mkdir -p /home/daytona/workspace/visual-pathway-ppt && ls /home/daytona/workspac…

~/visual-pathway-ppt/create_ppt.js

const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");

// Download images as base64
const imgUrls = [
  "https://cdn.orris.care/cdss_images/bd1278851846ed859a4efb624cd78639eb3c450552f802dbab6148e13de26783.png",
  "https://cdn.orris.care/cdss_images/cd81642f92c6e434dbe6a71de547426836acc00afab0e3ba944833a47f7415d4.png"
];

let images = [];
try {
  const result = execSync(
    `node /home/daytona/skills/shared/scripts/fetch_images.js "${imgUrls[0]}" "${imgUrls[1]}"`,
    { timeout: 30000 }
  ).toString();
  images = JSON.parse(result);
} catch (e) {
  console.error("Image fetch failed:", e.message);
  images = [{ base64: null }, { base64: null }];
}

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.author = "Orris Medical Education";
pres.title = "Physiological Basis of Lesions in the Visual Pathway";

// ─── Color Palette ────────────────────────────────────────────────────────────
const NAVY   = "0A1628";
const TEAL   = "0D7377";
const LTEAL  = "14BDBD";
const WHITE  = "FFFFFF";
const LGRAY  = "F0F4F8";
const YELLOW = "F5C518";
const ORANGE = "E07B3A";
const RED    = "C0392B";
const GREEN  = "1A7A4A";

// ─── Helper: accent bar ──────────────────────────────────────────────────────
function accentBar(slide, color) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color } });
}

// ─── SLIDE 1 — Title ─────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  // Full dark bg
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: NAVY } });
  // Teal bottom band
  s.addShape(pres.ShapeType.rect, { x: 0, y: 4.5, w: 10, h: 1.125, fill: { color: TEAL } });
  // Accent lines
  s.addShape(pres.ShapeType.rect, { x: 0.5, y: 1.2, w: 9, h: 0.05, fill: { color: LTEAL } });

  s.addText("PHYSIOLOGICAL BASIS OF", {
    x: 0.6, y: 0.55, w: 8.8, h: 0.55,
    fontSize: 22, color: LTEAL, bold: false, align: "center",
    fontFace: "Calibri", charSpacing: 4
  });
  s.addText("LESIONS IN THE\nVISUAL PATHWAY", {
    x: 0.6, y: 1.25, w: 8.8, h: 1.9,
    fontSize: 40, color: WHITE, bold: true, align: "center",
    fontFace: "Calibri"
  });
  s.addText("Anatomy · Physiology · Clinical Deficits · Localization", {
    x: 0.6, y: 3.25, w: 8.8, h: 0.55,
    fontSize: 16, color: LGRAY, align: "center", italic: true,
    fontFace: "Calibri"
  });
  s.addText("Sources: Gray's Anatomy | Ganong's Physiology | Kandel Neuroscience | Bradley & Daroff's Neurology", {
    x: 0.5, y: 4.6, w: 9, h: 0.4,
    fontSize: 9, color: WHITE, align: "center", fontFace: "Calibri"
  });
}

// ─── SLIDE 2 — Overview / Outline ────────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: LGRAY } });
  accentBar(s, TEAL);
  s.addShape(pres.ShapeType.rect, { x: 0.08, y: 0, w: 10, h: 0.75, fill: { color: NAVY } });

  s.addText("LECTURE OVERVIEW", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.55,
    fontSize: 22, color: WHITE, bold: true, fontFace: "Calibri"
  });

  const topics = [
    ["01", "Anatomy of the Visual Pathway", "Retina → Optic nerve → Chiasm → LGN → Radiation → Cortex"],
    ["02", "Physiological Principles", "Retinal representation, decussation, parallel processing"],
    ["03", "Optic Nerve Lesions", "Monocular blindness, scotomas, RAPD"],
    ["04", "Optic Chiasm Lesions", "Bitemporal hemianopia — pituitary tumors"],
    ["05", "Optic Tract Lesions", "Contralateral homonymous hemianopia, incongruent"],
    ["06", "Optic Radiation Lesions", "Meyer's loop (pie-in-sky), parietal defects"],
    ["07", "Visual Cortex Lesions", "Congruent hemianopia, macular sparing"],
    ["08", "Clinical Rules & Summary", "5 rules of visual field interpretation"],
  ];

  topics.forEach((t, i) => {
    const col = i < 4 ? 0 : 1;
    const row = i % 4;
    const x = col === 0 ? 0.18 : 5.1;
    const y = 0.9 + row * 1.1;

    s.addShape(pres.ShapeType.rect, { x, y, w: 4.7, h: 0.95, fill: { color: WHITE }, line: { color: TEAL, width: 1 } });
    s.addText(t[0], { x: x + 0.05, y: y + 0.08, w: 0.55, h: 0.75, fontSize: 22, bold: true, color: TEAL, fontFace: "Calibri", align: "center" });
    s.addText(t[1], { x: x + 0.65, y: y + 0.06, w: 3.95, h: 0.35, fontSize: 11, bold: true, color: NAVY, fontFace: "Calibri" });
    s.addText(t[2], { x: x + 0.65, y: y + 0.42, w: 3.95, h: 0.45, fontSize: 9, color: "444444", fontFace: "Calibri", wrap: true });
  });
}

