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Super Eye Palsies (Video)

This video shows the cranial nerve palsies that affect the eye … specifically third nerve palsy, fourth nerve palsy, and sixth nerve palsy. You can watch this presentation in full screen and high-definition by clicking the appropriate buttons. If you have problems you can also watch directly at Vimeo, Youtube, or download the video file directly to your computer (links below).

length: 29 minutes


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SuperPalsies.m4v (234 MB)
SuperPalsies720p.m4v (790 MB)

SCREEN SHOTS FROM THIS VIDEO LECTURE:
(comments below)


The lecture begins with a review of basic eye anatomy


We then discuss each cranial nerve and their presentation. A blown pupil is always concerning as the parasympathetics travel on the outside of the nerve and are affected by mass lesions and aneurysms.


The sixth nerve innervates only the lateral rectus muscle. High cranial pressure can create a crossed eye.


The superior oblique is particularly confusing. Fourth palsies can create head tilt and are also associated with trauma and congenital agenesis.


Ischemic damage to the peripheral nerves can regenerate because the underlying structure of the nerve is intact. With compressing lesions and trauma, this nerve structure is damaged and aberrant regeneration can occur.


Patient examples are given. In addition, temporal arteritis should be considered in patients over 60-65 years of age.



High intracranial pressure, such as from pseudotumor cerebri, can cause a 6th nerve palsy.


The subjective maddox rod test is demonstrated. Useful for detecting subtle vertical deviations.


The fourth nerve is sensitive to damage because it is long and exits from the dorsal side of the brainstem. Long standing vertical problems can sometimes be detected with an increased vertical fusion amplitude.



49 Comments



Awesomeness! Thanks a bunch!



Comment by Tom — February 10, 2013



Preciously well delivered! Thanks so very much sir! Pls kindly consider doing a video on HOW TO USE THE BINOCULAR INDIRECT OPHTHALMOSCOPE! This is one area that you have NOT touched on in terms of instrumentation usage. Pls sir counting on you so very much as we enjoy all your educative videos. God bless you sir and thanks once again for sharing your knowledge!!!!



Comment by Ozone — February 10, 2013



Excellent as usual. Thanks for sharing such a nicely presented video.



Comment by John Y. Mvula — February 11, 2013



The video being a mix of opthalmo-knowledge and super powers, is awesome way of learning, keep it up sir, its very unique ways of learning difficult things so easily



Comment by Ali Sajjad — February 11, 2013



Thanks for your great effort at this work



Comment by Wael Refaat — February 11, 2013



very nice sir



Comment by rohit — February 11, 2013



Saw this lecture LIVE in Daytona and it was wonderful – best and most concise explanation I’ve heard for these 3 motility disorders.



Comment by Sue — February 11, 2013



This so amazing. I love the effort you put in to simplifying the eye. I was just searching for a good web to understand the eye muscles and I get your email.

This is well explained and has definetly opened the pandoras box on palsies and cranial nerves.

you rock Dr Tim



Comment by maureen — February 11, 2013



Absolutely superb. So easy to understand. It is a pity I could not have seen a lecture like this when I was a student some 50 years ago.
It is a must for any college student.
Fantastic!!



Comment by Michael Blackstone — February 11, 2013



Thank you very much Dr. Root,
This video is the most interesting the way to learn the nerves and palsies.
I always had struggle to learn and memorize them BUT with this video like every thing were engraved into my brain and will remember them always.

Thank you very much.



Comment by atosa namvar — February 11, 2013



Thank you Dr. Root! Your online book & videos are great, easy to remember lectures! Thank you, thank you, thank you!!!!



Comment by Kym — February 11, 2013



…Well,I can not find the right words for that kind of education. It is great ; it is fun ; it is effective and for me it will be more and more a “addiction” – again – THANK YOU !!



Comment by Peter — February 12, 2013



Dear Dr.Timm thank you very much for your effort to make ophthalmology better and easier, I wish that someday I will be like You, again thanks .



Comment by eyad — February 13, 2013



super LIKE!!!



Comment by pinay_od — February 13, 2013



Thank you for so creative , positiv and interesting Lectures Dr. Root. So easy to learn! i enjoy it!



