Unilateral visual loss.

Date:
1975
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Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

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Credit

Unilateral visual loss. Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Source: Wellcome Collection.

About this work

Description

Unilateral visual loss, particularly when it occurs in one eye, may defy detection until irreversible changes have occurred. This lecture by M.D. Sanders of the Institute of Neurology, University of London, sets out some of the underlying principles and techniques of the clinical examination of a patient with painless unilateral visual failure. Examination of the visual fields, central vision, and pupillary responses are demonstrated, and this is followed by three cases demonstrating causes of visual loss at different sites in the optic nerve. The three patients also demonstrate different pathogenic mechanisms of visual loss. The programme is made to emphasise the importance of early detection of visual loss, to demonstrate the simple diagnostic tests that can be performed by any physician, and finally to demonstrate some of the techniques now available to aid the diagnosis of localisation of lesions. 6 segments.

Publication/Creation

London : University of London Audio-Visual Centre, 1975.

Physical description

1 encoded moving image (36 min.) : sound, black and white.

Contributors

Duration

00:36:14

Copyright note

University of London

Terms of use

Unrestricted
CC-BY-NC
Creative Commons Attribution-Non-Commercial 2.0 UK: England & Wales

Language note

In English

Creator/production credits

Produced by Trevor A. Scott for ULTV.

Notes

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Contents

Segment 1 Mr Sanders introduces the film and discusses the structure of the eye, and how it is vulnerable to lesions resulting in visual loss. He stresses the importance of the opthamologist in diagnosing these conditions. He explains the structure of the eye and how visual information passes into it. He says he will concentrate in this film on the painless causes of visual loss in the retina, the optic disc and the optic nerve. He explains what happens when light enters the eye, and how rods and cones in the retina interpret information. He then describes some ways in which damage to fibres in the eye can result in visual loss, and the way in which the eye is supplied with blood. Time start: 00:00:00:00 Time end: 00:05:53:03 Length: 00:05:53:03
Segment 2 Mr Sanders explains the important principles of ocular examinations, how to give a proper eye test, why the letters on eye test charts are the size they are, and how to work out how good the patient's vision is. He runs through all the main eye tests, including far vision, near vision, the pinhole test, the colour blindness test and also demonstrates the peripheral vision test with a real patient. Time start: 00:05:53:03 Time end: 00:12:06:19 Length: 00:06:13:15
Segment 3 Mr Sanders next explains how to test for lesions, with different sized objects being brought into the vision. He also explains how to test pupillary responses with light tests. Next, how to conduct eye investigations using examination with a Fundus camera and red free photography and Fluorescein photography. The results are shown of a test subject who has had fluorescent dye injected, which then shows up in the veins in the eye. Time start: 00:12:06:19 Time end: 00:18:41:01 Length: 00:06:34:11
Segment 4 Next, how to test for visual evoked responses is demonstrated, with electrodes measuring a patient's visual impulses. Conduction down the optic nerve and the amplitude of impulses are measured. Mr Sanders lists some possible disorders of the optic nerve. He interviews a male patient. The patient lost the top half of the vision in his right eye. Mr Sanders performs eye tests on the subject and then discusses the result of the tests with the aid of large photographs. Time start: 00:18:41:01 Time end: 00:24:06:13 Length: 00:05:25:11
Segment 5 He explains the patient's condition of Ischaemic papillopathy, and the medical causes for this, which can include vessel wall arteritis, arteriosclerosis, polycytheamia, emboli and hypotension. Another patient is interviewed; he suffered rapid deterioration of vision in his right eye. Mr Sanders performs tests on the patient and then discussion the condition, retrobulbar neuritis, and the medical causes for this. Time start: 00:24:06:13 Time end: 00:29:59:00 Length: 00:05:52:16
Segment 6 The final patient is interviewed, this one with compression of the optic nerve. Mr Sanders tests the patient and explains the results, which showed the patient had a tumour, since removed by operation. Mr Sanders explains compression of the optic nerve and lists the possible causes and types of tumour associated with it. He concludes the programme by listing the various conditions that can affect the retina and optic nerve, and summarises all the patients' conditions. Time start: 00:29:59:00 Time end: 00:36:13:24 Length: 00:06:14:24

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