By Linda Wilson-Pauwels; Elizabeth J. Akesson; Patricia A. Stewart; Sian D. Spacey
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Extra info for Cranial Nerves in Health and Disease, Second Edition
44 Cranial Nerves OBJECT IN CENTER VISUAL FIELD LEFT VISUAL FIELD UPPER QUADRANT RIGHT VISUAL FIELD UPPER QUADRANT LEFT VISUAL FIELD LOWER QUADRANT RIGHT VISUAL FIELD LOWER QUADRANT A Optic chiasma lesion B C Nasal half of left retina Nasal half of right retina Oblique cut through thalamus D Left and right lateral geniculate bodies © L. Wilson-Pauwels Geniculocalcarine tract (optic radiations) Left primary visual cortex Right primary visual cortex E F LEFT EYE RIGHT EYE Calcarine fissure Figure II–14 Lesion of the optic chiasma.
Optic Nerve A B Optic tract Optic chiasma Photoreceptors (mostly cones) Inflammation in optic nerve Optic nerve head (optic disk) Fovea (central area of retina) © L. Wilson-Pauwels Figure II–10 A, Normally Meredith's central vision has high acuity and color infomation. B, Inflammation in her right optic nerve interferes with the transmission of signals from the retina to the brain. Since half the axons in the optic nerve carry signals from the fovea, the major change Meredith perceives is a loss of acuity and color in her central vision.
Visualization of the Fundus Visualization of the fundus (Figure II–16) involves the use of an ophthalmoscope. The examination is performed in a dimly lit room so that the patient’s pupils are maximally dilated. Ask the patient to focus on an object in the distance. This helps to keep the eyes still and allows for better visualization of the fundus. The first thing to look at is the disk (optic nerve head). The margins of the disk should be sharp. Blurring of the disk margins is seen with raised intracranial pressure, and disk pallor is an indication of optic atrophy.