NOVEL - Moran Eye Center
 
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IdentifierTitleDescriptionSubject
101 Figure-02Anatomy 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.)Reflex, Pupillary; Parasympathetic Pupil
102 Figure-03Location 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 ...Autonomic Anatomy; Pupillomotor Fibers
103 Figure-04Anatomy 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.)Anatomy of the Oculosympathetic Pathway; Horner's Syndrome
104 Figure-05The 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...Sympathetic; Horner Syndrome; Physiology, Pupil; Pupil; Cervical Artery Dissection; Carotid Artery, Internal, Dissection; Parasympathetic Pupil
105 Figure-06The 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...Reflex, Pupillary; Examination, Pupillary
106 Figure-07Relationship 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...Physiology, Pupil; Management of a Large or a Small Pupil; Normal Pupillary Responses; Pupil Size with Age
107 Figure-08Pupillogram 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...Reflex, Pupillary; Pupillogram; Parasympathetic Pupil; Normal Pupillary Responses
108 Figure-09Right-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...Pupil Disorders; Relative Afferent Pupillary Defect; RAPD; Afferent Pupillary Defect
109 Figure-10Assessment 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...Pupil Disorders; RAPD; Afferent Pupillary Defect
110 Figure-11Hand-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...RAPD; Relative Afferent Pupillary Defect; Pupil; Reflex, Pupillary; Pupil Disorders; Afferent Pupillary Defect
111 Figure-12An 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...Physiology, Pupil; Reflex, Pupillary
112 Figure-13Light-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 ...Nystagmus, Etiology, Pathologic; Nystagmus, Physiopathology, Pathologic; Reflex, Pupillary
113 Figure-14Argyll 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).Argyll-Robertson Pupil; Diagnosis, Pupil Disorders; Etiology, Pupil Disorders; History, Pupil Disorders; Pathology, Pupil Disorders
114 Figure-15Aberrant 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 ...Pupil Disorders; Aberrant Regeneration; Third Nerve Palsy
115 Figure-16Pathophysiology 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...Adie's Tonic Pupil; Pupil Disorders; Physiopathology, Iris; Pupil
116 Figure-17Pupil 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...Adie's Tonic Pupil; Innervation, Pupil; Drug Effects, Pupil; Physiology, Pupil
117 Figure-19BBilateral 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.Congenital Pupillary Abnormalities; Pupil; Etiology, Pupil Disorders; Pathology, Pupil Disorders
118 Figure-20Left-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...Etiology, Horner Syndrome; Female; Child; Drug Effects, Pupil; Horner Syndrome; Effects of Drugs on the Pupils
119 Figure-21Left-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).Diagnosis, Horner Syndrome; Physiopathology, Horner Syndrome; Reflex, Pupillary; Dilation Lag; Horner's Syndrome
120 Figure-22Right-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...Infant; Diagnosis, Horner Syndrome; Etiology, Horner Syndrome; Horner's Syndrome
121 Figure-23Enhanced 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...Diagnostic Use, p-Hydroxyamphetamine; Pharmacology, p-Hydroxyamphetamine; Drug Effects, Pupil; Pharmacology, Amphetamines; Horner Syndrome; Testing, Pupillary Drop; Effects of Drugs on the Pupils
122 Figure-24Left-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...Diagnosis, Carotid Artery Diseases; Radiography, Carotid Artery Diseases; Carotid Artery, Internal; Diagnosis, Cerebral Arterial Diseases; Radiography, Cerebral Arterial Diseases; Dissection; Middle Older People; Male; Adult; Cervical Artery Dissection; Carotid Dissection
123 Figure-25Flow 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.Anisocoria; Adie Syndrome; Diagnostic Use, Cocaine; Constriction; Dark Adaptation; Diagnosis, Differential; Dilatation; Diagnosis, Eye Diseases; Physiopathology, Eye Diseases; Horner Syndrome; Humans; Innervation, Iris; Diagnostic Use, Methacholine Compounds; Diagnostic Use, Pilocarpine; Physiology,...
124 Figure-26Flow 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.Anisocoria; Adie Syndrome; Diagnostic Use, Cocaine; Constriction; Dark Adaptation; Diagnosis, Differential; Dilatation; Diagnosis, Eye Diseases; Physiopathology, Eye Diseases; Horner Syndrome; Humans; Innervation, Iris; Diagnostic Use, Methacholine Compounds; Diagnostic Use, Pilocarpine; Physiology,...
125 Figure-27Pupillogram 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-...Congenital, Color Vision Defects; Physiopathology, Color Vision Defects; Dark Adaptation; Flynn Phenomenon; Humans; Diagnostic Use, Infrared Rays; Congenital, Night Blindness; Physiopathology, Night Blindness; Physiopathology, Optic Nerve Diseases; Physiopathology, Pupil; Congenital, Retinal Disease...
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