Ophthalmology Book

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Miosis

Aka: Miosis, Pupil Constriction, Consensual Light Reaction, Near Reaction, Visual Accommodation
  1. Physiology: Pupil Constriction as a normal response
    1. Parasympathetic stimulation
      1. Parasympathetic fibers course with CN 3
      2. Parasympathetic fibers originate in Edinger-Westphal Nucleus and transmit to ciliary Ganglion
    2. Bright light results in bilateral Pupil Constriction
      1. Direct reaction to light in exposed eye
        1. Light strikes Retina of affected eye
        2. Signal passed via Optic Nerve to Midbrain
        3. CN 3 associated parasympathetic fibers signal same iris to constrict
      2. Consensual Light Reaction in opposite eye
        1. Midbrain receives signal from exposed eye
        2. CN 3 associated parasympathetic fibers signal opposite iris to constrict
    3. Accommodation
      1. Visual focusing
        1. Near Reaction (e.g. Reading)
          1. Also results in eye convergence (under CN 3 control as well)
      2. Pathway
        1. Ciliary body smooth muscle contracts
        2. Lens changes shape (more convex)
        3. Pupil constricts during accommodation to aid focusing
        4. Both ciliary body contraction and Pupil Constriction are mediated by CN 3 related parasympathetic fibers
        5. Visual cortex controls accommodation as part of a reflex loop based on Optic Nerve signals
  2. Causes: Abnormal Miosis
    1. Horner's Syndrome
    2. Mnemonic: COPS
      1. Cholinergic Toxicity
      2. Clonidine
      3. Opioids (e.g. Heroin, Morphine)
      4. Organophosphate Toxicity
      5. Phenothiazines
      6. Pilocarpine
      7. Pontine bleed or lesion
      8. Sedative-Hypnotics (e.g. Benzodiazepines)
  3. Causes: Other Abnormalities
    1. Syphilitic Pupil (Argyll-Robertson Pupil, Prostitute's Pupil)
      1. Pupil constricts during accommodation, but does not constrict to light

Visual Accommodation (C0000936)

Definition (MSH) The dioptric adjustment of the EYE (to attain maximal sharpness of retinal imagery for an object of regard) referring to the ability, to the mechanism, or to the process. Ocular accommodation is the effecting of refractive changes by changes in the shape of the CRYSTALLINE LENS. Loosely, it refers to ocular adjustments for VISION, OCULAR at various distances. (Cline et al., Dictionary of Visual Science, 4th ed)
Definition (PSY) Process of focusing an image on the retina by means of a flattening or bulging of the lens.
Definition (CSP) adjustment of the lens of the eye for various distances.
Concepts Clinical Attribute (T201)
MSH D000065
SnomedCT 251776000, 28365007, 246718000
English Accommodation, Ocular, eye accommodation, Visual Focusing, Visual accommodation, Accommodation, Acc - Accommodation, focusing, accommodation, accommodations, ocular accommodation, accommodation eye, accommodations eye, visual accommodation, Visual accommodation (observable entity), Ability to change between near and distance vision, Ocular accommodation, Ocular accommodation (observable entity), Visual Accommodation, Visual accommodation, NOS, Focusing (Visual), Eye Accommodation, Ocular Accommodation, Distance Accommodation, Ocular, Ocular Distance Accommodations, Ocular Distance Accommodation, Accommodation, Ocular Distance
Spanish acomodación, acomodación visual (entidad observable), acomodación visual, acomodación ocular (entidad observable), acomodación ocular, Acomodación Ocular
French Accommodation de l'oeil, Accommodation des yeux, Accommodation oculaire
Swedish Ackommodationsförmåga
Czech akomodace oční
Finnish Silmien mukautuminen
Russian AKKOMODATSIIA GLAZA, АККОМОДАЦИЯ ГЛАЗА
Japanese 眼球調節作用, 眼の調節, 調節作用-眼球, 調節-眼
Polish Akomodacja, Nastawność oka, Akomodacja oka
Norwegian Akkommodasjon, Akkommodasjon, øye
German Augenakkomodation, Akkomodation, okuläre
Italian Accomodazione oculare
Dutch Accommodatie, Accommodatie, lens-, Lensaccomodatie
Portuguese Acomodação Ocular
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Miosis disorder (C0026205)

