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Вуз:

Ростовский Государственный Медицинский Университет

Предмет:

Медицина общая

Файл:

Illustrated Tutorials in Ophthalmology Kanski, Bolton 2001

.pdf

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28.03.2026

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Recent right sixth nerve palsy

Right esotropia in primary position due to unopposed action of right medial rectus

Marked limitation of right abduction due to right lateral rectus weakness

Hess chart of recent right sixth nerve palsy

•Contraction of right chart and expansion of left

•Right chart - marked underaction of lateral rectus and mild overaction of medial rectus

•Left chart - marked overaction of medial rectus

Old right sixth nerve palsy

Straight in primary position due to partial recovery


Limitation of right abduction and	Normal right adduction
horizontal diplopia

Important causes of isolated sixth nerve palsy

Vascular - hypertension, diabetes

Raised intracranial pressure

Acoustic neuroma

Dilated

ventricles

Petrous tip

Brainstem pushed downwards

DISORDERS OF THE CHIASM

1.Anatomy

2.Pituitary adenomas

•Basophil adenoma

•Acidophil adenoma

•Chromophobe adenoma

3.Craniopharyngioma

4.Meningioma

Anatomy of chiasm and pituitary gland

Upper nasal fibres

Macular fibres

Lower nasal fibres

Anterior clinoid

Pituitary gland

III rd ventricle

Craniopharyngioma

Optic chiasm Diaphragma sellae

Posterior clinoid

Dorsum sellae

Normal anatomical variations

Central - 80%

Prefixed - 10%

Postfixed - 10%

Pituitary adenomas

Cushing syndrome

ACTH

Basophil

							l
						i
					h
				p
			o
		d
	i
c
A

Growth hormone

Acromegaly

Gigantism

Chromophobe PROLACTIN

Amenorrhoea Hypoglandism

Infertility Impotence

Galactorrhoea Infertility

Gynaecomastia

Galactorrhoea

Cushing syndrome


•	Moon face, pigmentation and	• Obesity, skin striae, bruising and
	hirsutism	muscle weakness
•	Hypertension and diabetes	• Ankle oedema and osteoporosis

Acromegaly


Enlargement of hands and feet	Enlargement of lower jaw

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