// ─── SLIDE 3 — Anatomy of Visual Pathway ─────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: NAVY } });
  accentBar(s, ORANGE);
  s.addShape(pres.ShapeType.rect, { x: 0.08, y: 0, w: 10, h: 0.65, fill: { color: ORANGE } });
  s.addText("ANATOMY OF THE VISUAL PATHWAY", {
    x: 0.3, y: 0.08, w: 9.4, h: 0.5,
    fontSize: 20, color: WHITE, bold: true, fontFace: "Calibri"
  });

  // Add the Ganong pathway diagram
  if (images[0] && images[0].base64) {
    s.addImage({ data: images[0].base64, x: 0.1, y: 0.7, w: 4.2, h: 4.8 });
  }

  const steps = [
    ["1", "Retina", "Photoreceptors (rods & cones) → Bipolar cells → Retinal Ganglion Cells (RGC). ~1.2 million RGC axons form each optic nerve."],
    ["2", "Optic Nerve (CN II)", "CNS-type myelination (oligodendrocytes). Covered by meninges. Carries ipsilateral retinal information."],
    ["3", "Optic Chiasm", "Nasal retinal fibers (60%) CROSS to contralateral optic tract. Temporal fibers (40%) remain ipsilateral."],
    ["4", "Optic Tract", "Contains temporal fibers from same-side eye + nasal fibers from opposite eye. Represents contralateral hemifield."],
    ["5", "LGN (Thalamus)", "6-layered structure. Layers 1-2 magnocellular (motion/depth); Layers 3-6 parvocellular (color/detail). Synapse here."],
    ["6", "Optic Radiation", "Upper fibers → parietal lobe (inferior visual field). Lower fibers (Meyer's loop) → temporal lobe (superior visual field)."],
    ["7", "Primary Visual Cortex (V1)", "Calcarine fissure, occipital lobe (Brodmann area 17). Macular vision represented posteriorly (large area)."],
  ];

  steps.forEach((st, i) => {
    const y = 0.72 + i * 0.68;
    s.addShape(pres.ShapeType.ellipse, { x: 4.55, y: y + 0.05, w: 0.35, h: 0.35, fill: { color: ORANGE } });
    s.addText(st[0], { x: 4.55, y: y + 0.05, w: 0.35, h: 0.35, fontSize: 9, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri" });
    s.addText(st[1], { x: 4.98, y: y, w: 2.3, h: 0.36, fontSize: 10, bold: true, color: LTEAL, fontFace: "Calibri" });
    s.addText(st[2], { x: 4.98, y: y + 0.32, w: 4.85, h: 0.36, fontSize: 8, color: LGRAY, fontFace: "Calibri", wrap: true });
  });
}

// ─── SLIDE 4 — Physiological Principles ──────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: LGRAY } });
  accentBar(s, TEAL);
  s.addShape(pres.ShapeType.rect, { x: 0.08, y: 0, w: 10, h: 0.65, fill: { color: NAVY } });
  s.addText("KEY PHYSIOLOGICAL PRINCIPLES", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.5,
    fontSize: 20, color: WHITE, bold: true, fontFace: "Calibri"
  });

