1. Describe Conjunctiva

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

3. Note conjunctival reflection

4. Note anterior and posterior chamber. Note ciliary body and lens connection

5. Diagnosis

6. Sub conjunctival hemorrhage. Sharply demarcated.

7. Afferent pathway for visual acuity?

8. Retina-Optic nerve-Optic chiasma-Optic radiation-Occiptal lobe visual cortex.

9. Note fovea as center for visual field. Locate site for blind spot in retina

10. Center of optic disc has no retinal receptors and leads to blind spot.

11. Pathway for light reflex?

12. Afferent: Retina-optic nerve-mid brain Efferent: Both oculo motor nerves

13. Note direct and consensual light reflex

14. Sorry the pupillary contraction on right is not visible

15. Note the pathway for pupillary contraction

17. Direct reflex on right Consensual reflex on left

18. Note the pathway for light reflex

19. Is this light reflex normal?

20. Yes. Note direct and consensual light reflex

21. Is this light reflex normal?

22. Afferent path on left eye is abnormal.

23. Which muscles are in action?

24. Right lateral rectus and left medial rectus. Gaze is conjugate.

25. Which nerves are in action?

26. Right abducens (right lateral rectus) and left oculomotor nerve (left medial rectus). Gaze is conjugate.

27. Which nerves are in action

28. Oculomotor nerves. Superior rectus in action. Gaze is conjugate.

29. Which cranial nerves are in action?

30. Both oculomotor nerves Inferior recti in action

31. Identify the ocular muscles

32. Levator palpabrae supreioris Superior rectus Inferior recrtus

33. Appreciate position of ocular muscles

34. Superior oblique: Trochlear nerve Lateral rectus: Abducens nerve Oculomotor supplies the rest

35. Ocular muscles influenced by sympathetic system

36. Levator palpabrae superioris Iris muscle Muscle in floor of orbit

37. Is the technique appropriate?

38. No. You should look at left fundus with your left eye.

39. Identify artery and vein

40. Artery is narrow with light reflex Vein is thicker than artery and is red

41. Diagnosis

42. Leukemic infiltration

43. Diagnosis

44. Macroglobunemia

45. Source for tears?

46. Lacrimal gland Meibonian glands Conjunctival glands Drained by puncta into lacrimal sac and on to nasolacrimal duct into nose.

47. Note pathway for aqueous humor

49. Your right eye compared to subject’s left eye

51. Normal mono-ocular field of vision

52. 80-90 degrees temporal. 45 degrees medial. Limited by nose Eye brows limit upward field

55. Anticipate the visual field defects with lesions marked.

56. Blind rught eye Bitempral hemianopsia Homonymous hemianopsia

57. Describe and locate the lesion for each visual field defect

58. Left upper retna Left optic nerve Chiasma Right optic tract Right optic radiation