome Ty...Image/MovingImage
101 Dysthyroid Optic Neuropathy: A Preventable Cause of BlindnessDysthyroid Optic Neuropathy (DON) is a treatable cause of visual loss in ~5% of pts w/ ted. Monitor closely those pts with risk factors (proptosis, tight orbit, restricted motility, strabismus, smoker, diabetic). Oral prednisone is often effective, but frequent relapses after tapering. Orbital xrt ...
102 The Electro-oculogram: Clinical ApplicationsThe electrooculogram measures the potential that exists between the cornea and Bruch's membrane at the back of the eye. The potential produces a dipole field with the cornea approximately 5 millivolts positive compared to the back of the eye, in a normally illuminated room. Although the origin of th...Text
103 The Electroretinogram and Electro-oculogram: Clinical ApplicationsThe global or full-field electroretinogram (ERG) is a mass electrical response of the retina to photic stimulation. The ERG is a test used worldwide to assess the status of the retina in eye diseases in human patients and in laboratory animals used as models of retinal disease.Text
104 Enhanced Mydriasis in Response to HydroxyamphetamineEnhanced mydriasis in response to hydroxyamphetamine in a 77-year-old woman with a long-standing, preganglionic, right-sided Horner's syndrome that occurred following cervical neck dissection for thoracic outlet syndrome 30 years earlier. Miosis of the right pupil is apparent in room light (top). Th...Image
105 ExophthalmometryDemonstration of exophthalmometry examination.Text
106 Facial Myokymia UnilateralExample of patient with facial myokymia, a disorder of the seventh nerve, probably due to brain stem involvement. Patient has multiple sclerosis. Discussion of characteristics, such as continuous, undulating, contractions in the distribution of the seventh nerve, and a spreading of these movements t...Image/MovingImage
107 Facial Nerve ExamExplanation of a facial nerve exam.
108 Flow Chart for Sorting Out Anisocoria - Bright Light and DarknessFlow chart for sorting out anisocoria based initially on how it is influenced by bright light and darkness.Image
109 Flow Chart for Sorting Out Anisocoria - Direct Light Reaction of the PupilFlow chart for sorting out anisocoria based initially on the integrity of the direct light reaction of the pupil.Image
110 Fluoresein AngiographyComprehensive description of using fluoresein angiography in examinations.
111 Flutter in DowngazeExamination of patient with flutter in downgaze (no audio)Image/MovingImage
112 Fourth Nerve PalsyDemonstration of examination of patient who experienced blurry vision and pain in the left eye. Demonstrates checking of eye movements, focusing on object while each eye is covered and uncovered, turning head both ways and repeating. Shows limitation of depression in adduction of left eye, left hype...Image/MovingImage
113 Fusional Vergence AmplitudesDemonstration of fusional vergence amplitudes examination. Incluudes: a. Convergence Amplitudes b. Divergence Amplitudes c. Vertical AmpitudesText
114 Gaze Palsy with Facial Weakness from Pontine AVMExample of a patient with torsional nystagmus in both eyes and pendular nystagmus in the left eye. Patient is led through instructions for direction of gaze.Image/MovingImage
115 Glaucoma: The BasicsGlaucoma is the most common optic neuropathy. Progressive cupping of the optic disc due to increased intraocular pressure together with visual field abnormalities and local disc susceptibility factors characterize this neuropathy. This PowerPoint lecture covers the basics of Glaucoma and includes ma...Text
116 Hand-held Equipment Used to Measure a Relative Afferent Pupillary DefectHand-held equipment used to measure a relative afferent pupillary defect and to record pupil sizes. Four neutral density filters (0.3, 0.6, 0.9, 1.2 log units) are conveniently carried in a soft cloth carrying pouch. A bright light source (a Finhoff model illuminator is shown here) is ideal for stim...Image
117 Hemifacial SpasmExample of patients with hemifacial spasm. First patient has a sequela of Bell's palsy, and is seen to have mainly clonic movements around the eye, with occasional tonic movements around the mouth. Second patient has a cerebellopontine angle epidurmoid tumor, and is seen to have movements around the...Image/MovingImage
118 Herpes Zoster Ophthalmicus with Third Nerve PalsyImages showing presentation of Herpes Zoster (Zoster Ophthalmicus).Text
119 How to Measure the RAPDThis clip demonstrates the examination technique for measuring the Relative Afferent Pupillary Defect (RAPD). Demonstration of balancing an afferent papillary defect using filters in a patient with a resolving optic neuritis and an afferent papillary defect on the left.Image/MovingImage
120 How to Use the Direct Ophthalmoscope in an ExamDemonstration of using the direct ophthalmoscope to examine the optic disc. Covers hand placement , which eye to use, and distance from patient.Image/MovingImage