  const principles = [
    {
      title: "Contralateral Representation",
      icon: "◀▶",
      color: TEAL,
      text: "Each cerebral hemisphere processes the OPPOSITE visual hemifield. Right hemisphere → left visual field; Left hemisphere → right visual field. This results from partial decussation at the chiasm."
    },
    {
      title: "Retinotopic Mapping",
      icon: "⊞",
      color: ORANGE,
      text: "The spatial arrangement of retinal ganglion cells is preserved throughout the entire visual pathway, creating a 'map' of the visual field at each relay station (LGN, V1)."
    },
    {
      title: "Partial Decussation at Chiasm",
      icon: "✕",
      color: RED,
      text: "Only NASAL retinal fibers cross (~60%). Temporal fibers remain ipsilateral (~40%). This ensures each optic tract carries information from the entire contralateral hemifield from BOTH eyes."
    },
    {
      title: "Parallel Processing (M & P Pathways)",
      icon: "⟶",
      color: GREEN,
      text: "Magnocellular pathway (M cells, layers 1-2 LGN): processes motion, depth, low contrast. Parvocellular pathway (P cells, layers 3-6 LGN): processes color, fine detail, high spatial frequency."
    },
    {
      title: "Macular Sparing Phenomenon",
      icon: "◎",
      color: NAVY,
      text: "The macula has disproportionately large cortical representation (over half of V1). Occipital lesions often spare central vision because: (1) dual blood supply to macular cortex, (2) extensive posterior cortical area."
    },
    {
      title: "Congruence Rule",
      icon: "≡",
      color: "7B2D8B",
      text: "More posterior retrochiasmal lesions → more CONGRUENT (identical pattern in both eyes) defects. Anterior retrochiasmal (optic tract) → more INCONGRUENT defects. Occipital lesions = highly congruent."
    },
  ];

  principles.forEach((p, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = col === 0 ? 0.18 : 5.1;
    const y = 0.8 + row * 1.55;

    s.addShape(pres.ShapeType.rect, { x, y, w: 4.7, h: 1.42, fill: { color: WHITE }, line: { color: p.color, width: 2 } });
    s.addShape(pres.ShapeType.rect, { x, y, w: 4.7, h: 0.4, fill: { color: p.color } });
    s.addText(p.title, { x: x + 0.1, y: y + 0.06, w: 4.5, h: 0.3, fontSize: 10, bold: true, color: WHITE, fontFace: "Calibri" });
    s.addText(p.text, { x: x + 0.1, y: y + 0.46, w: 4.5, h: 0.9, fontSize: 8.5, color: "333333", fontFace: "Calibri", wrap: true });
  });
}

// ─── SLIDE 5 — Optic Nerve Lesions ───────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: NAVY } });
  accentBar(s, RED);
  s.addShape(pres.ShapeType.rect, { x: 0.08, y: 0, w: 10, h: 0.65, fill: { color: RED } });
  s.addText("LESION SITE 1 — OPTIC NERVE (Pre-chiasmal)", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.5,
    fontSize: 19, color: WHITE, bold: true, fontFace: "Calibri"
  });

  // Visual field defect box
  s.addShape(pres.ShapeType.rect, { x: 0.18, y: 0.75, w: 2.8, h: 2.2, fill: { color: "1A2A3A" }, line: { color: RED, width: 2 } });
  s.addText("VISUAL FIELD DEFECT", { x: 0.18, y: 0.75, w: 2.8, h: 0.32, fontSize: 9, bold: true, color: RED, align: "center", fontFace: "Calibri" });
  // Left eye blind, right eye normal
  s.addShape(pres.ShapeType.ellipse, { x: 0.3, y: 1.12, w: 1.0, h: 0.85, fill: { color: "444444" } });
  s.addText("L", { x: 0.3, y: 1.12, w: 1.0, h: 0.85, fontSize: 18, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri" });
  s.addShape(pres.ShapeType.ellipse, { x: 1.55, y: 1.12, w: 1.0, h: 0.85, fill: { color: TEAL } });
  s.addText("R", { x: 1.55, y: 1.12, w: 1.0, h: 0.85, fontSize: 18, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri" });
  s.addText("Monocular Blindness (left eye)", { x: 0.18, y: 2.05, w: 2.8, h: 0.4, fontSize: 8.5, color: LGRAY, align: "center", italic: true, fontFace: "Calibri" });
  s.addText("(Complete optic nerve transection)", { x: 0.18, y: 2.42, w: 2.8, h: 0.4, fontSize: 8, color: "AAAAAA", align: "center", fontFace: "Calibri" });

  const findings = [
    ["Complete Transection", "Total monocular blindness in the ipsilateral eye. The contralateral eye is completely unaffected."],
    ["Central Scotoma", "Optic neuritis (demyelination, e.g., multiple sclerosis) typically causes a central or cecocentral scotoma with pain on eye movement."],
    ["Altitudinal Defect", "Nonarteritic anterior ischemic optic neuropathy (NAION) causes inferior altitudinal defect — cuts horizontally, respects horizontal meridian."],
    ["Junctional Scotoma", "Lesion at optic nerve-chiasm junction: ipsilateral cecocentral scotoma + contralateral superior temporal defect (from crossing fibers of Willbrand's knee)."],
    ["Afferent Pupillary Defect", "Marcus Gunn pupil: relative afferent pupillary defect (RAPD) ipsilateral to the optic nerve lesion — key clinical sign."],
  ];

