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126 Leber's Hereditary Optic NeuropathyText
127 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/StillImage
128 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/StillImage
129 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/StillImage
130 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
131 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
132 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/StillImage
133 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/StillImage
134 MaculaOverview of the structure and viewing of the macula.Text
135 Marcus 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
136 Measuring Visual AcuityDemonstration on self of visual acuity exam, using a standard card.Image/MovingImage
137 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
138 Mimics of AtrophyText
139 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
140 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
141 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 ...
142 Near Reflex and AccomodationDescription of testing the near reflex and accomodation.
143 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
144 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
145 Normal optic discOverview of the structure and function of the normal optic disc.Text
146 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/StillImage
147 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
148 Nutritional amblyopiaExample of patient with amblyopia with nutritional causes.Text
149 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
150 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
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