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201 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
202 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/StillImage
203 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/StillImage
204 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/StillImage
205 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/StillImage
206 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
207 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/StillImage
208 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/StillImage
209 Tadpole-shaped pupilTadpole-shaped pupil in a 20-year-old women with frequent episodes of blurred vision and achiness of the right eye lasting several minutes. The patient took a photograph of her eyes during an attack to document the peaked, segmental dilation of her right pupil (black arow). (Thompson HS, Zackon DH, ...Image/StillImage
210 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/StillImage
211 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
212 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/StillImage
213 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/StillImage
214 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/StillImage
215 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/StillImage
216 Tunnel Vision on Tangent Screen TestingDescription of tunnel vision and tangent screen testing.
217 Tangent Screen Testing Visual FieldDescription of tangent screen testing.
218 Tangent Screen Recording ChartThe tangent screen recording chart.
219 Fluoresein AngiographyComprehensive description of using fluoresein angiography in examinations.
220 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 TestingText
221 Fusional Vergence AmplitudesDemonstration of fusional vergence amplitudes examination. Incluudes: a. Convergence Amplitudes b. Divergence Amplitudes c. Vertical AmpitudesText
222 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...
223 Clover-leaf Visual Field DefectsDescription of clover-leaf visual field defects.
224 Introduction to Fogging RefractionAn introduction to fogging refraction.
225 Basic Neurologic Exam: Cranial NervesDemonstration of a cranial nerve examination.
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