Oculo cardiac reflex : An unique neural link between the eyes and Heart

Heart by development  originates from near  the same spot , where the brain develop (Neuralcrest) .Hence there is no surprise  though a richly a vascular organ, heart  retains many neural connections with brain .Eyeballs with it’s  extensive neural connections  can be considered  direct extension of brain. Occulo cardiac reflex . When the eyeballs or the ocular muscles are manipulated or massaged slowing of heart rate can occur .This is due to  a reflex called  Occulo cardiac reflex mediated by  vagal stimulation .This phenomenon is also referred to as  Aschner phenomenon The circuit Afferent _Trigeminal branch of opthalmic nerve Center- Medulla : Trigeminal  neural signal  spill over signals  to Vagal nucleus Efferent- Vagus -SA node Biochemical mediator -Acetyl choline Prevention Adequate local anesthesia Retro bulbar block of ciliary ganglion Prompt Atropine injection Courtesy :Indian journal of Ophthalmology   Clinical scenarios Opthalmic surgery : Serious bradycardia  even  asystole can occur as a rare complication especially in elderly and very young (Cataract /Squint surgery) . Cardiac events and  strokes  are clustered around opthalmic surgery in many elderly  for some unknown reason ( OCR triggered ?) OCR can unmask hidden sinus node dysfunction in elderly.Routine cardiac evaluation before eye surgery may be recommended . Orbital fracture especially Medial orbit can elicit dangerous bradycardia (BMJ Case Rep. 2014 Apr 15;2014.) Rar...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Neuro cardiology circuits for occulo cardiac reflex diver's reflex eye ball massage trigemianl vagal reflex Source Type: blogs