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Chapter 51 Visual Pathway

By Prof. Dr. Abdul Majid MBBS, M. Phil, FCPS

51.1

51.2

51.3

Lesion of Visual Pathway

51.4

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51.5

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Effects of Removing Primary Visual Cortex

There will be loss of conscious vision (blindness) but still one can react sub consciously to changes in light intensity. These reactions include turning of eyes, turning of head or of whole body. The neural pathway includes fibers from optic tract to superior colliculi & other areas of older visual system.
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Field of Vision

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Scotoma
Pathological types of scotomas include central, paracentral & peripheral scotomas. Type Causes Central Damage to optic nerve by glaucoma, occlusion of CRA Paracentral Allergic reactions in the retina, lead poisoning, excessive use of tobacco Peripheral Retinitis pigmentosa 14

Muscular Control of Eye Movements

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Cont:
Three pairs of muscles: 1. Medial & lateral recti muscles for side ward movements. 2. Superior & inferior muscles for up ward & down ward movements. 3. Superior & inferior oblique muscles for rotation of eye balls. Each set is reciprocally innervated
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Fixation Movements of Eyes

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Cont:
1. Voluntary fixation movement:
(Unlocking)

Controlled by areas present in the premotor cortex or by blinking of eyes or by putting hand in front of eyes for a short period of time. 2. In voluntary fixation movement: (locking) Controlled by secondary visual cortex through cortico tectal & cortico collicular pathways. 18

Prevention of Object of Attention from Leaving the Fovea Centralis

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Cont:
The eyes normally have three continuous but impercebtible. 1. Continuous tremors-occur at the rate of 30 to 80 cycles per second, caused by successive contraction of motor units in the ocular muscles. 2. A slow drift of the eye balls in one or other direction. 3. Sudden flicking movement that is controlled by involuntary fixation mechanism. Involuntary fixation ability is last when there is destruction of superior colliculi. 20

Saccadic & Pursuit Movement of Eyes

1. Saccadic movements occur when a visual seen is moving continuously before the eyes, such as a when person is riding in a car. Jumping occurs at the rate of 2-3 per second. 2. Saccadic movements while reading: eyes jump from one line to the next. 3. Pursuit movement: fixation of the eyes on a moving object. (leaving of train from 21 railway station)

Basic types of Strabismus

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Cont:
Lack of fusion of the eyes in one or more of the visual coordinates (horizontal, vertical or rotational or mixed). A young childs early efforts to fixate the two eyes on the same object, one of the eyes fixates satisfactorily while the other eye fails to do so or both eyes fixate satisfactorily but never simultaneously. Normal eye is called dominant eye & other is called repressed eye heaving poor 23 visual acuity.

Light Reflex Pathway & Sympathetic Nerve supply

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Argyll Robertson Pupil

Absence of constriction of pupils due to light reflex but presence of constriction of pupils due to accommodation reflex for near vision. Causes: Usually it is caused by syphilis, alcoholism, encephalitis which cause destruction of pretectal nuclei. Rarely there is destruction of light reflex fibers in the optic tracts.
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Horners Syndrome
Interruption of sympathetic NS to the eye at the cervical region. Effects: Drooping of upper eye lids. Pupils remain constricted. On the effected side face & head will be red due to vasodilatation. Loss of sweating ( anhydrosis).
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1. 2. 3. 4.