Download - Lecture1 anatomy of the eye
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ANATOMY AND PHYSIOLOGY OF THE EYE
Department of OphthalmologyFatima College of Medicine
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ORBIT
BONY CAVITY WHICH HOUSES THE EYEBALL
4 WALLS - ROOF,FLOOR, MEDIAL AND LATERAL WALL
30 mL in volumeHAS AN APEX WHERE NERVES AND
VESSELS EMERGE
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Orbital Walls
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ORBITAL WALLS
ROOF COMPOSED OF THE LESSER WING OF
THE SPHENOID, AND ORBITAL PLATE OF THE FRONTAL BONE
INTIMATELY RELATED TO THE FRONTAL SINUS
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ORBITAL WALLS
LATERAL WALL SEPARATED FROM THE ROOF BY THE
SUPERIOR ORBITAL FISSURE COMPOSED OF THE GREATER WING OF
THE SPHENOID, ZYGOMATIC BONE STRONGEST PART OF THE BONY ORBIT
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ORBITAL WALLS
FLOOR SEPARATED FROM THE LATERAL WALL BY
THE INFERIOR ORBITAL FISSURE INTIMATELY RELATED TO THE MAXILLARY
SINUS COMPOSED OF MAXILLARY BONE,
ZYGOMATIC BONE AND PALATINE BONE ORBITAL CONTENTS CAN HERNIATE INTO
THE MAXILLARY SINUS IN TRAUMA CASES
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ORBITAL WALLS
MEDIAL WALL INTIMATELY RELATED TO THE ETHMOID
AND SPHENOID SINUSES COMPOSED OF THE ETHMOID BONE,
SPHENOID BONE, LACRIMAL BONE AND MAXILLA
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ORBITAL APEX
SERVES AS A PORTAL FOR NERVES AND VESSELS
SITE OF ORIGIN OF ALL EOMS EXCEPT INFERIOR OBLIQUE
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Orbital Apex
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SUPERIOR ORBITAL FISSURE
LATERAL PORTION SUPERIOR OPHTHALMIC VEIN LACRIMAL NERVE FRONTAL NERVE TROCHLEAR NERVE
MEDIAL PORTION SUPERIOR AND INFERIOR DIV. OF
OCULOMOTOR NERVE
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ORBITAL APEX
OPTIC CANAL TRANSMITS OPTIC NERVE AND
OPHTHALMIC ARTERYSUPERIOR ORBITAL FISSURE
ALSO TRANSMITS THE INFERIOR OPHTHALMIC VEIN
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BLOOD SUPPLY OF THE ORBIT
OPHTHALMIC ARTERY CENTRAL RETINAL ARTERY LACRIMAL ARTERY MUSCULAR BRANCHES LONG AND SHORT POSTERIOR CILIARY
ARTERY MEDIAL PALPEBRAL ARTERIES
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Blood Supply of the Eyeball
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BLOOD SUPPLY
SHORT POSTERIOR CILIARY ARTERY CHOROID, OPTIC NERVE
LONG POSTERIOR CILIARY ARTERY SUPPLY CILIARY BODY, ANASTOMOSE
WITH EACH OTHER AND ANTERIOR CILIARY ARTERY TO FORM THE MAJOR ARTERIAL CIRCLE
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BLOOD SUPPLY
Anterior ciliary artery derived from muscular branches of the
rectus muscles anterior sclera, episclera, limbus,
conjunctiva
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Venous Drainage of the Orbit
Superior and Inferior Ophthalmic Veins
Vortex veinsAnterior Ciliary VeinsCentral retinal Veins
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Venous Drainage of the Eyeball
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Venous DrainageThe ophthalmic veins communicate with
the cavernous sinus via SOF and the pterygoid venous plexus via the inferior orbital fissure.
The SOV is formed from the supraorbital and suparatrochlear veins which drain the skin.
