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TitleDescriptionType
101 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
102 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
103 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
104 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
105 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
106 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
107 Bilateral Asynchronous Blepharospasm with Facial and Cervical DystoniaBilateral Asynchronous Blepharospasm with Facial and Cervical Dystonia.Image/MovingImage
108 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
109 Bilateral Facial MyokymiaExample of a patient with a brain stem glioma. Shows bilateral facial myokymia.Image/MovingImage
110 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
111 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
112 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
113 Cogan's Lid TwitchExample of a patient with Cogan's lid twitch, with discussion of how to detect it in an exam.Image/MovingImage
114 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
115 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
116 Square Wave JerksExample of patient with square wave jerks. Discussion of difference between square wave jerks (saccadic oscillations) and horizontal nystagmus.Image/MovingImage
117 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
118 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
119 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
120 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
121 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
122 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
123 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
124 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
125 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
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