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The reflex, controlled by the parasympathetic nervous system, involves three responses: pupil constriction, lens accommodation, and convergence. A near object (for example, a computer screen) subtends a large area in the visual field, i.e. the eyes receive light from wide angles. When moving focus from a distant to a near object, the eyes converge.
Convergence of the eyes, or the orientation of the visual axis of each eye towards an object in order to focus its image on each fovea, is the first of the three responses. This can be observed by the cross-eyed movement of the eyes when a finger is held up in front of a face and moved towards the face. Next, constriction of the pupil occurs.
Clinically, accommodative convergence is measured as a ratio of convergence, measured in prism diopters, to accommodation, measured in diopters of near demand. The patient is instructed to make a near target perfectly clear and their phoria is measured as the focusing demand on the eye is changed with lenses.
Accommodation usually acts like a reflex, including part of the accommodation-convergence reflex, but it can also be consciously controlled. The main ways animals may change focus are: Changing the shape of the lens. Changing the position of the lens relative to the retina. Changing the axial length of the eyeball. Changing the shape of the cornea.
Adie's pupil is caused by damage to peripheral pathways to the pupil (parasympathetic neurons in the ciliary ganglion that cause pupillary constriction to bright light and with near vision). The pathophysiologic mechanism which produces an Argyll Robertson pupil is unclear, but is believed to be the result of bilateral damage to the pretectal ...
The Edinger-Westphal nucleus moderates pupil dilation and aids (since it provides parasympathetic fibers) in convergence of the eyes and lens adjustment. [21] Nuclei of the optic tract are involved in smooth pursuit eye movement and the accommodation reflex, as well as REM.
Pupillary response is a physiological response that varies the size of the pupil between 1.5 mm and 8 mm, [1] via the optic and oculomotor cranial nerve. A constriction response ( miosis ), [ 2 ] is the narrowing of the pupil, which may be caused by scleral buckles or drugs such as opiates / opioids or anti-hypertension medications.
Gaze-stabilising movement may include the vestibulo-ocular reflex and optokinetic reflex, and gaze-shifting mechanisms as saccades and pursuit movements. Vergence movement or convergence is the movement of both eyes to make sure that the image of the object being looked at falls on the corresponding spot on both retinas.