Comment by afet — February 14, 2013



merci
thank you
your videos are very helpfull for me at my work
as an optician i am often the one that see s the customers for appointments
and many times we need to know if we have and ermegency in front of us
to have the patient seen more quikly
Sight can be dammaged so fast that timming is important

question when dammage has occured the option of working with prismes may be a possibility to use on a portion of the retina that is not dammaged
by making glasses will you treat of that subject in the futur

sorry for my english

again thank you for the help you are spreading

Andrée



Comment by andrée — February 14, 2013



Dr.Root:
Love your lectures and have even used one in my lecturing to Medical residents. I am an ophthalmologist. The most recent video “Super Eye Palsies” has a small error when you mention that the 3rd nerve innervates the Lateral Rectus. Thank you for all that you are doing and please don’t stop.
Bob Morello

Tim Root: Thanks Dr. Morello. I picked up on the typo before I uploaded the lecture. This is one of the difficulties with video lectures … it is hard to retract or “fix” these typos as I can’t simply delete that portion of the video. You’ll see that I inserted a “verbal typo” notice hovering over the animation at the moment I made the mistake. Thanks for commenting!



Comment by Robert Morello MD — February 17, 2013



thank for sharing your knowledge.God bless you.



Comment by Papa Mouhamadou — February 17, 2013



thnx a lot ,great lecture,i also find humor a useful way to pass pretty much every thing.



Comment by faten — February 18, 2013



dr roots,
i was n will remain ur biggest fan. u really made ophthalmo an easy subject.
thanks a lot!
saif.



Comment by dr. saad bin saif — February 20, 2013



thank you..
feed me more



Comment by mohammed suleiman — February 21, 2013



Thank you for an amazing lecture. I’ve never EVER understood eye palsies as I’m now. Thank you again.



Comment by gader — February 24, 2013



thank you so much



Comment by ati — March 3, 2013



Really good lecture, makes everything so much easier to grasp.



Comment by Arifa — March 14, 2013



Your videos has and continue to make me understand and retain immensely especially difficult and boring topics which are so important as this as mentioned can be life threatening ones. You have out done yourself ones more. So grateful, at the same time you are enjoying yourself too!



Comment by Maria Evangelista — March 15, 2013



I quite apreciate ur contribution in d development of d eye sector.try & upload Neuro-Ophthalmology lecture 2. Tanx



Comment by Dr.Kenneth Nkuche — April 4, 2013



This was fabulous. Thanks a lot.



Comment by Sauradeep Sarkar — June 7, 2013



Thanks a lot. The effect of learning is great.



Comment by Melanie Müller — June 9, 2013



just amazing
your work is soooooooooooooo great really thanks



Comment by magda — June 12, 2013



it is of great help.. thnx a lot



Comment by Ayman — June 14, 2013



you r d best….



Comment by Harbhajan Kaur — June 24, 2013



Not only you are a great teacher, you are also a great videographer! Looking forward to more of your great works.



Comment by Sel — July 1, 2013



You are a very impressive and good teacher….would love to have more tutorial videos from you…yes, indirect ophthalmoscopy is another topic which I am awaiting….Thanks.



Comment by Shuchi — July 7, 2013



With vertical deviations, is a Right Hyper the same as a Left Hypo during cover test? If so, how would you know which eye has the actual palsy?



Comment by Pablo — August 26, 2013



Pablo, you are correct … with small vertical deviations, it is hard to tell which eye has the problem. Using cover-uncover testing, however, you can sometimes tell which eye is deviated (because it is the one that moves to refixate). You may want to watch my tropia/phoria video to see examples of this.

In real life, I’ll often just document what the right eye is doing vertically (hyper,hypo) on paper … and try to figure out the pattern later.



Comment by Timothy Root, M.D. — August 27, 2013



Best lecture ever!
Best regards



Comment by Jonas Upphagen — September 28, 2013



THINK YOU; It’s really great.



Comment by Selmane TA — September 29, 2013



with a trauma injury that is suspected of causing my fourth nerve palsy….does the double vision, etc happen right after the accident or can it get worse over time?



Comment by Cindy — December 8, 2013



thank you so much sir.. awesome work!!!!!!!!



Comment by natasha — February 7, 2014



Fantastic videos! Where have you find the masks?



Comment by Jonas Upphagen — April 7, 2014



ur an actual legend



Comment by Farah — November 10, 2014



Thank you very much!! Great viedo!



Comment by Amy — November 26, 2014



Simple and clear. Thanks.



Comment by Dr Srinivas D R — January 3, 2015



Learning muscles has always made me squeamish. Thank you for providing a go-to.



Comment by Amy — January 7, 2015



Great job!! When will you be adding more topics?
Where do you typically lecture?
Thank you



Comment by Jim — March 31, 2015



Thanks a lot, that was the most interesting eye nerve palsy lecture I’ve seen! Thank you.



Comment by leiluccia — July 30, 2015



great lectures, thanks for this kind of contribution !!!



Comment by dr tiber — October 7, 2015



This is great! Do more! Med.students in Sweden love this!

Thank you sooo much!



Comment by Wilhelm — January 4, 2016



Excellent lecture.
Really enjoyed it.
Great graphics.



Comment by John Grylls — December 22, 2016




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