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Third Nerve Palsy
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The pupil constricting parasympathetic fibres are located superficially in the oculomotor (3rd) nerve as it exits the brain stem and consequently they are typically affected by a compressive lesion eg tumour, aneurysm but spared by a vascular event eg microvascular infarction secondary to diabetes. Sudden onset painful diplopia from a third nerve palsy with pupil involvement therefore requires urgent evaluation for a posterior communicating artery aneurysm in all age groups.

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Core Principles

1. Ocular Anatomy

2. Ophthalmic History

3. Measuring Visual Acuity

4. External Inspection / Eyelids

5. Everting The Eyelids

6. Anterior Segment

7. Pupillary Reflexes (and Dilatation)

8. Ocular Motility

9. Visual Fields

10. Direct Ophthalmoscopy

Ophthalmology in Practice

1. Red Eye Introduction

2. Red Eye Diagnosis

3. Visual Failure Introduction

4. Gradual Loss of Vision

5. Sudden Loss of Vision

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