  findings.forEach((f, i) => {
    const y = 0.78 + i * 0.96;
    s.addShape(pres.ShapeType.rect, { x: 3.18, y, w: 6.65, h: 0.88, fill: { color: "0D1F33" }, line: { color: "334466", width: 1 } });
    s.addText(f[0], { x: 3.3, y: y + 0.06, w: 6.4, h: 0.3, fontSize: 10.5, bold: true, color: LTEAL, fontFace: "Calibri" });
    s.addText(f[1], { x: 3.3, y: y + 0.38, w: 6.4, h: 0.45, fontSize: 9, color: LGRAY, fontFace: "Calibri", wrap: true });
  });

  s.addShape(pres.ShapeType.rect, { x: 0.18, y: 3.05, w: 2.8, h: 2.45, fill: { color: "0D1F33" }, line: { color: "334466", width: 1 } });
  s.addText("CAUSES", { x: 0.18, y: 3.05, w: 2.8, h: 0.32, fontSize: 9, bold: true, color: YELLOW, align: "center", fontFace: "Calibri" });
  const causes = ["• Optic neuritis (MS)", "• Ischemic (NAION, AION)", "• Compressive (meningioma, glioma)", "• Traumatic", "• Toxic/nutritional (B12, tobacco-alcohol)", "• Infiltrative (sarcoidosis, lymphoma)"];
  causes.forEach((c, i) => {
    s.addText(c, { x: 0.3, y: 3.42 + i * 0.34, w: 2.55, h: 0.3, fontSize: 8.5, color: LGRAY, fontFace: "Calibri" });
  });
}

// ─── SLIDE 6 — Optic Chiasm Lesions ──────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: LGRAY } });
  accentBar(s, "7B2D8B");
  s.addShape(pres.ShapeType.rect, { x: 0.08, y: 0, w: 10, h: 0.65, fill: { color: "7B2D8B" } });
  s.addText("LESION SITE 2 — OPTIC CHIASM", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.5,
    fontSize: 20, color: WHITE, bold: true, fontFace: "Calibri"
  });

  // Anatomy reminder box
  s.addShape(pres.ShapeType.rect, { x: 0.18, y: 0.75, w: 4.5, h: 1.1, fill: { color: WHITE }, line: { color: "7B2D8B", width: 2 } });
  s.addText("ANATOMICAL KEY", { x: 0.18, y: 0.75, w: 4.5, h: 0.3, fontSize: 9, bold: true, color: "7B2D8B", align: "center", fontFace: "Calibri" });
  s.addText("The optic chiasm sits anterior to the pituitary stalk. Nasal retinal fibers from BOTH eyes cross here. Temporal fibers remain ipsilateral. The crossing nasal fibers subserve the TEMPORAL visual fields.", {
    x: 0.3, y: 1.1, w: 4.2, h: 0.68, fontSize: 9, color: "333333", fontFace: "Calibri", wrap: true
  });

  // Visual field diagram
  s.addShape(pres.ShapeType.rect, { x: 4.85, y: 0.75, w: 4.95, h: 1.1, fill: { color: WHITE }, line: { color: "7B2D8B", width: 2 } });
  s.addText("BITEMPORAL HEMIANOPIA (hallmark defect)", { x: 4.85, y: 0.75, w: 4.95, h: 0.3, fontSize: 9, bold: true, color: "7B2D8B", align: "center", fontFace: "Calibri" });
  // Left eye — temporal field blind
  s.addShape(pres.ShapeType.ellipse, { x: 5.0, y: 1.1, w: 0.95, h: 0.65, fill: { color: "DDDDDD" } });
  s.addShape(pres.ShapeType.rect, { x: 5.0, y: 1.1, w: 0.475, h: 0.65, fill: { color: "888888" } });
  s.addText("L", { x: 5.0, y: 1.1, w: 0.95, h: 0.65, fontSize: 14, bold: true, color: NAVY, align: "center", valign: "middle", fontFace: "Calibri" });
  // Right eye — temporal field blind
  s.addShape(pres.ShapeType.ellipse, { x: 7.5, y: 1.1, w: 0.95, h: 0.65, fill: { color: "DDDDDD" } });
  s.addShape(pres.ShapeType.rect, { x: 7.975, y: 1.1, w: 0.475, h: 0.65, fill: { color: "888888" } });
  s.addText("R", { x: 7.5, y: 1.1, w: 0.95, h: 0.65, fontSize: 14, bold: true, color: NAVY, align: "center", valign: "middle", fontFace: "Calibri" });
  s.addText("Temporal fields lost in both eyes", { x: 5.5, y: 1.78, w: 4.0, h: 0.3, fontSize: 8, italic: true, color: "555555", align: "center", fontFace: "Calibri" });