121 Hydroxychloroquine Maculopathy (Plaquenil)An overview of Chloroquine Maculopathy.Text
122 Intermittent Square Wave JerksPatient with intermittent square wave jerks (no audio)Image/MovingImage
123 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
124 Introduction to Fogging RefractionAn introduction to fogging refraction.
125 Introduction to Headache, Migraine and Secondary HeadachesVideo lecture covering an introduction to headache, migraine, and secondary headaches by Kathleen Digre, MD.
126 Introduction to the Basic Neurologic ExamIntroduction to the neurological examinations section of NExT.
127 Latent NystagmusExample of a patient with latent nystagmus. Demonstrates a lack of oscillations in forward gaze, followed by the occlusion of each eye, showing how this generates a jerking oscillation in the non-occluded eye away from the occluded eye.Image/MovingImage
128 Leber's Hereditary Optic NeuropathyImages and visual fields from a boy with acute visual loss.Text
129 Left-sided Dilation Lag in a Man with Horner's SyndromeLeft-sided dilation lag in a 29-year-old man with Horner's syndrome caused by a posterior mediastinal ganglioneuroma. Note that the degree of anisocoria is greater after 5 seconds in darkness (top) compared with findings after 15 seconds in darkness (bottom).Image
130 Left-sided Horner's Syndrome with an Acquired Preganglionic LocalizationLeft-sided Horner's syndrome in a 12-year-old girl with an acquired preganglionic localization based on clinical and pharmacologic testing. The cause remained undetermined after extensive radiologic investigations. Left-sided ptosis and miosis are evident in room light (top), and the degree of aniso...Image
131 Left-sided Internal Carotid Artery DissectionLeft-sided internal carotid artery dissection identified on T-1 weighted magnetic resonance image from a 52-year-old man who suddenly developed left-sided neck and orbital pain along with a droopy left upper eyelid while dragging a deer out of the woods during hunting season. The normal dark flow vo...Image
132 Levator DisinsertionExample of patient with levator disinsertion, a lid disorder. Patient is pregnant and wears poorly fitting contacts. Discussion of characteristics, such as lid ptosis (shown in the left eye of patient), but with full levator function.Image/MovingImage
133 Light-near DissociationLight-near dissociation in a 51-year-old woman with multiple sclerosis who experienced double vision for 1 week. Her pupils are 5 mm in diameter in room light (top), react poorly in response to direct light reaction (middle), but constrict promptly in response to near stimulation (bottom). She also ...Image
134 Light-near DissociationExample of patient with Argyll Robertson pupil with neurosyphilis. Shows a lack of pupillary response to light and some pupillary response to nearness of finger.Image/MovingImage
135 Location of Pupillomotor FibersLocation of pupillomotor fibers are depicted as dark regions on cross-sections of the right (R) and left (L) oculomotor nerve at various locations along its course, including its emergence from the brain stem in the interpeduncular fossa (1), the midsubarachnoid segment (2), the level of the dorsum ...Image
136 MaculaOverview of the structure and viewing of the macula.Text
137 Marcus Gunn Jaw WinkingExample of patient with Marcus Jaw Winking. Patient is led through instructions for movement of jaw (open, close, back and forth), with eyelid seen to be affected. Patient is then led through instructions for direction of gaze and pursuit.Image/MovingImage
138 Measuring Visual AcuityDemonstration on self of visual acuity exam, using a standard card.Image/MovingImage
139 MELAS and RPMELAS; Mitochondrial Encephalopathy with Lactic Acidosis, Stroke and Pigmentary Changes in retina-associated with a retinal dystrophy. This 53 year old man had seizures, encephalopathy and lactic acidosis typical of MELAS. His fundus examination showed granularity and some slight pigmentary changes ...Text
140 Migraine and Cluster Pathophysiology and TreatmentVideo lecture covering pathophysiology and treatment of migraine and cluster headaches by Kathleen Digre, MD.