Definition (MSHCZE) Zúžení zornice (pupily). K m. dochází při zvýšené intenzitě světla (slunce, silné žárovky) a je ochrannou reakcí oka. Je zprostředkována stahem hladkého svalu v duhovce (iris) v důsledku působení parasympatického nervového systému. Kromě působení světla m. vyvolávají i látky či léky zesilující působení parasympatiku (morfin). M. snižuje nitrooční tlak, proto se v léčbě glaukomu užívají léky, které ji vyvolávají – miotika. Opak mydriáza. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (MSH) Pupillary constriction. This may result from congenital absence of the dilatator pupillary muscle, defective sympathetic innervation, or irritation of the CONJUNCTIVA or CORNEA.
Concepts Finding (T033)
MSH D015877
ICD9 379.42
SnomedCT 194166000, 61514009, 63251006
English Mioses, Miosis, MIOSIS, PUPILS CONSTRICTED, Small pupil, Miosis disorder, Constricted Pupil, Constricted Pupils, Pupil, Constricted, Pupils, Constricted, Mioses, Persistent, Miosis, Persistent, Persistent Mioses, Persistent Miosis, Mioses, Pupillary, Miosis, Pupillary, Pupillary Mioses, Pupillary Miosis, Pupil, Small, Pupils, Small, Small Pupil, Small Pupils, Miosis not d/t miotics, Miosis [Disease/Finding], constrict pupils, constricted pupil, constricted pupils, mioses, miosis disorder, pupillary miosis, small pupil, pupil constrict, Small pupils, Miosis (disorder), small pupils, small pupils (diagnosis), miosis persistent, Persistent miosis (diagnosis), Persistent miosis, Persistent miosis (disorder), miosis, myosis, Miosis, NOS, Persistent miosis [Ambiguous], Miosis (persistent), not due to miotics, Miosis, not due to miotics, Persistent miosis, not due to miotics
French MYOSIS, Miosis (persistant), non dû à des myotiques, RETRECISSEMENT DE LA PUPILLE, Myosis, Constriction pupillaire, Myosis pupillaire
Portuguese MIOSE, Miose persistente não causada por mióticos, CONTRACCAO DAS PUPILAS, Miose, Miose Pupilar
Spanish MIOSIS, Miosis (persistente) no producida por mióticos, PUPILAS CONTRAIDAS, miosis (trastorno), miosis, constricción de las pupilas, miosis persistente (trastorno), miosis persistente, Miosis, Miosis Pupilar
Dutch miosis (persisterend), niet door miotica, miose, Miose, Pupilmiose
German Miosis (persistierend), nicht durch Miotika verursacht, MIOSIS, PUPILLENVERENGUNG, Miose, Stenokorie, Pupillenverengung, Miosis
Italian Miosi (persistente), non dovuta a miotici, Pupilla piccola, Miosi persistente, Restringimento del diametro pupillare, Miosi pupillare, Miosi
Swedish Pupillsammandragning
Japanese シュクドウ, 瞳孔縮小, 縮瞳
Czech mióza, Mióza, Mióza ( perzistentní), nevyvolaná miotiky
Finnish Mioosi
Russian MIOZ, МИОЗ
Polish Zwężenie źrenicy
Hungarian Pupillaszűkület (persistáló), nem pupillaszűkítő okozta, Pupillaszűkület
Croatian MIOZA
Norwegian Miose, Pupillkontraksjon, Pupillsammensnøring
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Ocular accommodation near point (C0429572)

Concepts Finding (T033)
SnomedCT 251778004
English Ocular accommodation near point, Ocular accommodatn near point, NPA - Near point accommodation, Ocular accommodation near point (observable entity), NP - Near point, Near point
Spanish punto cercano de acomodación ocular (entidad observable), punto cercano de acomodación ocular
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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