The ocular motor network is controlled by supranuclear centres that help coordinate all ocular motility, including saccades, pursuit, vergence and vestibular movements. This control may be disrupted in congenital or acquired disorders that lead to characteristic syndromes that are described in this chapter.
KeywordsSupranuclear Parinauds Dorsal midbrain Internuclear ophthalmoplegia Ocular tilt reaction Skew deviation
A wheelchair bound patient with a right exotropia that alternates freely on a cover test. On Dextroversion there is limitation of left adduction and ataxic nystagmus of the right eye. On levoversion, there is limitation of left adduction and ataxic nystagmus of the left eye, suggestive of bilateral wall eyed internuclear ophthalmoplegia
A 25 year old woman with complaints of episodic oscillopsia. On switching on the slit lamp beam, the right eye exhibits bursts of spasmodic, involuntary intorsion with intermittent depression of the eye
- 4.Feroze KB, Bhimji SS. Parinaud syndrome. [Updated 2017 Oct 6]. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2018.Google Scholar
- 6.Kirkpatrick CA, Thurtell MJ. Ocular tilt reaction: 53-year-old female complaining of vertical diplopia following a stroke and found to have a skew deviation, fundus torsion, and torticollis. 2014. http://EyeRounds.org/cases/200-OTR.htm.
- 7.Manoj V. Parulekar. Head position–dependent changes in ocular torsion and vertical misalignment in skew deviation. Arch Ophthalmo. 2008;126(7):899–905.Google Scholar