2014 Vision

Critical facts iconCRITICAL FACTS:
(if med school is a Minnesota forest with millions of trees, these are the red pines)

  1. There are two fundamental protective mechanisms for the eye. Regulation of eyelid position (including BLINKING) involves striated (ACh; nicotinic) and smooth (NE; α1 adrenergic) muscles.  TEAR PRODUCTION occurs spontaneously (basal), reflexly or in response to emotional stimuli, and is partially regulated by the parasympathetic nervous system (ACh; muscarinic).  EPIPHORA (overflow of tears) can be due to either overproduction or blocked drainage.

  2. The cornea and lens focus light on the retina; the cornea has greater refractive power but the focusing power of the lens can be adjusted to allow near vision (accomodation).  Refractive errors include cataracts, hyperopia, myopia, presbyopia and astigmatism.

  3. Objects in the LEFT VISUAL FIELD are detected by cells in the LEFT NASAL RETINA and the RIGHT TEMPORAL RETINA.  Cells in the visual pathway maintain the topographic map established in the retina with ONE SIGNIFCANT MODIFICATION: information from the NASAL retinas CROSSES IN THE OPTIC CHIASM, ensuring that information from the left visual field is processed in the right visual cortex.

  4. Light intensity is regulated by the PUPILLARY LIGHT REFLEX, which causes MIOSIS as a result of parasympathetic stimulation of the sphincter pupillae muscles (muscarinic receptors).  MYDRIASIS results from sympathetic stimulation (α1 receptors) that activates the dilator pupillae muscles.

  5. Increased intraocular pressure can cause permanent vision loss. Closed angle glaucoma is a medical emergency and is caused by blockage of fluid outflowOpen angle glaucoma (a more slowly developing problem that is more common) results from either an increase in aqueous humour production or a blockage of outflow.

  6. Rods are responsible for SCOTOPIC vision (the monochromatic vision that occurs in low light).  The three types of cones (blue, green and red; or Short, Medium and Long wavelength) have better temporal and spatial resolution than rods, making PHOTOPIC VISION better for discrimination of surfaces and movement under bright light conditions.

  7. The ability to discriminate fine details of the visual scene is termed VISUAL ACUITY.  Three types are recognized:  SPATIAL, TEMPORAL and SPECTRAL.  Visual acuity is primarily a function of the cone system.

  8. PHOTOTRANSDUCTION occurs via a 4 step process that uses a 2nd messenger cascade to amplify the signal.  In rods, activation of rhodopsin ultimately results in the closure of cyclic nucleotide gated Na+ channels, and hyperpolarization of the photoreceptor.

  9. The VISUAL CYCLE consists of bleaching and recycling of 11-cis-retinol between the photoreceptors and the retinal pigment epithelium (RPE).  It is a key component of dark adaptation in rods and is disrupted in vitamin A deficiency, and macular degeneration.
Email: Dr. Janet Fitzakerley | ©2014 University of Minnesota Medical School Duluth | Last modified: 9-feb-14 7:14 PM