141 Mimics of AtrophyText
142 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
143 The Multifocal Electroretinogram: Clinical ApplicationsThe most important development in ERGs is the multifocal ERG (mfERG). Erich Sutter adapted the mathematical sequences called binary m-sequences creating a program that can extract hundreds of focal ERGs from a single electrical signal. This system allows assessment of ERG activity in small areas of ...Text
144 Multifocal ElectroretinogramsThe most important development in ERGs is the multifocal ERG (mfERG). Erich Sutter adapted the mathematical sequences called binary m-sequences creating a program that can extract hundreds of focal ERGs from a single electrical signal. This system allows assessment of ERG activity in small areas of ...
145 Near Reflex and AccomodationDescription of testing the near reflex and accomodation.
146 Normal Eye MovementsThis is an examination of a person with normal eye movements. Notice the patient has normal excursions. He has normal pursuit and saccades (horizontally and vertically).Text
147 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
148 Normal Optic DiscOverview of the structure and function of the normal optic disc.Text
149 The Normal Pupillary Light ReflexThe normal pupillary light reflex is initiated following exposure to light. After a brief latency, both the right (solid line) and left (broken line) pupil constrict, then undergo a small amount of redilation (escape), followed by oscillations (hippus) if the light is sustained. Hippus is not a path...Image
150 Notching of the Neuro-retinal RimThe neuro-retinal rim becomes thinner; in particular the rim superotemporally and inferortemporally may develop a notch which is usually superior or inferior and rarely nasal or temporal. These notches are believed to be due to focal ischemic damage to the neuro-retinal rim. Glaucoma with Notching a...Image
151 Nutritional AmblyopiaExample of patient with amblyopia with nutritional causes.Text
152 Ocular FlutterTwo examples of patients, the first with rotary, flutter-like movements, but not ocular flutter, and the second with genuine ocular flutter. Discussion of difference between ocular flutter and nystagmus, and how to elicit ocular flutter.Image/MovingImage
153 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
154 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
155 Ocular MyotoniaExample of patient with ocular myotonia. Patient is led through instructions for direction of gaze and opening and closing of eyes. Right eye is shown to be stuck in position after held gaze to the left and right, with very slow relaxation back into forward gaze.Image/MovingImage
156 Oculopalatal MyoclonusOculopalatal myoclonus (OPM) Rhythmic oscillations of eyes and palate. Occurred after specific brainstem injury from stroke, following stenting. Related PowerPoint Presentation: http://content.lib.utah.edu/u?/EHSL-Moran-Neuro-opth,129 Disease/Diagnosis: Oculopalatal myoclonus.Image/MovingImage
157 Oculopalatal Myoclonus (PPT)Oculopalatal myoclonus (OPM) Rhythmic oscillations of eyes and palate. Occurred after specific brainstem injury from stroke, following stenting. Related Video: http://content.lib.utah.edu/u?/EHSL-Moran-Neuro-opth,128 Disease/Diagnosis: Oculopalatal myoclonusImage/MovingImage
158 OpsoclonusExample of patients with opsoclonus, a saccadic abnormality. Discussion of characteristics of opsoclonus, such as involuntary, rapid, brief, random, conjugate saccades. Discussion of possible causes, including brain stem encephalitis (as in first patient), a paraneoplastic effect, tumors, and drug t...Image/MovingImage
159 OpsoclonusExample of patients with opsoclonus, a saccadic abnormality.Image/MovingImage
160 Optic Disc Pallor Pseudo and RealDiscussion of the causes of optic disc pallor.Text
161 Optic Disc: Anatomy, Variants, Unusual discsDiscussion of viewing the optic disc. Includes development of direct ophthalmoscope. Covers normal optic disc and nerve fiber; nerve fiber loss and defects; cilioretinal arteries; venous anomolies; papilledema; pseudopapilledema; myopic disc; hyperoptic disc; little red discs; megallopapilla; myelin...Text
