Armed Forces College of Medicine
AFCM
Physiology master 1
Vision I
Dr. Ghida Mohamed Hassan
Lecturer- Physiology department,
Faculty of Medicine- Ain Shams
university
By the end of this practical section, the student
will be able to understand:
1- Visual Pathway.
2-Pupillary light reflex
3- Accomodation reflex
4-Visual Acuity
5- Errors of refraction
Visual pathway
1- Pupillary light
reflex
Pupillary light reflex
• It is a reflex constriction of both pupils
when one eye is exposed to light.
Nervous pathway
• Stimulus: Applying light to the pupil
• Receptors: rods & cons in the retina.
• Afferent: Optic nerve, Optic chiasma
• Center: Pretectal nucleus in midbrain.
• Efferent : Occulomotor nerve.
• Response: Direct and consensual
pupilloconstriction
Importance of pupillary light reflex
• Regulation of amount of light entry
(protective).
• Diagnosis of nervous diseases and
localization of lesion in visual pathway
Near response
(Accommodation
reflex)
Near response
(Accommodation reflex)
• Reflex changes in both eyes in
response to near vision that enable
an object to be focused on the retina.
Components
• Afferent: Optic nerve, Optic chiasma,
Optic tract, Lateral geniculate body, Optic
radiation, Occipital cortex & Frontal
eyefileld area
• Centre: Superior colliculus
• Efferent: Oculomotor nerve
Oculomotor nerve supplies:
Ciliary muscle, Constrictor pupillae &Medial recti
The near response is formed of three
components:
I- Convergence
• To allow the object to lie on corresponding
points on the retinae
II- Pupilloconstriction
• Pupil constricts to prevent diverging light rays
from hitting the periphery of the lens.
• To prevent chromatic and spherical aberrations.
III- Increased convexity of the lens
(accommodation)
• To make the image falls on the retina .
Range of accommodation
It is the difference between the
refractive power of the eye when
adjusted for near & far vision
• Range of accommodation decreases
with age due to presbyopia (decreased
elasticity of lens)
Argyll Robertson pupil
Pupil does not react to light, but will react
to near reflex
Caused by: Lesion in pretectal nucleus
Examine visual acuity
• Visual Acuity is the capacity to detect, resolve or recognize the
details of objects.
• Requirements:
Light rays must fall on two cones with at least one un-stimulated in
between.
Visual angle at nodal point equals at least one minute 1/60
Visual acuity is tested by:
1- Snellen’s chart
3-Number chart
2- Landolt chart
Subject is placed at 6 meters from the chart
Each eye is tested separately
Chart is well illuminated, with black letters on white
screen.
• Results:
6/6: patient can see at 6 m what can usually be
seen from 6 m with normal vision.
6/9: patient can see at 6 m what can usually be
seen from 9 m with normal vision.
6/12: patient can see at 6 m what can usually be
seen from 12 m with normal vision.
6/18, 6/24, 6/60
If visual acuity of person is less than 6/60 (fail
to see the largest line), let the patient stand at
a less distance from the chart. If he can read
the largest line at a distance of 4 meters, his
visual acuity will be 4/60.
If visual acuity of person is less than 1/60, it is
recorded by:
a- Counting finger.
b- Hand movement.
c- Perception of light . of light = BLINDNESS
No perception
Mention the factors affecting visual acuity.
Degree of image illumination.
Degree of chart contrast.
Disturbance of focusing mechanisms e.g. errors of
refraction, glaucoma.
Opacity in the transparent media of the eye.
Lesion in the visual pathway.
Errors of Refraction
1- Myopia
2- Hypermetropia
3- Astigmatism
4-Presbyopia
ERRORS
TREATMENT
1- Myopia
• Near-sightedness, short-sightedness .
• Eye disorder where light focuses in front of,
instead of on, the retina.
• The underlying mechanism involves the length
of the eyeball growing too long or
the lens being too strong
• Myopia can be corrected with a concave lens,
which causes the divergence of light rays
before they reach the cornea.
Hypermetropia
• Far-sightedness.
• Eye disorder where distant objects are seen
clearly but near objects appear blurred.
• This blurred effect is due to incoming light
being focused behind the retina wall due to
insufficient accommodation by the lens
• This can arise from a cornea or crystalline lens
with not enough curvature or an eyeball that is
too short
• This can be corrected with convex lenses
3- Astigmatism
• Cylindrical errors cause astigmatism, when the
optical power of the eye is too powerful or too
weak across one meridian, such as if the
corneal curvature tends towards a cylindrical
shape.
• The angle between that meridian and the
horizontal is known as the axis of the cylinder.
• This defect can be corrected by refracting light
more in one meridian than the other.
Cylindrical lenses serve this purpose.
Lecture Quiz
Physiology master 34
During Accomodation:
a-Field of vision is decreased.
b-Amount of light increases
c-Ciliary muscle relaxes
d-Suspensory ligaments of the lens is stretched
A
If a subject has a visual cuity 6/60, this means:
a-6 meters the subject sees 60 times less than
normal.
b-6 meters the subject sees 60 times better than
normal.
c-6 meters the subject sees what a normal person
can see at 60 meters.
d-60 meters the subject sees what a normal person
can see at 6 meters.
C
Thank You