  // Details
  const details = [
    { hdr: "Why Bitemporal?", body: "The NASAL retinal fibers (which see the temporal visual fields) are the ones that CROSS at the chiasm. A chiasmal lesion destroys these crossing fibers, eliminating both temporal visual fields — one from each eye. This is a HETERONYMOUS hemianopia (defects on opposite sides).", color: "7B2D8B" },
    { hdr: "Superior vs Inferior Field Loss", body: "Early/superior chiasmal compression (e.g., pituitary tumor growing upward) first affects the INFERIOR crossing fibers → bitemporal SUPERIOR quadrantanopia. As the lesion grows, full bitemporal hemianopia develops. Note: macular fibers are posterior in the chiasm, so they are spared initially.", color: ORANGE },
    { hdr: "Binasal Hemianopia (rare)", body: "Results from lesions compressing the lateral aspects of the chiasm (e.g., bilateral internal carotid artery aneurysms, bilateral optic nerve lesions). Each lesion destroys the NON-crossing temporal fibers on each side, causing binasal defects.", color: RED },
    { hdr: "Causes of Chiasmal Lesions", body: "Pituitary adenoma (most common — 90% of cases), craniopharyngioma, meningioma, aneurysm (ICA, ACA), glioma, hypothalamic tumors, empty sella syndrome, demyelination.", color: GREEN },
  ];

  details.forEach((d, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = col === 0 ? 0.18 : 5.1;
    const y = 2.0 + row * 1.75;
    s.addShape(pres.ShapeType.rect, { x, y, w: 4.7, h: 1.62, fill: { color: WHITE }, line: { color: d.color, width: 2 } });
    s.addShape(pres.ShapeType.rect, { x, y, w: 4.7, h: 0.38, fill: { color: d.color } });
    s.addText(d.hdr, { x: x + 0.1, y: y + 0.06, w: 4.5, h: 0.3, fontSize: 10, bold: true, color: WHITE, fontFace: "Calibri" });
    s.addText(d.body, { x: x + 0.1, y: y + 0.44, w: 4.5, h: 1.12, fontSize: 8.5, color: "333333", fontFace: "Calibri", wrap: true });
  });
}

// ─── SLIDE 7 — Optic Tract Lesions ───────────────────────────────────────────
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: NAVY } });
  accentBar(s, ORANGE);
  s.addShape(pres.ShapeType.rect, { x: 0.08, y: 0, w: 10, h: 0.65, fill: { color: ORANGE } });
  s.addText("LESION SITE 3 — OPTIC TRACT (Post-chiasmal)", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.5,
    fontSize: 19, color: WHITE, bold: true, fontFace: "Calibri"
  });

  // Key fact banner
  s.addShape(pres.ShapeType.rect, { x: 0.18, y: 0.75, w: 9.65, h: 0.55, fill: { color: ORANGE } });
  s.addText("KEY: Each optic tract contains fibers from the TEMPORAL retina of the ipsilateral eye + NASAL retina of the contralateral eye → represents the entire CONTRALATERAL visual hemifield from both eyes.", {
    x: 0.3, y: 0.78, w: 9.4, h: 0.48, fontSize: 9.5, color: WHITE, bold: true, fontFace: "Calibri", wrap: true
  });

  // Left panel: defect illustration
  s.addShape(pres.ShapeType.rect, { x: 0.18, y: 1.4, w: 3.2, h: 3.95, fill: { color: "0D1F33" }, line: { color: ORANGE, width: 2 } });
  s.addText("VISUAL FIELD DEFECT", { x: 0.18, y: 1.4, w: 3.2, h: 0.32, fontSize: 8.5, bold: true, color: ORANGE, align: "center", fontFace: "Calibri" });
  s.addText("Right Optic Tract Lesion:", { x: 0.3, y: 1.78, w: 2.95, h: 0.28, fontSize: 9, color: LTEAL, bold: true, fontFace: "Calibri" });
  s.addText("Left Homonymous Hemianopia", { x: 0.3, y: 2.08, w: 2.95, h: 0.28, fontSize: 9, color: LGRAY, fontFace: "Calibri" });
  // Visual field boxes
  s.addShape(pres.ShapeType.ellipse, { x: 0.35, y: 2.45, w: 1.1, h: 0.9, fill: { color: "DDDDDD" } });
  s.addShape(pres.ShapeType.rect, { x: 0.35, y: 2.45, w: 0.55, h: 0.9, fill: { color: "666666" } });
  s.addText("LE", { x: 0.35, y: 2.45, w: 1.1, h: 0.9, fontSize: 12, bold: true, color: NAVY, align: "center", valign: "middle", fontFace: "Calibri" });
  s.addShape(pres.ShapeType.ellipse, { x: 1.95, y: 2.45, w: 1.1, h: 0.9, fill: { color: "DDDDDD" } });
  s.addShape(pres.ShapeType.rect, { x: 1.95, y: 2.45, w: 0.55, h: 0.9, fill: { color: "666666" } });
  s.addText("RE", { x: 1.95, y: 2.45, w: 1.1, h: 0.9, fontSize: 12, bold: true, color: NAVY, align: "center", valign: "middle", fontFace: "Calibri" });
  s.addText("Left half blind in both eyes\n(INCONGRUENT — patterns differ between eyes)", {
    x: 0.3, y: 3.42, w: 2.95, h: 0.55, fontSize: 8, italic: true, color: LGRAY, fontFace: "Calibri", wrap: true
  });
  s.addText("WHY INCONGRUENT?\nFibers from 2 eyes not yet merged into single bundle at tract level → slight positional difference → non-identical defects", {
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  });

