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VISUAL PATHWAY
Presenter :Dr. Ankita Lakhotiya
Moderator :Dr. Tanvi Haldipurkar
Key points
 Anatomy of different components of visual pathway
 Arrangement of visual fibers
 Lesions and its characteristics
Anatomy of different
components of visual pathway
Optic Nerve
Parts of optic nerve
 Intraocular (1 mm)
 Intraorbital (30 mm)
 Intracanalicular (6-
9mm)
 Intracranial (10 mm)
Intraocular part
 Passes through sclera ,
choroid and appears in
eye as optic disc
 Intraocular portion is
of 1.5mm which
expands to 3mm just
behind eye because of
myelin sheath
 ONH has 4 portions
Intraorbital part
 Extends back from eyeball
to optic foramina
 Covered by dura,
arachnoid and pia.
 Central retinal artery
enters nerve on its
inferomedial aspect about
10mm behind eyeball
 Some fibers of superior
rectus and medial rectus
are adherant to its sheath
so painful ocular
movements in retrobulbar
neuritis.
 Intracanalicular part
-6-9mm length
-closely related to ophthalmic artery
 Intracranial part
-10mm length
-above cavernous sinus and coverges with its fellow to
form chiasma
-covered by pia only
Optic Chiasma
 Flattened structure measuring
12mm Horizantally
8mm Anterio-posteriorly
 It lies over diaphragma sella
 Continues posteriorly as optic tracts and forms
anterior wall of third ventricle
 Nerve fibers arising from nasal halves of the two
retinae decussate at the chiasma
ANATOMICAL VARIATION
Optic Tracts
 Bundles of nerve fibers running outwards and
backwards from postero-lateral aspect of optic
chiasma
 Consist of temporal fibers of retina of same eye and
nasal half of opposite eye
 Each optic tract end in LGB
Lateral Geniculate Body
 Oval structures situated at termination of optic tract
 Each LGB consist six layers of neurons alternating
with white matter
 Each body is split into 6 laminae
 Fibers from Ipsilateral Temporal Retina End in
Lamina 2,3,5 and contralateral nasal retina end in
Lamina 1,4,6.
This 6 laminae divide LGB into 2 portions
Lateral geniculate body
Functions of LGB
Relay station to relay visual information from optic
tract to visual cortex
To gate transmission of signals to visual cortex
Optic Radiations
 Extend from LGB to visual cortex
 Fibers of optic radiation spreads out fanwise to form
medullary optic lamina
 Superior fibers of radiation ( which subserve inferior
field) proceed directly posteriorly through parietal
lobe
 Inferior fibers of
radiation ( which
subserve Superior
field) first sweep
anteriorly in meyers
loop around anterior
tip of temporal horn of
lateral ventricle and
then into temporal
lobe
Visual cortex
 Located on medial aspect of occipital lobe
 Subdivided into
-Visuosensory area (striate area 17)
-Visuopsychic area (striate area 18 and 19)
Arrangement of nerve fibers
Arrangement of nerve fibers
Retina
 Fibers from nasal half
come directly to optic
disc as srf and irf
 Fibers from temporal
half as saf and iaf
 Fibers from macular
region pass straight in
temporal part of optic
disc as pmb
Arrangement of nerve fibers
 Optic nerve
1. Optic nerve head
arrangement of fiber
exactly same as
retina
2. Distal region of optic
nerve
Arrangement of nerve fibers
3. Proximal region of
optic nerve
-macular fibers present
centraly
-Temporal fibers present
temporaly and nasal
fibers present nasally
Arrangement of nerve fibers
 Optic Chiasma
Temporal fibers from
retina remains
uncrossed and runs
backward in lateral
part of optic chaisma
Arrangement of nerve fibers
 Optic Chiasma
Nasal peripheral fibers-
 ¾ of fibers
 Cross over to enter medial part of
opposite optic tract in following
manner
lower nasal fibers in optic tract
traverse chiasma low and anteriorly
Upper nasal fibers in optic tract
trasverse chiasma high and
posteriorly
Arrangement of nerve fibers
 Optic Chiasma
Macular fibers-
 Some fibers crossed n
runs backward in
opposite optic tract
 Some fibers uncrossed
n runs on same side in
optic tract
Arrangement of nerve fibers
Optic Tract
 Macular fibers – occupy dorso-lateral aspect of the
optic tract
 Upper peripheral fibers – situated medially in the
optic tract
LGB
The macula fibers coming in the optic
tract occupy the posterior 2/3 of the LGB
Arrangement of nerve fibers
Optic tract LGB
Arrangement of nerve fibers
 Optic Radiations
 Upper retinal fibers – upper part of optic radiations
 Lower retinal fibers – lower part of optic radiations
 Macular fibers – central part of optic radiations
optic radiations visual cortex
OPTIC NERVE
 Lesion of optic nerve-
-characterised by complete blindness on affected side
-Absence of light reflex on ipsilateral side and
consensual on contralateral side
-Near reflex present
Cause: Traumatic optic avulsion,
Acute optic neuritis,
Optic atrophy.
