VISION

Sosa, Diane

Visual Field
Visual Acuity
Train Nystagmus

PERIMETRY
a visual field
test of each
eye
To diagnose
blindness in
specific portion
of the retina

PERIMETRY CHART
LEFT EYE

RIGHT EYE

VISUAL
FIELD
Visual area seen by
the eye at a given
instant.
NASAL FIELD OF
VISION
Area seen on the
nasal side
LATERAL FIELD OF
VISION
Area seen on the
lateral side

The normal
extent of field of
vision

60nasally.
50superiorly

70inferiorly .
90
temporally

FACTORS THAT LIMITS VISUAL FIELD

Superiorly:
Roof of the Orbit,
Forehead, and
Glabella.

Medially:
Nose

Inferiorly:
Cheek bones

VISUAL FIELD DEFECTS

OPTIC NERVE :
Causes:
optic atrophy
indirect optic
neuropathy
acute optic neuritis
traumatic avulsion
of optic nerve.
Characterised by:
complete blindness in
affected eye with loss
of both direct on
ipsilateral &
concensual light
reflex on
contralateral side.
Near reflex is
preserved.
Eg. Right optic
nerve
involvement

2)Lesions through
proximal part of
optic nerve :
ipsilateral
blindness.
contralateral
hemianopia
abolition of direct
light reflex on
affected side &
concensual light
reflex on
contralateral side.
near reflex intact.
Eg. Rt optic nerve
Involvement in
Proximal part

causes:
suprasellar aneurysm
tumors of pituitary
gland
craniopharyngioma
suprasellar
meningioma & glioma of
3rd ventricle.
third ventricular
dilatation due to
obstructive
hydrocephalus.
chronic chiasmal
arachnoiditis.
Characterised by:
Bitemporal
hemianopia
Bitemporal
hemianopic
paralysis of pupillary
reflex. (usually lead to
partial descending optic

4)Lateral chiasmal
lesions :
causes:
Distension of 3rd
ventricle causing
pressure on each side
of optic chiasma
Atheroma of carotids
& posterior
communicating artery.
Characterised by
Binasal hemianopia
Binasal hemianopic
parallysis of
pupillary reflex
(usually lead to partial
descending optic
atrophy)

5)Lesions of optic
tract :
Causes:
Syphilitic meningitis/
gumma.
Tuberculosis
Tumors of optic
thalamus
Aneurysm of superior
cerebellar or posterior
cerebral arteries.
Characterised by :
Incongruous
homonymous
hemianopia with C/L
hemianopic pupillary
reaction( wernickes
reaction)
These lesions usually
lead to partial
descending optic
atrophy & may be
associated with C/L 3rd
nerve paralysis &

6)Lesions of
lateral
geniculate
body :
leads to
homonymous
hemianopia with
sparing of
pupillary reflexes
& may end in
partial optic
atrophy.

7)Lesions of optic
radiations :
Causes:
Vascular occlusion
Primary & secondary
tumors
Trauma
Characterised by :
COMPLETE
HOMONYMOUS
HEMIANOPIA( sometime
s sparing macula)
TOTAL OPTIC
RADIATION
INVOLVEMENT

LESIONS OF
PARIETAL LOBE
(involving
superior fibres
of optic
radiations)

LESIONS OF
TEMPORAL
LOBE (involving
inferior fibres of
optic radiations)

INFERIOR
QUADRANTIC
HEMIANOPIA(
PIE ON THE
FLOOR)

SUPERIOR
QUADRANTIC
HEMIANOPIA( PI
E ON THE
ROOF)

8)Lesions of
visual
cortex :
pupillary light
reflex is normal
& optic atrophy
does not occur
following visual
cortex lesions.

Congruous
homonymous
hemianopia(sparin
g macula)
Occlusion of
posterior cerebral
artery supplyin
anterior part of
occipiatl cortex

Congruous
homonymous
macular defect
Head injury/gun
shot injury
leading to lesions
of tip of occipital
cortex+

PHYSIOLOGICAL BLIND SPOT

Corresponding to optic nerve head
15 deg temporal to point of fixation
Span 5 deg horizontal
-- 7 deg vertical
Two thirds below the horizontal
meridian

21

VISUAL ACUITY
A measure of spatial resolution of the
eye
An estimation of its ability to
discriminate between two points

RESULTS

Right
Eye
Without 3/100
Lens
With
20/30
Lens

Left
Eye
2/100
20/25

FOVEA CENTRALIS

VISUAL PATHWAY

VISUAL PATHWAY

SNELLENS CHART
Principle: DISTANT
VISUAL ACUITY
the ratio of ones
visual acuity to
that of a person
with normal visual
acuity

IV. VISUAL ACUITY

20
---40

the distance
that the
patient was
made to stand
from thechart
the distance
assigned to the
last row they
were able to
read

RETINAL OR TRAIN
NYSTAGMUS

OPTOKINETIC NYSTAGMUS

-happens when repetitive stimuli traverse the field of

vision
-allows the eye to follow objects in motion when head
remains stationary

Retinal (train nystagmus)

- Dancing eyes
- Oscillatory or rhythmic movements
of the eye in which there is a fast and
a slow phase.
- It is named according to the direction
of the fast phase, because it is more
easily observed.

Retinal (train nystagmus)

Optokinetic Reflex (OKR)

- Is a second mechanism by which the

nervous system stabilize the visual
scene on the retina

- Activated by movement of the visual

scene.

Retinal (train nystagmus)

Saccades
- To be able to move the eye with respect to
the world
- So that objects of importance can be focused
onto the fovea
- Scrutinized with this high-resolution part of
the retina.

Retinal (train nystagmus)

Smooth Pursuit

- This system allows us to keep it

stable on the fovea despite its
continued motion.

Retinal (train nystagmus)

Nystagmus
- these reflexes will initially counterrotate the eyes in an attempt to
maintain a stable image on the retina.

Retinal (train nystagmus)

Vergence
- these reflexes will initially
counterrotate the eyes in an attempt to
maintain a stable image on the retina.
- allows a target to be maintained on
both fovea during eye movement

THANK YOU