Professional Documents
Culture Documents
& visual
pathway
Dr. Tara M. Hassan
OPTIC NERVE
Anatomy
Afferent fibres. The optic nerve carries
approximately 1.2 million afferent nerve
fibres, each of which originates in a retinal
ganglion cell. Most of these synapse in the
lateral geniculate body, although some
reach other centres, notably the pretectal
nuclei in the midbrain. Within the optic
nerve itself the nerve fibres are divided into
about 600 bundles by fibrous septae derived
from the pia mater.
2
Surrounding layers
The innermost layer is the
delicate and vascular pia mater.
The outer sheath comprises the
arachnoid mater and the tougher
dura mater which is continuous
with the sclera; optic nerve
fenestration involves incision of
this outer sheath. The
subarachnoid space is continuous
with the cerebral subarachnoid
space and contains CSF.
4
Anatomical subdivisions
The optic nerve is approximately 50 mm
long from globe to chiasm. It can be
subdivided into four segments:
Intraocular segment (optic nerve head)
is the shortest, being 1 mm deep and
approximately 1.5 mm in vertical diameter.
The ophthalmoscopically visible portion is
called the optic disc.
Intraorbital segment is 2530 mm long
and extends from the globe to the optic
foramen at the orbital apex. Its diameter is
34 mm because of the addition of the
myelin sheaths to the nerve fibres.
5
12
13
15
Postgeniculate Structures
accidents
Classic migraine
Occipital trauma
17
clinical problems:
18
19
papilloedema
Papilloedemaisdefinedasswellingoftheopticnerve
headsecondarytoraisedintracranialpressure.Itis
nearlyalwaysbilateralalthoughitmaybe
asymmetrical.Allothercausesofdiscoedemanot
associatedwithraisedintracranialpressure(e.g.optic
papillitis,centralretinalveinocclusion)arereferredto
as'discswelling'andusuallyproducevisual
impairment.Allpatientswithpapilloedemashouldbe
suspectedofhavinganintracranialmassuntilthereis
prooftothecontrary.notallpatientswithpapilloedema
willhaveatumour,assomemayhavebenign
intracranialhypertensionorotherpathology.
Papilledema.
A. Papilledema of raised intracranial