OPTIC NERVE
 Lesion through proximal part of optic nerve-
- ipsilateral blindness on affected side
-Absence of light reflex on ipsilateral side and
consensual on contralateral side
-Near reflex present.
OPTIC CHIASMA
 Lesion of optic chaisma-
1.Central chiasmal lesion-
-Bitemporal hemianopia
-Bitemporal hemianopic paralysis of pupillary reflex
-Also leads to partial descending optic atrophy
Cause: Pituitary tumors
Craniopharyngioma,
Suprasellar aneurysm.
OPTIC CHIASMA
2.Lateral chiasma lesion-
- Binasal hemianopia
-Binasal hemianopic paralysis of pupillary reflex
-Also leads to partial descending optic atrophy
Cause: Internal carotid aneurysm,
Lesions causing distension of third ventricle
OPTIC TRACT
 Lesions of optic tract-
-Incongruous homonymous hemianopia
-contralateral hemianopia pupillary reaction(wernicke’s
reaction)
- partial descending optic atrophy
Causes- syphilitic meningitis or gumma, tuberculosis,
and tumors of optic thalamus.
LATERAL GENICULATE BODY
 Lesions of LGB-
- incongruous homonymous hemianopia
-sparing of light reflex or pupillary reflex
- Partial descending optic atrophy
OPTIC RADIATION
Features varies depending on site of lesion
1.Involvment of total optic radiation- complete
homonymous hemianopia ( more congruous )
OPTIC RADIATION
2. Involvement of part of optic radiation in
temporal lobe
- Superior quandrantic hemianopia ( pie in the sky)
OPTIC RADIATION
3. Involvement of part of optic radiation in parietal lobe
– Inferior quandrantic hemianopia (pie on the floor)
VISUAL CORTEX
 Lesions of visual cortex-
- Anterior occipital cortex
- Homonymous hemianopia(sparing macula)
- Cause – occlusion of posterior cerebral artery
Tip of occipital cortex
Homonymous hemianopia(macula defect)
Causes – head injury, gunshot injury involving tip of
cortex
Thank you

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Visual pathway

  • 1. VISUAL PATHWAY Presenter :Dr. Ankita Lakhotiya Moderator :Dr. Tanvi Haldipurkar
  • 2. Key points  Anatomy of different components of visual pathway  Arrangement of visual fibers  Lesions and its characteristics
  • 4.
  • 5. Optic Nerve Parts of optic nerve  Intraocular (1 mm)  Intraorbital (30 mm)  Intracanalicular (6- 9mm)  Intracranial (10 mm)
  • 6. Intraocular part  Passes through sclera , choroid and appears in eye as optic disc  Intraocular portion is of 1.5mm which expands to 3mm just behind eye because of myelin sheath  ONH has 4 portions
  • 7. Intraorbital part  Extends back from eyeball to optic foramina  Covered by dura, arachnoid and pia.  Central retinal artery enters nerve on its inferomedial aspect about 10mm behind eyeball  Some fibers of superior rectus and medial rectus are adherant to its sheath so painful ocular movements in retrobulbar neuritis.
  • 8.  Intracanalicular part -6-9mm length -closely related to ophthalmic artery  Intracranial part -10mm length -above cavernous sinus and coverges with its fellow to form chiasma -covered by pia only
  • 9. Optic Chiasma  Flattened structure measuring 12mm Horizantally 8mm Anterio-posteriorly  It lies over diaphragma sella  Continues posteriorly as optic tracts and forms anterior wall of third ventricle  Nerve fibers arising from nasal halves of the two retinae decussate at the chiasma
  • 11.
