Eyes

Breach of the eye

All eye movements in humans are normally binocular and integrated with the visual system in order to ensure the perception of three-dimensional space. Both eyes function as a unit and move in such a way as to ensure a stable view of the moving object and to ensure the stabilization of the visual image on the retina.

Interernal ophthalmoplegia

Intraocular ophthalmoplegia is a kind of disorder of horizontal eye movements that develops when the medial (posterior) longitudinal fasciculus is damaged (it provides a "bundle" of eyeballs in gaze movements) in the middle part of the variolium bridge at the level of nuclei III and VI with cranial nerves.

Acute ophthalmoplegia (ophthalmoparesis)

The main causes of acute ophthalmoplegia (an ophthalmoparesis): An aneurysm or vascular anomaly (hemorrhage or compression of the nerve) in the region of the connection of the posterior connective artery and internal carotid artery (oculomotor nerve) or anterior lower cerebellar and main arteries (abduction nerve).

Ophthalmoplegia (ophthalmoparesis)

Each eye moves (is rotated) by six muscles: four straight and two oblique. Disturbances in eye movements can be caused by injuries at different levels: the hemisphere, the stem, at the level of the cranial nerves and, finally, the muscles.

Disturbance of eye movements with doubling

The presence of double vision in the eyes of a patient with sufficient visual acuity implies the involvement of the eye muscles or oculomotor nerves or their nuclei in the pathological process. The deviation of the eyes from the neutral position (strabismus) is always noted, and can be detected by direct examination or with the use of instruments.

Disturbance of eye movements without twitching

If the violation of eye movements is not accompanied by double vision, then this presupposes a supranuclear character of the lesion, that is, eye violations. At a clinical examination, paralysis is found only with friendly eye movements, in both eyes the same deficiency of movements is detected, eyeballs remain parallel with the preservation of the direction of the eye.

Pupillary disorders and areflexia

When the pupil disorders are detected in the form of changes in the width, shape of the pupils, their response to light and convergence with accommodation, combined with the loss of deep reflexes from the extremities (at least Achilles reflexes), there is usually a suspicion of neurosyphilis. However, there are at least four other pathological conditions that should be borne in mind in the presence of this clinical picture.

Disturbance of pupillary reactions

The normal pupil always responds to light (direct and friendly reactions) and to convergence. This group of syndromes includes cyclic oculomotor paralysis, ophthalmoplegic migraine, benign episodic unilateral mydriasis and tadpole pupil (intermittent segmental spasm of the dilator lasting several minutes and repeating several times a day).

Irregular pupil size

Extended pupils (more than 5 mm in diameter) are called mydriasis. Narrowed pupils (less than 2 mm in diameter) are called miosis. Bilateral dilatation of pupils (mydriasis)

Dysplasia of pupils (anisocoria)

The study of pupils is of particular importance for the diagnosis of a large number of pathological conditions. To examine pupils in darkness (darkened room), turn off all light sources and hold a flashlight near the patient's chin, giving a quantity of scattered light so that the size of the pupil can be measured.

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