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TitleDescriptionType
76 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
77 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
78 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
79 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
80 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
81 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
82 Square Wave JerksExample of patient with square wave jerks. Discussion of difference between square wave jerks (saccadic oscillations) and horizontal nystagmus.Image/MovingImage
83 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
84 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
85 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
86 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
87 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
88 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
89 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
90 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
91 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
92 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
93 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
94 Bilateral Asynchronous Blepharospasm with Facial and Cervical DystoniaBilateral Asynchronous Blepharospasm with Facial and Cervical Dystonia.Image/MovingImage
95 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
96 Bilateral Facial MyokymiaExample of a patient with a brain stem glioma. Shows bilateral facial myokymia.Image/MovingImage
97 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
98 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
99 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
100 Cogan's Lid TwitchExample of a patient with Cogan's lid twitch, with discussion of how to detect it in an exam.Image/MovingImage
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