  • 12. Optic Tracts  Bundles of nerve fibers running outwards and backwards from postero-lateral aspect of optic chiasma  Consist of temporal fibers of retina of same eye and nasal half of opposite eye  Each optic tract end in LGB
  • 13. Lateral Geniculate Body  Oval structures situated at termination of optic tract  Each LGB consist six layers of neurons alternating with white matter  Each body is split into 6 laminae  Fibers from Ipsilateral Temporal Retina End in Lamina 2,3,5 and contralateral nasal retina end in Lamina 1,4,6. This 6 laminae divide LGB into 2 portions
  • 15. Functions of LGB Relay station to relay visual information from optic tract to visual cortex To gate transmission of signals to visual cortex
  • 16. Optic Radiations  Extend from LGB to visual cortex  Fibers of optic radiation spreads out fanwise to form medullary optic lamina  Superior fibers of radiation ( which subserve inferior field) proceed directly posteriorly through parietal lobe
  • 17.  Inferior fibers of radiation ( which subserve Superior field) first sweep anteriorly in meyers loop around anterior tip of temporal horn of lateral ventricle and then into temporal lobe
  • 18. Visual cortex  Located on medial aspect of occipital lobe  Subdivided into -Visuosensory area (striate area 17) -Visuopsychic area (striate area 18 and 19)
  • 20. Arrangement of nerve fibers Retina  Fibers from nasal half come directly to optic disc as srf and irf  Fibers from temporal half as saf and iaf  Fibers from macular region pass straight in temporal part of optic disc as pmb
  • 21. Arrangement of nerve fibers  Optic nerve 1. Optic nerve head arrangement of fiber exactly same as retina 2. Distal region of optic nerve
  • 22. Arrangement of nerve fibers 3. Proximal region of optic nerve -macular fibers present centraly -Temporal fibers present temporaly and nasal fibers present nasally
  • 23. Arrangement of nerve fibers  Optic Chiasma Temporal fibers from retina remains uncrossed and runs backward in lateral part of optic chaisma
  • 24. Arrangement of nerve fibers  Optic Chiasma Nasal peripheral fibers-  ¾ of fibers  Cross over to enter medial part of opposite optic tract in following manner lower nasal fibers in optic tract traverse chiasma low and anteriorly Upper nasal fibers in optic tract trasverse chiasma high and posteriorly
  • 25. Arrangement of nerve fibers  Optic Chiasma Macular fibers-  Some fibers crossed n runs backward in opposite optic tract  Some fibers uncrossed n runs on same side in optic tract
  • 26. Arrangement of nerve fibers Optic Tract  Macular fibers – occupy dorso-lateral aspect of the optic tract  Upper peripheral fibers – situated medially in the optic tract LGB The macula fibers coming in the optic tract occupy the posterior 2/3 of the LGB
  • 27. Arrangement of nerve fibers Optic tract LGB
  • 28. Arrangement of nerve fibers  Optic Radiations  Upper retinal fibers – upper part of optic radiations  Lower retinal fibers – lower part of optic radiations  Macular fibers – central part of optic radiations
  • 30.
  • 31. OPTIC NERVE  Lesion of optic nerve- -characterised by complete blindness on affected side -Absence of light reflex on ipsilateral side and consensual on contralateral side -Near reflex present Cause: Traumatic optic avulsion, Acute optic neuritis, Optic atrophy.
  • 32. OPTIC NERVE  Lesion through proximal part of optic nerve- - ipsilateral blindness on affected side -Absence of light reflex on ipsilateral side and consensual on contralateral side -Near reflex present.
  • 33. OPTIC CHIASMA  Lesion of optic chaisma- 1.Central chiasmal lesion- -Bitemporal hemianopia -Bitemporal hemianopic paralysis of pupillary reflex -Also leads to partial descending optic atrophy Cause: Pituitary tumors Craniopharyngioma, Suprasellar aneurysm.
  • 34. OPTIC CHIASMA 2.Lateral chiasma lesion- - Binasal hemianopia -Binasal hemianopic paralysis of pupillary reflex -Also leads to partial descending optic atrophy Cause: Internal carotid aneurysm, Lesions causing distension of third ventricle
  • 35. OPTIC TRACT  Lesions of optic tract- -Incongruous homonymous hemianopia -contralateral hemianopia pupillary reaction(wernicke’s reaction) - partial descending optic atrophy Causes- syphilitic meningitis or gumma, tuberculosis, and tumors of optic thalamus.
  • 36. LATERAL GENICULATE BODY  Lesions of LGB- - incongruous homonymous hemianopia -sparing of light reflex or pupillary reflex - Partial descending optic atrophy
  • 37. OPTIC RADIATION Features varies depending on site of lesion 1.Involvment of total optic radiation- complete homonymous hemianopia ( more congruous )
  • 38. OPTIC RADIATION 2. Involvement of part of optic radiation in temporal lobe - Superior quandrantic hemianopia ( pie in the sky)
  • 39. OPTIC RADIATION 3. Involvement of part of optic radiation in parietal lobe – Inferior quandrantic hemianopia (pie on the floor)
  • 40. VISUAL CORTEX  Lesions of visual cortex- - Anterior occipital cortex - Homonymous hemianopia(sparing macula) - Cause – occlusion of posterior cerebral artery Tip of occipital cortex Homonymous hemianopia(macula defect) Causes – head injury, gunshot injury involving tip of cortex
  • 41.