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NEURO OPHTHALMOLOGY

NEURO OPHTHALMOLOGY. Pavel Stodůlka. VISU AL PATHWAY. VISUAL PATHWAY. Clinical point of view :. 1. RETINA 2. OPTICAL NERVE 3. CHIASMA 4. OTICAL TRACT 5. VISUAL CORTEX – area striata. VISUAL PATHWAY. Anatomical point of view:. 1. NEURON – cones & rods

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NEURO OPHTHALMOLOGY

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  1. NEURO OPHTHALMOLOGY Pavel Stodůlka

  2. VISUAL PATHWAY

  3. VISUAL PATHWAY Clinical point of view: 1. RETINA 2. OPTICAL NERVE 3. CHIASMA 4. OTICAL TRACT 5. VISUAL CORTEX – area striata

  4. VISUAL PATHWAY Anatomical point of view: 1. NEURON – cones & rods 2. NEURON – bipolar cells of retina 3. NEURON - ganglioncells(nervus opticus) 4. NEURON – cells from corpus geniculatum lat. (radiatio optica)

  5. VISUAL PATHWAY

  6. OPTIC HEAD PATHOLOGY 1. PAPILLEDEMA 2. NEURITIS 3. NEUROPATHY 4. OPTIC HEAD ATROPHY

  7. DIRECT OPHTHALMOSCOPE

  8. INDIRECT OPHTHALMOSCOPE

  9. DISC: sharp edges flat physiological colour

  10. OPTIC HEAD PATHOLOGY 1. PAPILLEDEMA 2. NEURITIS 3. NEUROPATHY 4. OPTIC HEAD ATROPHY

  11. PAPILLEDEMA It is not a disease buta sign of increased intracranial (or intraorbital) pressure.

  12. PAPILLEDEMA “Champane cork“ • prominence • blurry edges • haemorhagies

  13. DISC: sharp edges flat physiological colour

  14. PAPILLEDEMA

  15. PAPILLEDEMA Obvious pathology on the disc but no visual problems.

  16. Increased intracranial pressure Papilledema is present BILATERAL.

  17. Increased intracranial pressure ??

  18. Increased intracranial pressure Intracranial expansion

  19. PAPILLEDEMA Absolute CONTRAINDICATION of lumbal puncture.

  20. OPTIC HEAD PATHOLOGY 1. PAPILLEDEMA 2. NEURITIS 3. NEUROPATHY 4. OPTIC HEAD ATROPHY

  21. NEURITIS 1. NEURITIS INTRAOCULARIS 2. NEURITIS RETROBULBARIS

  22. NEURITIS INTRAOCULARIS 1. blurry edges of optic head 2. haemorhagies 3. decreased visual accuity

  23. neuritis intraocularis neuroretinitis

  24. NEURITIS INTRAOCULARIS Ethiology: brain infections, meningitis, infectious diseases

  25. NEURITIS RETROBULBARIS Marked visual deterioration, but no pathologies on optic head.

  26. NEURITIS RETROBULBARIS Patient does not see anything, doctor does not see anything too.

  27. NEURITIS RETROBULBARIS Ethiology: Sclerosis multiplex

  28. OPTIC HEAD PATHOLOGY 1. PAPILLEDEMA 2. NEURITIS 3. NEUROPATHY 4. OPTIC HEAD ATROPHY

  29. OPTIC HEAD PATHOLOGY 1. PAPILLEDEMA 2. NEURITIS 3. NEUROPATHY 4. OPTIC HEAD ATROPHY

  30. NEUROPATHIES DEGENERATIONS

  31. NEUROPAHTIES 1. inherited 2. acquired - a) exogenous - b) endogenous

  32. EXOGENOUS NEUROPATHIES 1. ethanol 2. tabacco 3. psychopharmacs 4. methanol

  33. METHANOL INTOXICATION Patient is sleepy the next day with vomiting and high heart rate. Delirium and spasms are signs of bad prognosis. If they survive they become blind.

  34. METHANOL INTOXICATION Acute event with dramatic scenario. 10 ml of methanol is enough for intoxication.

  35. How does methanol harm ??

  36. METHANOL INTOXICATION Methanol molecule is been split and products are toxic for retinal ganglion cells.

  37. NEUROPAHTIES 1. inherited 2. acquired - a) exogenous - b) endogenous

  38. ENDOGENOUS NEUROPATHIES 1. diabetics 2. pregnancy and brest feeding 3. anaemia 4. undernourishment

  39. OPTIC HEAD PATHOLOGY 1. PAPILLEDEMA 2. NEURITIS 3. NEUROPATHY 4. OPTIC HEAD ATROPHY

  40. OPTIC HEAD PATHOLOGY 1. PAPILLEDEMA 2. NEURITIS 3. NEUROPATHY 4. OPTIC HEAD ATROPHY

  41. Optic nerve atrophy Manifestation of pathology of 2. neuron of visual pathway.

  42. Optic nerve atrophy pale disc

  43. Optic nerve atrophy ATROPHIA SIMPLEX ATROPHIA GLAUCOMATOSA ATROPHIA FLAVA

  44. Glaucomatous disc

  45. Pavel Stodůlka, MD, PhD stodulka@lasik.cz www.LASIK.cz BREAK !

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