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InhoudsopgaveAfwijkingen in de horizontale blik vanuit de hersenstam................................................................................4
Internucleaire Ophthalmoplegie..........................................................................................................................4
One and a half syndrome.....................................................................................................................................4
Overige laesies in de pons....................................................................................................................................5
Afwijkingen in de verticale blik...................................................................................................................... 6
Afwijkende saccades............................................................................................................................................6
Syndroom van Parinaud.......................................................................................................................................7
Double elevator palsy...........................................................................................................................................8
Oogbewegingsstoornissen veroorzaakt door cerebellum en cerebrum...........................................................9
Arnold chiarie.......................................................................................................................................................9
SpinoCerebellaire Ataxie....................................................................................................................................10
OculoMotore Apraxie.........................................................................................................................................10
Oogbewegingsproblemen veroorzaakt door verschillende delen van de hersenen........................................11
Skew deviation...................................................................................................................................................11
MS......................................................................................................................................................................11
Dementie............................................................................................................................................................12
Alzheimer.......................................................................................................................................................12
Creutzfeldt jakob disease..............................................................................................................................12
AIDS dementia complex.................................................................................................................................12
Divergentie paralyse..........................................................................................................................................13
Convergentie paralyse/parese...........................................................................................................................13
Nystagmus................................................................................................................................................... 14
Infantiele vormen van nystagmus......................................................................................................................15
Infantiel nystagmus syndroom......................................................................................................................15
Latent en manifest latent nystagmus............................................................................................................16
Infantiele vorm van volwassen nystagmus....................................................................................................16
Overig.............................................................................................................................................................16
Verworven vormen van nystagmus....................................................................................................................16
Spasmus nutans.............................................................................................................................................16
Nystagmus geassocieerd met intracraniale ziekten......................................................................................16
Nystagmus geassocieerd met ipsilateraal visusverlies..................................................................................17
DVD............................................................................................................................................................. 18
Infantiel scheelzien...................................................................................................................................... 19
Intermitterende exotropie..................................................................................................................................19
Infantiele esotropie............................................................................................................................................21
Pareses........................................................................................................................................................ 22
NIII parese..........................................................................................................................................................22
, Sursoadductorius................................................................................................................................................23
NIV parese..........................................................................................................................................................23
NVI parese..........................................................................................................................................................24
Graves orbitopathie..................................................................................................................................... 24
Amblyopie................................................................................................................................................... 25
Behandeling........................................................................................................................................................25
Amblyopie bij oudere kinderen..........................................................................................................................25
Compliance.........................................................................................................................................................25
Functioneel visusverlies......................................................................................................................................25
Diplopie....................................................................................................................................................... 27
Incongruente diplopie........................................................................................................................................27
Horror fusionis....................................................................................................................................................27
Conservatieve behandelingen...................................................................................................................... 28
Bril......................................................................................................................................................................28
Botuline toxine...................................................................................................................................................28
Prisma’s..............................................................................................................................................................29
Orthoptisch oefenen...........................................................................................................................................30
Strabismus chirurgie.................................................................................................................................... 31
Operatie indicaties.............................................................................................................................................31
Factoren de operatie beïnvloeden......................................................................................................................31
Vooronderzoek operaties...................................................................................................................................32
Soorten operaties...............................................................................................................................................32
Manieren om de conjunctiva te openen.......................................................................................................32
Verzwakking (vermindering van de actie).....................................................................................................33
Versterken (versterken van de actie)............................................................................................................33
Transponeren (de richting van actie veranderen).........................................................................................33
A/V-patroon.......................................................................................................................................................34
POOS...................................................................................................................................................................36
Voor en nadelen vroeg/laat opereren................................................................................................................37
Operatievoorstel.................................................................................................................................................37
Complicaties operatie.........................................................................................................................................38
Overig operaties.................................................................................................................................................39
Overig.......................................................................................................................................................... 41
Accommodatie/convergentie anomalieën.........................................................................................................41
Accommodatiespasme..................................................................................................................................41
Accommodatie traagheid..............................................................................................................................41
Accommodatie insufficiëntie.........................................................................................................................41
Spasm of the Near Reflex..............................................................................................................................41
Decompenserende oogstand..............................................................................................................................42
, Torticollis............................................................................................................................................................42
Spieren en oogbewegingen................................................................................................................................43
Origo van de oogspieren................................................................................................................................43
Oogbewegingen.............................................................................................................................................43
Oogbewegingssystemen................................................................................................................................44
Pupillen...............................................................................................................................................................46
Anisometropie/aniseikonie................................................................................................................................46
Sensoriek (ARC/NRC of ARL/NRL).......................................................................................................................46
Asthenope klachten............................................................................................................................................46
Werking oogdruppels.........................................................................................................................................46
Onderzoeken............................................................................................................................................... 49
Diagnostische Occlusie.......................................................................................................................................49
Prisma Adaptatie Test........................................................................................................................................49
Postoperatieve diplopietest...............................................................................................................................49
Botuline Toxine...................................................................................................................................................49
15^PT en OPT.....................................................................................................................................................50
Diagnostische prisma’s.......................................................................................................................................50
Accommodatie...................................................................................................................................................50
Fusie...................................................................................................................................................................51
Convergentie......................................................................................................................................................51
Random dots stereozien.....................................................................................................................................51
Beeldvorming.....................................................................................................................................................51
Begrippen.................................................................................................................................................... 52
, Afwijkingen in de horizontale blik vanuit de hersenstam
Internucleaire Ophthalmoplegie
Bij een INO is de MLF aangedaan.
Kenmerken
- Rechter oog adductiebeperking en links abductienystagmus betekend rechter INO
- Ipsilesiale adductie beperking (adductie beperking aan de kant van de laesie)
- Convergentie is wel intact bij een caudale laesie (posterior ino van cogan) maar niet bij
een rostrale laesie (anterior ino van cogan)
- Skew deviation en Dissociated vertical nystagmus kunnen ook voorkomen
- Dissociated nystagmus door overschietende saccades (wet van hering), blik gebonden
nystagmus door onderbreking van de paramediale banen (voor blik behoud) of
verhoofde convergentie tonus (centripitale drift)
- Veel verschillende oorzaken maar MS is wel een van de hoofdoorzaken, bij oudere
mensen is een beroerte waarschijnlijker
- Kan ook bilateraal voorkomen (WEBINO)
(WE)BINO
- Binoculaire INO
- Beide MLF zijn aangedaan
- Oogstand is hetzelfde als bij een INO met abnormale vertical bewegingen en
afwijkende saccades.
Bij een rostrale INO is de convergentie afwezig en bij een caudale INO is de convergentie
aanwezig.
Bij een INO noteer je geen oog, maar een kant. Dit omdat het vanuit de hersenen komt, niet
vanuit het oog zelf.
One and a half syndrome
One and a half syndrome is een uitgebreide INO; een gecombineerde NVI nucleus en MLF
laesie.
Kenmerken
- Ipsilaterale horizontale blikverlamming met een INO met een abductiebeperking van
het contralesionele oog als enige beweging.
- Rechtsblik horizontale conjugate blik parese
- Linksblik adductiebeperking OD, abductienystagmus OS
- Paralytic pontine exotropia
One and a half syndroom wordt gekenmerkt door een blikparese gecombineerd met een INO
aan de andere kant.
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