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VISION

Objective: To demonstrate the sensation of vision.
1. Visual Acuity for Far Vision
OD (Right Eye) OS (Left Eye)
Without corrective
lenses/eyeglasses
20/25-3

20/20
With corrective
lenses/eyeglasses
20/20 20/20


Interpretation:
It was observed that when the right eye was tested, without corrective lenses, the subject can
read at 20 feet what a person with normal vision can read at 25 feet. As the subject moved at
about 5 feet closer to the Snellen’s chart, she was able to read the letters at the level of 20/25
accurately. As for the left eye, without corrective lenses, the subject can read at 20 feet what a
person with normal vision can read at 20 feet.

When the subject wore her corrective eyeglasses (for astigmatism), both the right eye and the
left eye can read at 20 feet what a person with normal vision can read at 20 feet.

2. Visual Acuity for Near Vision
OD (Right Eye) OS (Left Eye)
Without corrective
lenses/eyeglasses
14/20

14/20

Interpretation:
The subject can see at 13 inches the smallest type of words that she can read on both the right
eye and the left eye.

3. Accommodation Reflex
Pupil Size in Centimeters
Far/Distant 0.127 cms
Near/Close 0.254 cms

Interpretation:
When the subject’s eyes focus on something that is far or distant, the pupils were observed to
become smaller or to constrict. As for when the subject’s eyes focus on something near or close,
the pupils were observed to become bigger in size or to dilate.





4. Near visual acuity
The purpose in testing near vision is to determine how people can cope with near tasks. If
they need some changes to the task or the environment, or if spectacles or low vision
devices would be useful.
The results of a near vision test show a person's ability to see the details of near objects
(within arm's distance from the body). The results of the test will give an idea of the detail
that can be discriminated. Near tasks include craft and leisure activities, eating, personal
care and hygiene, some work tasks and reading.
5. Blind Spot
LEFT EYE RIGHT EYE



12.7mm 22.9mm





Blind spot
Center
Tip Reappeared
Tip Disappeared
Computation for Blind Spot

=

RIGHT EYE: X = 15.3mm
22.9mm 257mm
X= 22.9mm (15.3mm) = 350.37mm = X= 1.36mm
257mm 257mm

LEFT EYE: X = 15.3mm
12.7mm 257mm
X= 12.7mm (15.3mm) = 194.31mm = X= 0.76mm
257mm 257mm


Answers to the Questions:

1. What is emmetropic vision?

The eye is considered to be normal, or “emmetropic,” if parallel light rays from distant objects
are in sharp focus on the retina when the ciliary muscle is completely relaxed. This means that
the emmetropic eye can see all distant objects clearly with its ciliary muscle relaxed

2. What is the purpose of doing the pinhole test?

Test performed on a person who has diminished visual acuity to distinguish a refractive error
from organic disease. A refractive error may be corrected with glasses, whereas organic disease
may signal the development of preventable blindness.

3. How does the eye use its refractive power to see near objects?

The two major focusing components of the eye are the cornea and the lens.
When light coming from an image, they hit the cornea which causes the rays to begin to move
towards each other causing all the rays from the image to converge to a point on the retina.
The power with which this process occurs is the refractive power, and is vital in producing clear
images.

4. What is the clinical value of determining the visual acuity for near vision?

Visual acuity reading is the most important element of an eye test. It gives the doctor a gauge,
or starting point to determine the health of the eye vision.

5. Define ‘near point of distinct vision?

Least distance of distinct vision (LDDV) or the reference seeing distance (RSD) is the closest
someone with "normal" vision can comfortably look at something.
Thus, LDDV is the minimum comfortable distance between the naked human eye and a visible
object.




6. Enumerate the components of accommodation reflex?
 Chromatic aberration
 When the eyes fixate on a near object, the eyes must converge. The neural mechanisms
for convergence cause a simultaneous signal to strengthen the lens of the eye.
 Because the fovea lies in a hollowed-out depression that is slightly deeper than the
remainder of the retina, the clarity of focus in the depth of the fovea is different from
the clarity of focus on the edges.
 degree of accommodation of the lens oscillates slightly all the time

7. What enables the eye to perceive the different colors? Explain the mechanisms.

Light- sensitive chemicals in the cones, called cone pigments or color pigments, have
compositions only slightly different from that of rhodopsin.
Each of the different cones, thus making the cones selectively sensitive to different colors: blue,
green, or red. These color pigments are called, respectively, blue-sensitive pigment, green-
sensitive pigment, and red-sensitive pigment.
The absorption characteristics of the pigments in the three types of cones show peak
absorbencies at light wave- lengths of 445, 535, and 570 nanometers, respectively.
These are also the wavelengths for peak light sensitivity for each type of cone, which begins to
explain how the retina differentiates the colors.