  // Right panel: features
  const features = [
    { h: "Contralateral Homonymous Hemianopia", b: "Complete lesion of right optic tract → left homonymous hemianopia. Defect is present in the same hemifield (left field) of BOTH eyes." },
    { h: "Incongruent Defect", b: "Unlike occipital lesions, optic tract defects are incongruent — the pattern of loss differs slightly between the two eyes because the fibers from the two retinas are not yet fully intermixed." },
    { h: "Contralateral RAPD", b: "Relative afferent pupillary defect occurs in the EYE WITH THE TEMPORAL FIELD DEFECT (contralateral to the lesion). This is because the nasal retina (with the temporal field defect) has more RGC axons contributing to the pupillary reflex than the temporal retina." },
    { h: "Wernicke's Hemianopic Pupil", b: "Light stimulus to the blind hemifield → no pupillary constriction (afferent arc disrupted). Light to intact hemifield → normal constriction. This 'sectoral' pupillary response can localize the lesion to the optic tract." },
    { h: "Causes", b: "Craniopharyngioma, aneurysm (ICA/ACA/PCA), trauma, pituitary adenoma (lateral extension), demyelination, glioma of optic tract." },
  ];

  features.forEach((f, i) => {
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}

// ─── SLIDE 8 — Optic Radiation & LGN ─────────────────────────────────────────
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  const lgnInfo = [
    "6 clearly laminated layers in the thalamus",
    "Layers 1 & 2: Magnocellular — receive input from M-type ganglion cells (motion, depth, low contrast)",
    "Layers 3-6: Parvocellular — receive input from P-type ganglion cells (color, fine detail)",
    "Interlaminar zones: koniocellular pathway (color, orientation)",
    "Layers 1, 4, 6 → contralateral eye; Layers 2, 3, 5 → ipsilateral eye",
    "LGN lesions are rare but produce homonymous hemianopia — may have sector-shaped 'wedge' defects due to laminar structure",
    "Cause: Infarcts of posterior thalamic arteries, tumors"
  ];
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  s.addText("OPTIC RADIATION (Geniculocalcarine Tract)", { x: 5.15, y: 0.78, w: 4.55, h: 0.28, fontSize: 9.5, bold: true, color: WHITE, fontFace: "Calibri" });

  const radParts = [
    { title: "Upper Radiation (Parietal lobe)", desc: "Carries fibers from LOWER retinal quadrants (representing UPPER visual field). Lesion → contralateral inferior homonymous quadrantanopia." },
    { title: "Lower Radiation — Meyer's Loop (Temporal lobe)", desc: "Lower fibers loop anteriorly around temporal horn of lateral ventricle before coursing posteriorly. Lesion → contralateral SUPERIOR homonymous quadrantanopia = 'Pie-in-the-sky' defect. Classic cause: temporal lobectomy for epilepsy." },
    { title: "Complete Optic Radiation Lesion", desc: "Damages both upper and lower fibers → complete contralateral homonymous hemianopia, more congruent than optic tract lesion." },
    { title: "PARIETAL vs TEMPORAL Radiation", desc: "Parietal: inferior quadrantanopia. Temporal (Meyer's loop): superior quadrantanopia 'pie-in-the-sky'. This distinction helps lateralize temporal lobe surgery." },
    { title: "Causes", desc: "Stroke (MCA territory), trauma, tumor, abscess, temporal lobectomy (epilepsy surgery), radiation necrosis." },
  ];

  radParts.forEach((r, i) => {
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}

