NEUROPHYSIOLOGY OF

EYE
VISUAL ACUITY,
ACCOMMODATION,
PUPILLARY REFLEXES,
VISUAL PATHWAYS,
INTRAOCULAR PRESSURE.
 VISUAL ACUITY,
• It is the most important criterion of testing
the functional integrity of the eye

• Distance vision is assessed from 6

meters.

• Near vision- 14 inches from the eye.

 VISUAL ACUITY,
V A of infants and children
• Age • Snellen’s acuity
6-8weeks (20/600) 6/1800

5 months (20/60) 6/18

18-24 months (20/40) 6/12

2-3 years (20/30) 6/9

>3 years (20/20) 6/6

 VISUAL ACUITY,
• V A of infants and children
-Occlude one eye and observe the
behaviour
-Cover test for fixation

-Electroretinogram (ERG)

-Visual evoked response (VER)

-Opticokinetic nystagmus (OKN)

 VISUAL ACUITY,
V A of infants and children Very young and infants
 VISUAL ACUITY
V A of infants and children Very young and infants
VISUAL ACUITY,
 VISUAL ACUITY,
V A of infants and children (6 months old and above)
VISUAL ACUITY,
 VISUAL ACUITY,
V A of infants and children (2-3 years)
VISUAL ACUITY,
 VISUAL ACUITY,
V A of infants and children (Preschool children)
 VISUAL ACUITY,

Adult –with snellen’s visual acuity chart

VISUAL ACUITY,
VISUAL ACUITY,
VISUAL ACUITY,

Near visual acuity

 The pupil
• NEAR REACTION HAS A TRIAD OF
ACTIONS.
-Convergence of eyes

-Accommodation of the lenses

-Miosis of the pupil

 The pupil
• Accommodation-
Function of:-
-inner radial muscle
-outer longitudinal muscle of
cillary body
*contraction of the round muscle shortens
the diameter of circle
*Lens by virtue of its own elasticity tends
to assume a more spherical shape
for near objects
 Accommodation
• The refractive power of the lens 20 diopters

can be increased up to 54 diopters in

young Stress on the suspensory ligaments

change the shape of the lens

contraction of circular muscle- spherical
lens
it increases its refractive power –capable of focusing on near objects.
relaxation of circular muscle -flat lens
for distance vision
• Controlled by parasympathetic supply
 Pupillary reflexes
• Iris
increase the amount of light that enters
the eye during dull illumination
decrease the amount of light that enters
the eye in bright illumination

• By changing the size of the pupil

Pupillary reflexes
Pathway of the pupillary light reflex
Light & near input to EW nucleus
 Presbyopia
• When a person is old
lens grows larger and thicker
loosing its elasticity
lens remains totally non-accommodating

to see near –use hypermetropic correction

(+ diopteric lens)
Oculo sympathetic pathway
7th nerve& lacrimal gland innervations
NEUROPHYSIOLOGY
NEUROPHYSIOLOGY
 Intraocular pressure
• Aqueous secretion
* Active secretion
80% of aqueous production
by nonpigmented ciliary
epithelium
via active metabolic process
*Passive secretion
20% of production
ultrafiltration,diffusion
depend on
BP,plasma oncotic pressure& IOP
 Intraocular pressure
• Factors determine the level of IOP
Rate of aqueous secretion
Resistance encountered in the outflow
channels
Level of episcleral venous pressure

• Normal IOP
10mmHg to 21mmHg
• Diurnal variation
high IOP in the morning
lower in the afternoon
 Intraocular pressure
• Methods of examination
tonometry
*indentation- Schiotz tonometer
*applanation-Goldman
-The Perkins
-The air puff
-The Pulsair
-The Tono pen
 Noncontact
pulsair

Schiotz tonometer

perkins

tonopen