Describe%20Conjunctiva

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Describe Conjunctiva
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• Conjunctiva is translucent and clear. The pink
  color of palpebral conjunctiva is due to
  underlying vascular bed. White Sclera is seen
  through bulbar conjunctiva

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Note conjunctival reflection
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• Note anterior and posterior chamber.
• Note ciliary body and lens connection

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Diagnosis
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• Sub conjunctival hemorrhage.
• Sharply demarcated.

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Afferent pathway for visual acuity?
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• Retina-Optic nerve-Optic chiasma-Optic
  radiation-Occiptal lobe visual cortex.

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Note fovea as center for visual field. Locate
site for blind spot in retina
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• Center of optic disc has no retinal receptors and
  leads to blind spot.

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Pathway for light reflex?
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• Afferent Retina-optic nerve-mid brain
• Efferent Both oculo motor nerves

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Note direct and consensual light reflex
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• Sorry the pupillary contraction on right is not
  visible

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Note the pathway for pupillary contraction
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• Direct reflex on right
• Consensual reflex on left

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Note the pathway for light reflex
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Is this light reflex normal?
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• Yes.
• Note direct and consensual light reflex

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Is this light reflex normal?
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• Afferent path on left eye is abnormal.

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Which muscles are in action?
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• Right lateral rectus and left medial rectus. Gaze
  is conjugate.

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Which nerves are in action?
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• Right abducens (right lateral rectus) and
• left oculomotor nerve (left medial rectus).
• Gaze is conjugate.

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Which nerves are in action
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• Oculomotor nerves. Superior rectus in action.
  Gaze is conjugate.

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Which cranial nerves are in action?
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• Both oculomotor nerves
• Inferior recti in action

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Identify the ocular muscles
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• Levator palpabrae supreioris
• Superior rectus
• Inferior recrtus

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Appreciate position of ocular muscles
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• Superior oblique Trochlear nerve
• Lateral rectus Abducens nerve
• Oculomotor supplies the rest

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Ocular muscles influenced by sympathetic system
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• Levator palpabrae superioris
• Iris muscle
• Muscle in floor of orbit

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Is the technique appropriate?
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• No.
• You should look at left fundus with your left eye.

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Identify artery and vein
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• Artery is narrow with light reflex
• Vein is thicker than artery and is red

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Diagnosis
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• Leukemic infiltration

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Diagnosis
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• Macroglobunemia

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Source for tears?
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• Lacrimal gland
• Meibonian glands
• Conjunctival glands
• Drained by puncta into lacrimal sac and on to
  nasolacrimal duct into nose.

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Note pathway for aqueous humor
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Your right eye compared to subjects left eye
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Normal mono-ocular field of vision
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• 80-90 degrees temporal.
• 45 degrees medial. Limited by nose
• Eye brows limit upward field

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Anticipate the visual field defects with lesions
marked.
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• Blind rught eye
• Bitempral hemianopsia
• Homonymous hemianopsia

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Describe and locate the lesion for each visual
field defect
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• Left upper retna
• Left optic nerve
• Chiasma
• Right optic tract
• Right optic radiation
• Right optic radiation