// ─── SLIDE 9 — Visual Cortex Lesions ─────────────────────────────────────────
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  // Anatomy note
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  s.addText("V1 (Brodmann area 17) lines the calcarine fissure. Upper bank = lower visual field; Lower bank = upper visual field. Macular (foveal) vision → posterior pole (large area). Peripheral vision → anterior calcarine.", {
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  const cortexItems = [
    { h: "Congruent Homonymous Hemianopia", b: "Complete occipital (V1) lesion → highly congruent contralateral homonymous hemianopia. Both eyes show nearly IDENTICAL field defect pattern — this is the most congruent defect in the entire pathway.", color: LTEAL },
    { h: "Macular Sparing", b: "Most characteristic feature of occipital lesions. Central vision (macula) is preserved despite peripheral hemianopia. Reasons: (1) Macular cortex has dual blood supply (MCA + PCA); (2) Huge cortical magnification factor makes macular area hard to completely destroy; (3) Bilateral macular representation at vertical meridian.", color: YELLOW },
    { h: "Quadrantic Defects", b: "Upper bank of calcarine sulcus (cuneus) → inferior quadrant defect. Lower bank (lingual gyrus) → superior quadrant defect. The distinct anatomy of calcarine banks allows isolated quadrantic lesions.", color: ORANGE },
    { h: "Cortical Blindness", b: "Bilateral occipital lobe damage (e.g., bilateral PCA occlusion) → complete loss of vision (cortical blindness). Pupils remain reactive (pupillary reflex leaves optic tract before LGN, reaches pretectum). Anton's syndrome: patient denies blindness.", color: RED },
    { h: "Macular Sparing vs Macular Splitting", b: "Vascular lesion: often spares macula (PCA supply). Traumatic/mass lesion: often splits macula (does not spare it). This difference helps distinguish etiology.", color: GREEN },
    { h: "Causes", b: "Posterior cerebral artery (PCA) infarction (most common), trauma (occipital trauma), tumor, AVM, occipital cortex migraine (transient), eclampsia (PRES).", color: "7B2D8B" },
  ];

  cortexItems.forEach((item, i) => {
    const col = i % 2;
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    s.addText(item.h, { x: x + 0.1, y: y + 0.04, w: 4.5, h: 0.28, fontSize: 9.5, bold: true, color: "111111", fontFace: "Calibri" });
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}

// ─── SLIDE 10 — Complete Pathway Diagram ─────────────────────────────────────
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  s.addText("VISUAL PATHWAY LESION MAP — All Defects at a Glance", {
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    fontSize: 19, color: WHITE, bold: true, fontFace: "Calibri"
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    s.addImage({ data: images[1].base64, x: 0.1, y: 0.7, w: 5.2, h: 4.75 });
  }

  // Side-by-side table
  const rows = [
    ["#", "Site", "Defect", "Key Feature"],
    ["1", "Optic Nerve", "Monocular blindness / scotoma", "RAPD ipsilateral"],
    ["2", "Optic Chiasm", "Bitemporal hemianopia", "Heteronymous; pituitary"],
    ["3", "Optic Tract", "Contralateral homonymous hemianopia", "INCONGRUENT + RAPD"],
    ["4", "LGN", "Contralateral homonymous hemianopia", "Wedge defects possible"],
    ["5", "Meyer's loop", "Contralateral sup. quadrantanopia", "'Pie in the sky'"],
    ["6", "Upper radiation", "Contralateral inf. quadrantanopia", "Parietal lobe"],
    ["7", "V1 (occipital)", "Congruent homonymous hemianopia", "Macular SPARING"],
  ];

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  const colX = [5.4, 5.77, 6.94, 9.26];

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    });
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}

// ─── SLIDE 11 — Clinical Rules ────────────────────────────────────────────────
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  s.addText("5 CLINICAL RULES OF VISUAL FIELD INTERPRETATION", {
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    fontSize: 18, color: WHITE, bold: true, fontFace: "Calibri"
  });

  const rules = [
    {
      num: "01",
      title: "MONOCULAR = Pre-chiasmal",
      body: "Lesions of the retina or optic nerve produce field defects in the IPSILATERAL eye ONLY (unless bilateral). A monocular defect always localizes the lesion anterior to the chiasm.",
      color: RED
    },
    {
      num: "02",
      title: "BITEMPORAL = Chiasmal",
      body: "TRUE bitemporal hemianopia is the exclusive hallmark of optic CHIASM disease. It respects the vertical meridian. Pseudo-bitemporal from tilted discs does NOT respect the vertical meridian.",
      color: "7B2D8B"
    },
    {
      num: "03",
      title: "HOMONYMOUS = Retrochiasmal",
      body: "Any homonymous defect (same hemifield in both eyes) places the lesion POSTERIOR to the chiasm. The specific type (incongruent/congruent) helps further localization.",
      color: TEAL
    },
    {
      num: "04",
      title: "INCONGRUENT = More Anterior",
      body: "ANTERIOR retrochiasmal lesions (optic tract, temporal lobe) → INCONGRUENT homonymous defects (different pattern in each eye). Optic tract lesions also show a contralateral RAPD.",
      color: ORANGE
    },
    {
      num: "05",
      title: "CONGRUENT = More Posterior (Occipital)",
      body: "POSTERIOR retrochiasmal lesions (occipital cortex) → HIGHLY CONGRUENT defects (virtually identical in both eyes). Occipital lesions also characteristically show MACULAR SPARING.",
      color: GREEN
    },
  ];