8. What is color anomaly? What is the most common kind of color anomaly?

Color blindness or color vision deficiency is the inability or decreased ability to see color, or
perceive color differences, under normal lighting conditions.
There is no actual blindness but there is a deficiency of color vision.

9. Define stereopsis.

Stereopsis is the impression of depth that is perceived when a scene is viewed with both eyes by
someone with normal binocular vision. Binocular viewing of a scene creates two slightly
different images of the scene in the two eyes due to the eyes' different positions on the head

10. Enumerate the cues for depth perception using monocular vision?

 Motion parallax
 Depth from motion
 Perspective
 Relative size
 Familiar size
 Aerial perspective
 Accommodation
 Occlusion
 Curvilinear perspective
 Texture gradient
 Lighting and shading
 Defocus blur

2.2 AUDITORY SENSATION
2.2.1 Hearing Threshold
In front Back Left side Right side
Distance 2m 3m 2m 2m
* the absolute threshold of hearing is the minimum sound level of a pure tone
that an average ear with normal hearing can hear with no other sound present. Thus, in terms of the
distance of hearing, the threshold for the patient are given in the table above.
2.2.2 Localization
Sound localization refers to the ability to identify the location or origin of a detected sound
through time and level differences between both ears.
Result: The patient was able to localize the sound from several origins. The patient has a normal
hearing function in terms of localization
2.2.3 Tuning fork test
2.2.3.1 Weber’s test
The Weber’s test can detect unilateral (one-sided) conductive hearing loss and unilateral
sensorineural hearing loss.
Result: The patient was able to hear the sound with equal loudness on both ears. The patient
does has equal functioning of both ears.
2.2.3.2 Rinne’s Test
The Rinne’s test compares perception of sounds transmitted by air condution to those
transmitted by bone conduction through the mastoid.
Result: The sound was heard for through air conduction long after it was heard through bone
conduction.
Sound conduction through air is more efficient than that through bone. This is because sound
waves travel much faster through solid media (bone) than through gas (air). This faster conduction
bypasses processing and buffering of sound waves into readable impulses by the nervous system (which
occurs in the middle ear).

If the sound is heard longer through the mastoid process, it is indicative of conductive hearing
loss.
2.2.3.3 Schwabach’s Test
The Schwabach’s test is a hearing test using a series of tuning forks of different tones, used for
comparing duration of bone conduction of the impaired ear with that of the normal.
Result: The patient was able to hear the sound for the same amount of time as that of the
examiner. This is referred to as a normal Schwabach test.
2.2.3.4 Correlation
Given: Lateralization of sound on the left with Weber, Air conduction better than bone
conduction with Rinne test, Diminished hearing with the Schwabach test
Diagnosis: Based on the given results above, the patient may have unilateral sensorineural
hearing loss.
Sensorineural hearing loss is a type of hearing loss in which the root cause lies in the
vestibulocochlear nerve (CN VIII), the inner ear, or central processing centers of the brain.
2.2.3 AUDIOMETRY

1. Give the three types of deafness and discuss them.

Conductive hearing loss occurs when sound is not conducted efficiently through the outer earcanal
to the eardrum and the tiny bones (ossicles) of the middle ear. Conductive hearing loss usually
involves a reduction in sound level or the ability to hear faint sounds. This type of hearing loss can
often be corrected medically or surgically.

Some possible causes of conductive hearing loss:

Fluid in the middle ear from colds
Ear infection (otitis media)
Allergies (serous otitis media)
Poor eustachian tube function
Perforated eardrum
Benign tumors
Impacted earwax (cerumen)
Infection in the ear canal (external otitis)
Swimmer's Ear (otitis ecxterna)
Presence of a foreign body
Absence or malformation of the outer ear, ear canal, or middle ear

Sensorineural hearing loss (SNHL) occurs when there is damage to the inner ear (cochlea), or to the
nerve pathways from the inner ear to the brain. Most of the time, SNHL cannot be medically or
surgically corrected. This is the most common type of permanent hearing loss.

SNHL reduces the ability to hear faint sounds. Even when speech is loud enough to hear, it may still
be unclear or sound muffled.

Some possible causes of SNHL:

Illnesses
Drugs that are toxic to hearing
Hearing loss that runs in the family (genetic or hereditary)
Aging
Head trauma
Malformation of the inner ear
Exposure to loud noise

Mixed hearing loss. Sometimes a conductive hearing loss occurs in combination with a
sensorineural hearing loss (SNHL). In other words, there may be damage in the outer or middle ear
and in the inner ear (cochlea) or auditory nerve. When this occurs, the hearing loss is referred to as
a mixed hearing loss.

2. Compare the tuning fork test results for normal hearing, bone conduction deafness and nerve
deafness. Tabulate your answer.