162 Optic Nerve Tumors Benign and MalignantDiscussion of optic nerve tumors including meningioma and glioma.Text
163 The Orbital ExamComprehensive demonstration of the entire orbital examination.
164 Papilledema 2013Discussion of papilledema, the swelling due to increased pressure.Text
165 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
166 Parinaud's SyndromeTwo examples of patients with Parinaud's syndrome, a dorsal midbrain syndrome. Discussion of hallmarks of this syndrome, including convergence retraction nystagmus, vertical gaze palsies, light-near dissociation, and Collier's Sign. Discussion of age-dependent disorders associated with this syndrome...Image/MovingImage
167 Pathophysiology of Signs Associated with a Tonic PupilPathophysiology of signs associated with a tonic pupil. Normally, all parasympathetic fibers of the third cranial nerve synapse in the ciliary ganglion (top). Most postganglionic fibers innervate the ciliary muscle (dashed lines). After injury to the ciliary ganglion, the pupil becomes denervated an...Image
168 Periodic Alternating NystagmusExample of a patient with periodic alternating nystagmus, showing an alternation between left-beats and right-beats as the patient maintains forward gaze. Nystagmus maintain horizontal direction regardless of position of gaze.Image/MovingImage
169 Physiologic (End-Gaze) NystagmusDemonstration of physiological nystagmus, where oscillations do not represent pathology, but occur when the patient's gaze is drawn too far laterally.Image/MovingImage
170 Progressive Supranuclear PalsyProgressive Supranuclear PalsyImage/MovingImage
171 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
172 Pulsating ExophthalmosExample of a patient with neurofibromatosis with an absent sphenoid wing. Shows left eye pulsating back and forth with the pulse from front and side views.Image/MovingImage
173 Pupil ExamDemonstration of pupil examination.Text
174 Pupil Signs in a 32-year-old Woman with Right-sided Adie's PupilPupil signs in a 32-year-old woman with right-sided Adie's pupil. The right pupil is larger than the left pupil (top), reacts poorly to direct light stimulation (second panel), and better in response to near stimulation (third panel). The right pupil also shows a supersensitive response 30 minutes a...Image
175 Pupillogram Demonstrating Paradoxical Pupillary Constriction to DarknessPupillogram demonstrating paradoxical pupillary constriction to darkness in four patients with congenital achromatopsia. Note that the pupils initially constrict when the light is extinguished. (Price MJ, Thompson HS, Judisch GF et al: Pupillary constriction to darkness. Br J Ophthalmol 1981;69:205-...Image
176 Pupillogram of a Healthy Young SubjectPupillogram of a healthy young subject showing continuous pupillary oscillations of both pupils when light is sustained, indicated by the dark arrow at the top of the recording. Note that the oscillations of the pupils are synchronous and demonstrate variable amplitude and frequency. This pattern of...Image
177 RAPD PresentThis clip demonstrates the technique used to determine that Relative Afferent Pupillary Defect (RAPD) is present in a patient.Image/MovingImage
178 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
179 Relationship Between Age and Pupil SizeRelationship between age and pupil size, determined using an infrared flash photograph technique with subjects placed in darkness for 3 minutes. The numbers above the abscissa indicate the number of subjects tested in each age range. (Reprinted with permission of Loewenfeld IE: "Simple, central" ani...Image
180 Retinal Fluorescein AngiographyThis slide set provides a brief description of Retinal Fluorescein Angiography. First introduced in 1960, sodium fluorescein, a dye, is administered through an angiocatheter (3-5cc) by a nurse or technician. The dye reaches the central retinal artery after passing through the heart and lungs.Text
