Week 2 Flashcards
WIT: Image is held steadily on the fovea by the eye and head
Fixation
What 3 purposes is there for fixation?
- to see stationary object
- for 20/20 vision
- To study targets of high spatial frequency
For fixation to occur, motion of the image on the fovea can be NO MORE than ___ degrees per second
5 degrees/sec
For fixation, image should like within ___ degrees of the center of fovea
0.5 degrees
Is a tremor a conjugate movement between the 2 eyes?
No
Microsaccades correct for ____.
Drifts
MS is larger by 4x in peripheral positions of gaze
Microsaccades occure how many times per second in all directions?
1-5 times
Are MS correlated between the two eyes in (1) time of onset and (2) direction?
Yes, but many not be correlated in amplitude
By concentrating, can you suppress MS?
Yes!
WIT: Deviation from the point of fixation of about 0.1 deg (6mins) w/ a velocity of about 0.25 deg/sec
Drifts
Can drifts occur in opposite directions in the two eyes?
Yes
In darkness, velocity of drifts increase by ___.
4x
WIT: Visual cues to fixate are important for steady control of gaze called ?
Field holding reflex
Fixation + Saccades = ?
Reading
WIT: Illusion of motion, caused by a nystagmus disrupting steady fixation
Oscillopsia
WIT: Initial slow-phase drift w/ fast reset
Pathological nystagmus
WIT: Small, less than 2 degree movement, this starts with an abnormal saccade
Saccadic intrusions
- more common in smokers, medications and caffeine ppl
What is an abnormal saccadic intrusion?
Anything more than 20/min
WIT: Repetitive to and from movment of the eyes initiated by slow phases
Nystagmus
What is the vertical gaze holding NI?
Interstitial Nucleus of Cajal
What is the horiontal gaze holding NI?
NPH - Nucleus Prepositus Hypoglossi
MVN - Medial Vestibular Nuclei
What part of the cerebellum is important for gaze holding?
Flocculus
What neurotransmitters to the NI use?
ACH
GABA
NMDA
A leaky neural integrator create a mismatch between what 2 things?
Pulse and Step!
WIT: Pulse signal keeps attempting to move eye to eccentric position but eye keeps drifting back due to fault step signal
Gaze- evoked nystagmus
When attempting to look back in primary gaze after adapting to gaze-evoked nystamus you get what?
Rebound nystagmus
WIT: Slow, large nystagmus toward thel lesion (R), but rapid small nystagmus away from lesion (L)
Brun’s nystagmus
Brun’s nystagmus occurs in ___% of large acoustic tumors > 3.5 cm
11%
What disorder occurs when there’s a lesion in the MLF?
Internuclear Ophthalmoplegia (INO)
What controls horizontal conjugate gaze?
Abducen’s nucleus in pons
With a lesion to the LEFT abducen’s nucleus causing a horizontal gaze palsy, what results?
- No VOR
2. No left gaze (pt can’t look left)
Lesion of the right MLF, what happens?
- INO
2. Right eye cannot adduct (Abducen’s nucleus can’t tell MR to adduct for left gaze)
Is there such thing as a normal endpoint nystagmus?
Yes, dampens after 3 beats
What is the most common cause of gaze-evoked nystagmus?
A drug side effect (sedatives, tranquilizers, anticonvulsants, alcohol)
WIT: Occurs naturally during sustained self-rotation in the light or stimulated by motion of the VF
Optokinetic Nystagmus
What are the 3 dynamics of OKN?
- Gain
- Frequency
- Amplitude
WIT: the ratio of slow phase velocity to stimulus velocity
Gain
WIT: the extent of each slow phase excursion
Amplitude
WIT: The rate at which the gaze is reset by the fast phase
Frequency
What is the purpose of OKAN?
To help neutralize PRN
What is the purpose of OKN/OKR?
To stabilize images on the retina
What is circularvection?
The sensation of self-rotation, feeling like we’re moving
- becomes more sensative w/ age
What factors affect OKN?
- Target Luminance
- Spatial Frequency
- Velocity of Target Motion
- Direction (gain is highest horiontally)
- Torsion (watching a revolving disk)
When does VOR tend to stop?
When acceleration = 0 and there’s a constant velocity
What type of VOR do ice skaters use when doing long high-speed spins
VOR Habituation - VoR adjust and adapts to a changing environment
Since OKN is a reflex, it must be ____ to follow a small moving target. What other eye movement do you use to suppress this?
Suppressed
Smooth pursuits
What is the first neural pathway to develop? What’s another name for it
NOT - Nucleus of Optic Tract
Subcortical pathway
What is the second neural pathway to develop? What’s another name for it?
MT, MST, PP
Higher Level Cortical Pathway
The subcortical pathway for OKN is mediated by what two things?
Accessory Optic System (AOS) and Nucleus of Optic Tract (NOT)
The cortical Pathway is mediated by what pathway?
Geniculo-Striate Pathway
Naso-temporal asymmetry is observed when visual cortex is not well-developed in who?
Infants, amblyopes, albinos
In under-developed cortex, what direction dominates?
Naso-Temporal direction dominates
Infants show OKN asymmetry until about what month?
2 months
OKN is much stronger for monocular stimulus toward _____?
toward the nose (drum is rotating toward the nose, temporal –> nasal)
T or F: In normal adults, there is no assymetry evident.
True, cortex is fully developed
What are the 2 consequences of the VN providing information to the sensory cortex?
- Vestibular Sensation = circularvection
2. Ability to distinguish between self-motion and environmental motion
The ability to distinguish between self-motion and environmental motion aids in what?
helps to maintain sense of stability during locomotion
The VN-complex receives feedback and feed-forward inputs from many areas, that allow for the effectiveness of ?
Vision Therapy - ability to improve one’s eye movements
What are the 4 types of nystagmus?
- Vestibular
- Gaze-Evoked
- Congenital Jerk
- Pendular
WIT: Constant velocity drift of the eyes w/ quick phases, vestibular disease
Vestibular Nystagmus
WIT: Drift back to center, negative exponential slow phase
Gaze-evoked
WIT: Well-defined slow and fast phases, Positive exponential waveform, sometimes found in amblyopia
Jerk Nystagmus
NO defined fast-phase, found in patients with known foveal disorder
Pendulum Nystagmus
What are the 2 types of congenital nystagmus?
- Latent/Jerk Nystagmus
2. Pendulum Nystagmus
T or F: Latent/Jerk nystagmus only occurs when the eye is occluded
True
What are the 4 different treatments for nystagmus?
- Pharmaceutical (muscle relaxant)
- BCVA, w/ CL
- Find Null Point w/ prisms or surgery
- Vision Therapy