Normal Hearing Bone Conduction
Deafness
Nerve Deafness
Weber’s test With
lateralization to
both ears
Louder in the
affected ear
Quieter in the
affected ear
Rinne’s test Air conduction is
longer than bone
conduction

Bone conduction
is longer than air
conduction
Both bone and
air conduction is
equally
diminished
Schwabach test Normal hearing;
patient hears for
same length of
time as examiner
Prolonged
schwabach;
patient hears for
longer time than
examiner
Diminished
schwabach;
patient hears for
shorter time
than examiner







3. Plot a normal hearing threshold on an audiograph form



The audiogram shows hearing thresholds within normal rangesfor the left ear. The white area
represents the sounds that the person would not hear (softer than their thresholds) and the tan area
indicates all of the sounds that the person would be able to hear (louder then their thresholds).
3.3.1 TASTE
1. Why is there discrepancy between the reaction time for sugar crystals and sugar solution?
To depolarize the cell, and ultimately generate a response, the body uses a different taste receptor
pathway for each taste—sweet, sour, salty, bitter, umami, etc. Incoming sweet molecules bind to their
receptors, which causes a conformational change in the molecule. This change activates the G-protein,
gustducin, which in turn activates adenylate cyclase. Adenylate cyclase catalyzes the conversion
of ATP to cAMP. The cAMP molecule then activates a protein kinase, which in turn phosphorylates and
closes a potassium ion channel. The excess potassium ions increase the positive charge within the cell
causing voltage-gated calcium ion channels to open, further depolarizing the cell. The increase in
calcium ultimately causes neurotransmitter release, which is then received by a primary afferentneuron.
Sugar solution was first perceived by the sense of taste because it is readily diffusible through the papilla
of the tongue. On the other hand the sugar crystals still need to be dissolved by the saliva for it to
diffuse.
2. Discuss the general somatic (motor) and gustatory (sensory) innervations of the tongue.
Sensory
Anterior 2/3rds of tongue
General somatic afferent: lingual nerve branch of V3 of the trigeminal nerve CN V
Taste: chorda tympani branch of facial nerve CN VII (carried to the tongue by the lingual nerve).
Posterior 1/3rd of tongue
General somatic afferent and taste: Glossopharyngeal nerve CN IX
Motor
All intrinsic and extrinsic muscles of the tongue are supplied by the hypoglossal nerve (CN XII), except
for one of the extrinsic muscles, palatoglossus, which is innervated by the Vagus nerve CN X of the
pharyngeal plexus.

3. Why do some substances give a painful sensation when they get in contact with the tongue?
The threshold for stimulation of the sour taste by hydrochloric acid averages 0.0009N; for stimulation of
salty taste by sodium chloride, 0.1M; for the sweet taste by sucrose, 0.1M and for the bitter taste by
quinine, 0.000008M. Note especially how much more sensitive is the bitter taste sense than all the
others, which would be expected, because this sensation provides an important protective function
against many dangerous toxins in food.
3.3.2 SMELL
Results:
1. Time it takes until the smell can no longer be detected?
It took 20 seconds for the smell to be no longer detected.
2. She can distinguish between alcohol and ether because of the ff:
First, only volatile substances that can be sniffed into the nostrils can be smelled. Second, the
stimulating substance must be at least slightly water soluble so that it can pass through the mucus to
reach the olfactory cilia. Third, it is helpful for the substance to be at least slightly lipid soluble,
presumably because lipid constituents of the cilium itself are a weak barrier to non-lipid-soluble
odorants.
Answers to the Questions:
1. Where are the receptors of smell located?

The receptor cells for the smell sensation are the olfactory cells, which are actually bipolar nerve cells
derived originally from the central nervous system itself.


2. Diagram the pathway for smell.


(1) Activation of the receptor protein by the odorant
Substance activates the G-protein complex


(2) This, in turn, activates multiple molecules of adenylyl cyclase
inside the olfactory cell membrane



(3) This causes the formation of many times more molecules of cAMP



(4)Finally, the cAMP opens still many times more sodium
ion channels. Thus it causes exquisite sensitivity of
the olfactory neurons to even the slightest amount of
odorant.

3.3.2 Relationship between Smell and Taste
Tongue Closed nose Opened nose
Tip 1sec 1sec
Side 2secs 2secs
Middle 3secs 2secs
Result:
It’s faster to identify the taste of a food if the nose is unplugged.
Rationale:
Taste and Smell are separate senses with their own receptor organs, yet they are intimately entwined.
Chemicals in foods are detected by taste buds, they consists of special sensory cells. When stimulated
these cells send signals to specific area of the brain which make us conscious of the perception of taste.
Similarly specialized cells in the nose pick-up odorants airborne odor molecules odorants stimulate
receptor proteins found in hair cilia at the tips of the sensory cells, senses that send neural response,
ultimately, messages of taste and smell converge and help to detect flavors of food.