1. Internuclear ophthalmoplegia

2. Horizontal gaze centers

3. Diplopia midbrain Infarction Hemorrhage Neoplasm Demylination
Subarachnoid portion
Infarction
Hemorrhage
Neoplasm
Demylination
Aneurysm
Infectious meningitis
Meningeal infiltration
granulomatous inflammation
Rise intracranial pressure (VI)
Trauma (IV)
Cerebello-pontine angle tumour 3

4. Diplopia Cavernous sinus Orbit Vascular Infection Tumor Granuloma
Aneurysm
Carotid artery- cavernous sinus fistula
Cavernous sinus thrombosis
Ischemia from microvascular disease in vasa nervosa
Inflammatory
Vascular
Infection
Tumor
Granuloma
Trauma 4

5. Investigations

6. Investigations

7. Ptosis

8. Ptosis
Partial
Complete

9. Ptosis
Muscle disease
Myasthenia Gravis

10. Horner's syndrome

11. Pupil disorders Dilated III lesion Trauma Anticholinergi cs &
Sympathmime tics intoxication
Ethanol & sedative withdrawal

12. Pupil disorders Cosntrection Opioid intoxication
Argyll Robertson pupil
Holmes Adie pupil
Horner's syndrome

13. Pathway for pupillary dilatation (sympathetic)
hypothalamus
brain stem
cervical spinal cord C8, T1
sympathetic chain superior cervical ganglion
internal carotid artery
ciliary ganglion
dilator pupillae in the iris

14. A lesion anywhere along its path results in
Horner’s syndrome
A lesion anywhere along its path results in
Miosis
Ptosis
enopthalmos
anhydrosis.