12/5/2019 Visual Pathway - Neurology - Medbullets Step 1

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Updated: 2/24/2018
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Visual Pathway
 Neurology
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Moises Dominguez

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Review Topic 3 1

Overview

Introduction

When light passes through the lens it reaches the

the retina, where the formed image is
inverted and reversed
for example, upper visual space information will be projected to the
lower retina
axons leave the retina into the optic nerve

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fibers pass through the optic chiasm and subsequently in the optic tract
  there is fiber SEARCH
crossing in the optic chiasm
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neuronal fibers from the left side of the retina (left hemi-retina) will
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end up in the
left optic tract
neuronal fibers from the right hemi-retina will end up in the
 Neurology right optic tract
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axons in the optic tracts will synapse in the lateral geniculate nucleus (LGN) of the
thalamus
fibers from the LGN makes it way to the visual cortex as optic radiations
inferior optic radiations form the Meyer's loop
which carries information from the inferior retina (and thus the
superior visual field)
note that these radiations pass into the temporal lobe and
therefore
temporal lobe lesion result in a
contralateral homonymous superior quadrantopia ("pie
in the sky")
superior optic radiations pass by the parietal lobe and therefore
lesions of the parietal lobe results in a
contralateral homonymous inferior quadrantopia ("pie on the
floor")
optic radiations eventually synapse in the primary visual cortex
superior optic radiations project to the
superior bank of the calcarine fissure
inferior optic radiations will project to the
lower bank of the calcarine fissure
Summary of conscious vision perception
retina → optic nerve → optic chiasm → optic tract → lateral geniculate body → optic
radiation to primary visual cortex
Additional pathways
retina → optic nerve → optic chiasm → optic tract → pretectal area and superior
colliculus
the pretectal area is important for the
pupillary light reflex
swinging flashlight test is used to diagnose a relative afferent
pupillary defect
normal
both pupils constrict quickly and equally when either is
exposed to direct light
pupils do not change in size when light moves quickly
between eyes
abnormal (lesion in the afferent pathway)
sensory stimulus from affected pathway to the midbrain
is reduced
unaffected pupil will dilate from its constricted state
when light is moved from the unaffected to the affected
eye
common causes include unilateral optic nerve lesions
and severe unilateral retinal disease
the superior collicus and pretectal area is important for
eye movement towards visual stimuli
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Common Lesions SEARCH JOIN NOW LOGIN

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Select Visual Field Defects

Visual Field Deficit Etiology

 Neurology Macular degeneration

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Retinal
infarction
Central scotoma
hemorrhage
degeneration
infection

Optic neuritis
Monocular vision loss Anterior ischemic optic neuropathy
Optic glioma

Pituitary adenoma
Bitemporal hemianopia Craniopharyngioma
Hypothalamic glioma

Optic tract lesions (rare) secondary to

malignancy
demyelination
Contralateral homonymous hemianopia
infarction
Optic radiation lesions
Lesion involving the entire primary visual cortex

Temporal lobe lesions

Contralateral superior quadrantanopia ("pie in the sky") Lesions involving the lower bank of the calcarine
fissure

Parietal lobe lesions such as

infarction of the superior division of the middle
Contralateral inferior quadrantanopia ("pie on the floor") cerebral artery
Lesions involving the superior bank of the calcarine
fissure

Homonymous heminanopia with macular sparing Posterior cerebral artery infarction

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