Visual
pathway
Vishal Bhatia
Roll No.119
Contents
ANATOMY
Neurons of Visual Pathway
Optic Nerve
Optic Chiasma,
Optic Tracts
Lateral Geniculate Bodies
Optic Radiations
Visual Cortex
BLOOD SUPPLY
PATHWAY OF VISUAL SENSATIONS VERSUS
SOMATIC SENSATIONS
LESIONS OF THE VISUAL PATHWAY
ANATOMY
Components of the visual pathway.
Neurons of Visual Pathway
First order neurons : Bipolar cells
Receive sensations from photoreceptors
Pass on to ganglion cells
Second order neurons : Ganglion cells
Their axons form: nerve fiber layer of retina, optic nerves, optic chiasma and optic tracts.
Pass on sensations to Lateral Geniculate body
Third order neurons : Lateral geniculate body
Form optic radiations
Transmit sensations to neurons of visual cortex.
OPTIC NERVE
starts from the optic disc
extends up to optic chiasma
also contains the afferent fibres of the pupillary light reflex
fibres of optic nerve, number about a million, are very fine (2-10 µm in diameter as compared
to 20 µm of sensory nerves)
Meningeal sheaths:
Pia mater, arachnoid and dura covering the brain are continuous over the optic nerves.
The subarachnoid and subdural spaces are also continuous
Parts of optic nerve. The optic nerve is about 47-50
mm in length, and can be divided into 4 parts:
1. Intraocular part (1 mm) through starts from optic disc and pierces the sclera(lamina
cribrosa).
2. Intraorbital part (30mm) extends from back of the eyeball to the optic foramina. Some
fibres of superior rectus muscle are adherent to its sheath here, and accounts for the
painful ocular movements seen in retrobulbar neuritis.
3. Intracanalicular part (6-9 mm) is closely related to the ophthalmic artery(inferolateral)
and crosses obliquely over it, as it enters the orbit, to lie on its medial side. This
accounts for retrobulbar neuritis following infection of sinuses.
4. Intracranial part (10 mm) of the optic nerve lies above the cavernous sinus and
converges with its fellow (over the diaphragma sellae) to form the optic chiasma.
OPTIC CHIASMA
Flattened structure
12 mm horizontally and 8 mm anteroposteriorly.
Directly above Diaphragma sellae
Therefore justifies visual field defects in patient with pituitary tumor
(suprasellar extension).
Fibres originating at nasal halves of the retina decussate at the chiasma.
OPTIC TRACT
cylindrical bundles of nerve fibres
running outwards and backwards from the posterolateral aspect of the optic
chiasma
consists of fibres from the temporal half of the retina of the same eye and
the nasal half of the opposite eye
ends in the lateral geniculate body
LATERAL GENICULATE BODIES
Oval structures situated at the posterior termination of the optic tracts.
Consists of six layers of neurons (grey matter)
Alternating with white matter (formed by optic fibres)
The fibres of second-order neurons coming via optic tracts relay in these
neurons.
OPTIC RADIATIONS
Extend from the lateral geniculate bodies to the visual cortex
Consist of the axons of third-order neurons of visual pathway.
VISUAL CORTEX
Located on the medial aspect of the occipital lobe
Above and below the calcarine fissure
Subdivided into:
the visuosensory area (striate area 17)
and the surrounding visuopsychic area (peristriate area 18 and
parastriate area 19)
BLOOD SUPPLY
mainly supplied by pial network of vessels
except the orbital part of optic nerve which is also supplied by an axial
system derived from the central artery of retina
The pial plexus around different parts of the visual pathway gets contribution
from different arteries as shown
Blood supply of the optic nerve head
The surface layer of the optic disc is supplied by capillaries derived from the retinal arterioles
The prelaminar region is mainly supplied by centripetal branches of the peripapillary choroid
The lamina cribrosa is supplied by branches from the posterior ciliary arteries and arterial circle of Zinn.
The retrolaminar part of the optic nerve is supplied by centrifugal branches from retinal artery and
centripetal branches from the choroidal arteries, circle of Zinn, central retinal artery and ophthalmic artery.
Pathway of visual sensations vs
somatic sensations
(A) The path of somaesthetic sensation (B) The visual pathway.
LESIONS OF VISUAL
PATHWAY
Lesions of optic nerve
Distal part of optic nerve (1)
Complete blindness on affected side
Associated with abolition of the direct light reflex on the ipsilateral
side and consensual on the contralateral side
Proximal part of optic nerve (2)
Ipsilateral blindness
Contralateral superotemporal quadrantanopia
Associated with abolition of the direct light reflex on the ipsilateral
side and consensual on the contralateral side.
Chiasmal lesions
Anterior chiasmal
syndrome (3) Middle chiasmal
syndrome (4)
Central scotoma in one eye
Bitemporal hemianopia
Temporal hemianopia in other
eye
Lesions of the optic tract (7)
characterised by incongruous homonymous hemianopia
Common causes are
Intrinsic: demyelinating diseases and infarction.
Extrinsic: pituitary adenomas, craniopharyngioma
Others: syphilitic meningitis, gumma, tubercular meningitis.
Lesions of lateral geniculate body
These produce homonymous hemianopia
sparing of pupillary reflexes
Lesions of Optic radiations
1. Involvement of total optic radiations (10) :
homonymous hemianopia (sometimes sparing the macula)
2. Lesions of parietal lobe (9) :
Inferior quadrantic hemianopia (pie on the floor)
Superior fibres involved.
3. Lesions of temporal lobe (8) :
Superior quadratic hemianopia (pie in the sky)
Inferior fibres involved
Common lesions include
vascular occlusions
primary and-secondary tumours
trauma.
Lesions of Visual Cortex (11)
Congruous homonymous hemianopia (usually sparing the macula) is a feature of
occlusion of posterior cerebral artery supplying the anterior part of occipital
cortex.
Pupillary light reflexes are normal
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