This is a video of a patient who presented with difficulty in looking up. Vision was normal in both eyes. The pupils were mid-dilated, not reacting to light but constricting to near. Horizontal and downgaze were normal but upgaze was absent. Attempted upgaze brought about a convergence retraction nystagmus. She also had convergence insufficiency. This is dorsal midbrain syndrome or pretectal or Parinaud’s syndrome. The lesion was localized to the dorsal midbrain on neuroimaging. Such a patient may present to the ophthalmologist but the management is the realm of the neurologist or the neurosurgeon.
Dorsal midbrain syndrome
Quiz on general ophthalmology
Here are two quizzes with MCQs (multiple choice questions) on general ophthalmology for undergraduate medical students. Topics include cataracts, neuro-ophthalmology, strabismus, glaucoma and systemic diseases with ophthalmic findings.
Show/Hide Quiz 2 on general ophthalmology 
Retina Quiz
This quiz contains MCQs on retinal diseases including diabetic retinopathy, vein occlusions, age-related macular degeneration. It also deals with examination, signs and symptoms of retinal diseases.
