
Contents
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1. Nerve innervation of intraocular muscles 1. Nerve innervation of intraocular muscles
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A. Light reflex and convergence reflex A. Light reflex and convergence reflex
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B. Sympathetic nervous system and Horner syndrome B. Sympathetic nervous system and Horner syndrome
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C. Accommodation and its abnormality C. Accommodation and its abnormality
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2. Examination of intraocular muscles 2. Examination of intraocular muscles
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A. Oculomotor nerve palsy and Horner syndrome A. Oculomotor nerve palsy and Horner syndrome
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B. Examination of the light reflex and its abnormality B. Examination of the light reflex and its abnormality
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C. Special abnormal findings of pupils C. Special abnormal findings of pupils
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D. Examination of the convergence reflex D. Examination of the convergence reflex
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E. Examination of accommodation E. Examination of accommodation
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Bibliography Bibliography
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8. C8Pupils and accommodation
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Published:August 2022
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Abstract
There are two kinds of muscles in the eyes: extraocular muscles, which move the ocular bulb, and intraocular muscles, which are innervated by the autonomic nervous system. The intraocular muscles have two functions; one controls the diameter of pupils and the other controls thickness of the lens (accommodation). For examining the ocular muscles, we can start from either muscle, but it is practical to examine the intraocular muscles first in order to avoid overlooking them by examining the extraocular muscles first. First, the shape and diameter of pupils should be observed, paying special attention to possible asymmetry between the two eyes. Asymmetry of pupillary diameter is called anisocoria. A pathologically large pupil is called mydriasis, and a pathologically small pupil is called miosis.
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