Distinct early and late subcomponents of the photic blink reflex: response characteristics in patients with retrogeniculate lesions.

To assess cortical contributions to the photic blink reflex, signal averaged electromyograms (EMG) were compared for responses to strobe flashes presented within the blind and sighted hemifields of 13 patients with occipital lobe lesions. Reflexes evoked by flashes within the scotoma were virtually identical to those evoked by flashes within the intact visual field. This suggests that both the early and late components of this reflex (R50 and R80, respectively) are mediated by subcortical structures that do not require, or benefit from, conscious visual processing. Additional findings included larger R80s at the eyelid contralateral to the lesion, regardless of stimulated hemifield. This presumably reflects the loss of a tonic descending influence of visual cortex onto the motor limb of the reflex arc. The R80 was also larger for stimuli activating the crossed (temporal hemifield) rather than the uncrossed (nasal hemifield) afferent pathway.