II. Background
- Vision is among the most complex neurologic functions of the human body
- Eye is a high-end camera
- Mechanisms to adjust aperture (pupil size) and focal length (lens shape)
- Projected onto a more than 500 Megapixel Retina
- Contains over 120 Million rods (black and white) and 6 Million cones (color Vision)
- One third of the Cranial Nerves (CN 2, 3, 4, 6) are dedicated to Vision, Extraocular Movement and pupillary reflex
- Most of the Occipital Lobe is dedicated to the processing of visual input
III. Anatomy: Visual Pathway
- Background
- Visual Field Overview
- Objects in the Visual Field are projected onto each eye's Retina as a mirror image
- Upper right Visual Field localizes to the lower left Retina of each eye
- Signals from each Retina follow the Optic Nerve to the Optic Chiasm, in the region of the Pituitary Gland
- Left Visual Field signals from each Retina (left medial and right lateral) join at Optic Chiasm
- Left Visual Field signals follow the Optic Nerve to the right Lateral Geniculate Body
- Right Lateral Geniculate Body signals follow right Optic Radiations
- Upper Visual Fields through the Temporal Lobe
- Lower Visual Fields through the Parietal Lobe)
- Signals terminate in the right Occipital Lobe visual cortex (Brodmann Area 17-19)
- Right Visual Fields are similarly routed to the left Occipital Lobe
- Light Pathway
- Light is refracted from Cornea and lens through pupil onto the Retina
- Light Refraction: Human eye refracts light at two locations
- See Refractive Error
- Cornea (66% of eye's focusing power)
- Fixed focusing power
- Non-Refractive Errors (e.g. Cataracts, Corneal opacities) may disrupt light pathway
- Crystalline lens (33% of eye's focusing power)
- Accommodation changes lens shape to focus objects
- Pupil is analogous to a camera aperture
- Shutter aperture decreases in size under bright light conditions and for sharper focus
- Pupil constricts under bright light and with near focus (e.g. reading) known as accomodation
-
Retina (each eye)
- Components
- Pathway
- Visual Field Deficits
- Scotomata
- Glaucoma (peripheral Vision Loss)
-
Optic Nerve (each eye)
- Components
- Pathway
- Optic Nerve fibers from the Retina lateral to the fovea course to the ipsilateral brain
- Optic Nerve fibers from the Retina medial to the fovea course to the contralateral brain
- Visual Field Deficits
- Complete loss of Vision from affected eye
- Example: Left Optic Nerve lesion results in complete blindness of the left eye, but the right eye is unaffected
- Optic Chiasm (central, near pituitary)
- Components
- Left Retinal fibers (right Visual Field) join from each eye, forming Optic Tract to left Cerebral Hemisphere
- Right Retinal fibers (left Visual Field) join from each eye, forming Optic Tract to right Cerebral Hemisphere
- Visual Field Deficits
- Bilateral loss of lateral Visual Fields
- Example: The left eye cannot see the left Visual Field and the right eye cannot see the right Visual Field
- Components
- Optic Tract (each hemisphere)
- Components
- Left Optic Tract
- Right Optic Tract
- Visual Field Deficits
- Vision Loss in each eye of the contralateral Visual Field
- Example: Left Optic Tract lesion results in a right sided Visual Field cut for each eye
- Components
- Lateral Geniculate Body (each hemisphere)
- Optic Radiation (each hemisphere)
- Components
- Parietal Lobe Optic Radiation
- Transmits superior Retina signals to Occipital Lobe above the calcarine fissure
- Temporal Lobe Optic Radiation
- Transmits inferior Retina signals to Occipital Lobe below the calcarine fissure
- Parietal Lobe Optic Radiation
- Visual Field Deficits
- Affected Optic Radiation results in a quarter segment Vision Loss
- Example: Left Parietal Optic Radiation defect results in a right upper Visual Field cut
- Components
-
Occipital Lobe (each hemisphere)
- Components
- Foveal (central Retina) is represented in the posterior Occipital Lobe
- Peripheral Retina is represented in the more anterior Occipital Lobe
- Visual Field Deficits
- Affected Occipital Lobe results in a quarter segment Vision Loss
- Central Vision (posterior Occipital Lobe)
- Peripheral Vision (anterior Occipital Lobe)
- Example: Left posterior occiput lesion above the calcarine fissure
- Results in a right upper, central Visual Field cut
- Affected Occipital Lobe results in a quarter segment Vision Loss
- Components
IV. Anatomy: Images
- See Extraocular Movement
- See Retinal Anatomy
- Nerves
- Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
- Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
- Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
- Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
- Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
- Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
- Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
- Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
V. References
- Goldberg (2014) Clinical Neuroanatomy, Medmaster, p. 40-54
- Netter (1997) Atlas Human Anatomy, ICON Learning, p. 114, 126