Pupil block in aphakic eyes.
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BACKGROUND: The normal pupillary constriction to light is an involuntary reflex that can be easily elicited and observed without specialized equipment or discomfort to the patient. Attenuation of this reflex in optic nerve disorders was first described 120 years ago. Since then, pupil examination has become a routine part of the assessment of optic nerve disease. CLINICAL TECHNIQUES: The original cover/uncover test compares pupillomotor drive in the two eyes, but requires two working pupils and is relatively insensitive. The swinging flashlight test is now the standard clinical tool to detect pupillomotor asymmetry. It requires only one working pupil, is easily quantified, and has high sensitivity in experienced hands, but interpretation of the results needs care. Measurement of the pupil cycle time is the only clinical test that does not rely on comparison with the fellow eye, but it can only be measured in mild to moderate optic nerve dysfunction, is more time consuming, and less sensitive. LABORATORY TECHNIQUES: Infrared video pupillography allows recordings to be made of the pupil responses to full-field or perimetric light stimulation under tightly controlled conditions with a high degree of accuracy. Frustratingly, there is a wide range in reflex gain in normal subjects limiting its usefulness unless comparison is made with the fellow eye or stimulation of unaffected adjacent areas of the visual field. CORRELATION WITH OTHER TESTS: In general, pupillomotor deficit shows good correlation with visual field deficit. However, some diseases of the optic nerve are associated with relative sparing either of pupil function or visual function implying that pupil tests and psychophysical tests may assess function in different subpopulations of optic nerve fibres. Less is known of the relationship between pupil measurements and electrodiagnostic tests. USES IN CLINICAL PRACTICE: Pupil assessment is invaluable when distinguishing functional from organic visual loss. Its usefulness in distinguishing between different causes of optic neuropathy and as a prognostic sign is gradually emerging.
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The present study examined the role of the developmental coordination disorder in 154 children's socialization and the expression of deviant behaviors in the context of Greek primary education. For assessment of their motor coordination, the Movement Assessment Battery for Children of Henderson and Sugden was used. The peer nomination method (sociogram) was used for the estimation of children's social status, and the expression of deviant behaviors was assessed via Conners' Teacher Questionnaire. Analyses showed that developmental coordination disorder was associated with poor socialization and the expression of deviant behaviors. These findings support the development of educational programs to include children with poor motor coordination.
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Combining an understanding of neuro-ophthalmologic anatomy with proper imaging techniques provides a powerful method to detect lesions involving the afferent and efferent visual pathways. Precise documentation of the extent of injury within the nervous system is becoming increasingly important to assess and monitor the effect of neurologic therapies. This review will focus on those common neuro-ophthalmologic problems that have exquisite localizing value on neuro-imaging.