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// ─── SLIDE 12 — Summary Table & Mnemonic ─────────────────────────────────────
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  s.addText("SUMMARY & MNEMONICS", {
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  s.addText("CLINICAL MNEMONIC — VISUAL PATHWAY LESION RULES", {
    x: 0.3, y: 0.8, w: 9.4, h: 0.32, fontSize: 10.5, bold: true, color: YELLOW, fontFace: "Calibri"
  });

  const mnem = [
    { letter: "M", word: "Monocular defect", arrow: "→", meaning: "pre-chiasmal (optic nerve/retina)" },
    { letter: "B", word: "Bitemporal hemianopia", arrow: "→", meaning: "chiasm (pituitary tumor — most common)" },
    { letter: "H", word: "Homonymous — Incongruent", arrow: "→", meaning: "optic tract (with RAPD contralateral)" },
    { letter: "H", word: "Homonymous — 'Pie-in-sky'", arrow: "→", meaning: "Meyer's loop (temporal lobe)" },
    { letter: "H", word: "Homonymous — Congruent + Macular Sparing", arrow: "→", meaning: "occipital cortex (PCA stroke)" },
  ];

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      });
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    });
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  // Quick Reference Table
  const tableData = [
    { site: "Optic Nerve", defect: "Monocular blindness / scotoma", congruence: "N/A", macular: "Affected", rapd: "Ipsilateral", cause: "MS (optic neuritis), NAION" },
    { site: "Optic Chiasm", defect: "Bitemporal hemianopia", congruence: "Heteronymous", macular: "Initially spared", rapd: "None", cause: "Pituitary adenoma" },
    { site: "Optic Tract", defect: "Contralat. hom. hemianopia", congruence: "Incongruent", macular: "Affected", rapd: "Contralateral", cause: "Craniopharyngioma" },
    { site: "LGN", defect: "Contralat. hom. hemianopia", congruence: "Congruent (wedge)", macular: "Affected", rapd: "None", cause: "Posterior thalamic infarct" },
    { site: "Optic Radiation", defect: "Quadrantanopia (upper or lower)", congruence: "Semi-congruent", macular: "Often affected", rapd: "None", cause: "MCA stroke, temporal surgery" },
    { site: "Visual Cortex V1", defect: "Contralat. hom. hemianopia", congruence: "Highly congruent", macular: "SPARED", rapd: "None", cause: "PCA stroke" },
  ];

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}

// ─── SLIDE 13 — Thank You / References ───────────────────────────────────────
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  s.addText("THANK YOU", {
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  s.addText("Questions & Discussion Welcome", {
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  s.addText("Key Take-Home: Determine whether the defect is monocular or binocular first, then\nuse congruence, RAPD, and macular sparing to precisely localize the lesion.", {
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  s.addText("REFERENCES", { x: 0.5, y: 3.9, w: 9, h: 0.3, fontSize: 11, bold: true, color: WHITE, fontFace: "Calibri" });
  const refs = [
    "Gray's Anatomy for Students, 4th ed. — Chapter 9: Central Visual Pathway",
    "Ganong's Review of Medical Physiology, 26th ed. — Chapter 10: Effect of Lesions in the Optic Pathways",
    "Kandel: Principles of Neural Science, 6th ed. — Chapter 21: Visual Processing & Geniculostriate Pathway",
    "Bradley & Daroff's Neurology in Clinical Practice — Chapter 16: General Rules of Visual Field Interpretation",
    "Localization in Clinical Neurology, 8th ed. — Chapter 7: Localization of Visual Field Defects",
  ];
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// Save
pres.writeFile({ fileName: "/home/daytona/workspace/visual-pathway-ppt/Visual_Pathway_Lesions.pptx" })
  .then(() => console.log("PPT created successfully!"))
  .catch(e => console.error("Error:", e));

cd /home/daytona/workspace/visual-pathway-ppt && node create_ppt.js 2>&1

ls -lh /home/daytona/workspace/visual-pathway-ppt/Visual_Pathway_Lesions.pptx