181 Retinitis Pigmentosa Disease of RodsDiscussion of retinitis pigmentosa which is a retinal/choroidal degeneration caused by various genetic defects.Text
182 Retino-choroidal Vessels or Optociliary Veins or Ciliary ShuntOverview of retino-choroidal collaterals, which are potential telangiectatic connections between the retina and choroidal circulation. Although sometimes called "shunts", these collaterals are between the retinal venous circulation and the choroidal venous circulation.Text
183 Retraction NystagmusPatient with retraction nystagmus (no audio)Image/MovingImage
184 Right-sided Pseudo-Horner's SyndromeRight-sided pseudo-Horner's syndrome in an 8-month-old infant referred because her mother had noted a larger pupil on the left for a few months and her pediatrician thought the right upper lid was droopy. Both pupils reacted normally to light and darkness, the degree of anisocoria was similar in bot...Image
185 Right-sided Relative Afferent Pupillary DefectRight-sided relative afferent pupillary defect in a man with optic nerve glioma. When the unaffected left eye is stimulated by light, both pupils constrict (top). When the light is then swung over to the affected right eye, both pupils dilate (bottom). This indicates that pupillomotor conduction thr...Image
186 Rotary DownbeatPatient with rotary downbeat nystagmus (no audio)Image/MovingImage
187 Rotary NystagmusExample of a patient with rotary nystagmus, showing occasional counterclockwise rotary movements of both eyes. Seen more in intrinsic disorders of the brainstem.Image/MovingImage
188 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
189 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
190 See-saw Nystagmus7-year-old female whose mother noticed her eyes "bouncing" for 2 months. Visual acuity 20/70 OD and 20/40 OS, reduced color vision OU, and no afferent pupillary defect. See-saw nystagmus documented with videography. Manual perimetry revealed a complete right homonymous hemianopia. MRI revealed a lar...Image/MovingImage
191 See-saw Nystagmus MRI 1MRI; See-saw NystagmusImage
192 See-saw Nystagmus MRI 2MRI; See-saw NystagmusImage
193 Shaken Baby SyndromeText
194 Shunt Vessel MeningiomaRETINO-CHOROIDAL (OPTO-CILIARY) COLLATERAL VESSELS: (also known as Retinal-choroidal venous collaterals, opticociliary veins or ciliary shunt vessels) Retino-choroidal collaterals are potential telangiectatic connections between the retina and choroidal circulation. Although sometimes called "shunts...Image
195 Shunt Vessel Meningioma - MRIMeningiomas block venous egress and open potential venous channels known as retinochoroidal (optociliary) collateral vein. This meningioma extends from the back of the globe through the optic canal.Image
196 Silent Sinus SyndromeSilent sinus syndrome (SSS) is characterized by spontaneous and progressive unilateral enophthalmos.
197 Spasm of the Near ReflexExample of patient with spasm of the near reflex and voluntary nystagmus. Discussion of similar-looking conditions (e.g. six nerve palsy, limitation of abduction, lateral rectus muscle problems) and how to tell them apart from spasm of the near reflex by observing the myosis evoked by the near respo...Image/MovingImage
198 Spasmus NutansExample of patient with spasmus nutans. Discussion of characteristics of this disorder, such as dissociated or monocular nystagmus, abnormal head position, and to-and-fro head oscillation. Sometimes an eccentric gaze is seen as well (as in patient). Patient has a monocular horizontal nystagmus in th...Image/MovingImage
199 Spasmus NutansExample of patient with spasmus nutans.Image/MovingImage
200 Spiral and Stellate Visual Fields Non-physiologic VariantsDescription of testing the spiral and stellate visual fields.
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