* potential communication between skin infection and cavernous sinus causing thrombosis
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Eyeball
Roughly sphericalapproximately 24.5 mm (less than
an inch) in lengthabout 5mL in total volume
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Eyeball
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Histological Cross Sectionof the Eyeball
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Conjunctiva
Thin transparent mucous membrane which covers the posterior surface of the eyelid (palpebral conjunctiva) and the anterior surface of the sclera (bulbar conjunctiva)
composed of two to five layers of stratified columnar epithelial cells
contains glands which help in ocular lubrication
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Conjunctiva
Blood Supply anterior ciliary artery palpebral aretries
Nerve Supply first division of the trigeminal nerve
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Upper Eyelids
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Lower Lid Retractors
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Tenon’s Capsule
A fibrous membrane that envelopes the globe from the limbus to the optic nerve
continuous with the EOM’sthickens to form check ligaments
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Sclera
Fibrous outer protective coating of the eye
composed of dense bands of well hydrated connective tissue
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Episclera
Fine elastic tissue containing blood vessels and covers the anterior surface of the sclera
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CorneaTransparent tissue which accounts for
most of the refractive power of the eyethicker at the limbus, and thinner at the
center5 layers
epithelium Bowman’s layer Corneal stroma Descemet’s layer Endothelium
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Cornea
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Cornea
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Uveal Tract
IrisCiliary BodyChoroid
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Posterior View of Uveal Tissue
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Iris
Flat anterior extension of the ciliary body
has a central round aparture known as the pupil
divides the anterior from the posterior chamber
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Iris
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Ciliary Body
Extends from the choroid to the irisdivided into the pars plicata and pars
planapoint of suspension of the lens produces aqueous humor
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Aqueous Flow
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Choroid
Posterior segment of the uveal tract in between the retina and sclera
joins the ciliary body anteriorlychoroidal blood vessels nourish outer
portion of the retina
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Ora Serrata
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Choroidal Circulation
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Lens
Biconvex, avascular, colorless and transparent structure
second most powerful refractive tissue
held in place by suspensory ligaments known as zonules
accommodates to facilitate near vision
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Lens Accommodation
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Lens in the Young
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Lens in the Aged
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Anterior Chamber Angle
Schwalbe’s lineSchlem’s canalTrabecular meshworkScleral spur
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Anterior Chamber Angle
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Trabecular Meshwork
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Aqueous Flow
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Optic Nerve Cupping
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Retina
Thin, semitransparent, multilayered sheet of neural tissue
lines the inner aspect of the posterior two thirds of the globe
terminates anteriorly as the ora serrata
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Fundus
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Posterior Pole
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Layers of the Retina
1. Internal limiting membrane 2. Nerve fiber layer 3. Ganglion cell layer 4. Inner plexiform layer 5. Inner nuclear layer 6. Outer plexiform layer 7. Outer nuclear layer 8. External limiting membrane 9. Photoreceptor layer (rods and cones) 10. Retinal pigment epithelium
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Retinal Layers
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Macula
Center of the posterior retinaresponsible for fine central visionhas yellow pigment (xantophyll)histologically empty space tends to
the accumulation of extracellular material that cause thickening
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Photoreceptors
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Blood Supply of the Retina
Choriocapillaries outer third of the retina
Central Retinal Artery inner two thirds of the retina
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Embryonic Eye
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Embryonic Eye
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Vitreous
Clear, avascular, gelatinous bodycomprises 2/3 of the volume of the
eye99% water ; 1% hyaluronic acid and
collagenfirmly attached to the pars plana and
ora serrata
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Eyeball
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External Anatomic Landmarks
Limbus - point of referance , site of incision for basic cataract extraction
Ora Serrata - 6mm from the limbus on the nasal side ; 7mm from the limbus on the temporal side
Pars plana - 4mm from the limbusPars plicata - 2-3 mm from the
limbus
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Extraocular Muscles
Rectus Muscles superior rectus inferior rectus medial rectus lateral rectus
Oblique Muscles Superior oblique Inferior oblique
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Extraocular Muscles
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Nerve Supply of EOMS
Oculomotor nerve innervates medial, inferior and superior rectus muscles as well as the inferior oblique muscle
Abducens nerve innervates the lateral rectus muscles
Trochlear nerve innervates the superior oblique muscle
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Blood Supply of the EOMS
Muscular branches of the ophthalmic artery
Lateral rectus also receives additional supply from lacrimal artery
Inferior oblique also receives additional supply from the infraorbital artery
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Ocular Adnexa
Eyebrows thickened skin covered with hair
Eyelids modified folds of skin closes to protect the eyeball blinks to lubricate cornea
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Eyelids
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Eyelids
Skin LayerOrbicularis OculiAreolar tissueTarsal platePalpebral conjunctiva
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Orbicularis Muscle
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Lid Margins
EyelashesGlands of ZeisGlands of MollMeibomian glandslacrimal punctum
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Palpebral Fissure
Elliptical space between the two eyelids
terminates at the lateral and medial canthi
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Orbital septum
Fascia behind the portion of orbicularis muscle and serves as a barrier between the lid and the orbit
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Eyelids
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Eyelid Anatomy
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Lid retractors
Responsible for opening the eyelids levator palpebrae superioris muscle
aponeurosismeuller’s muscle
Lower lid retractorinferior rectus, extends with the inferior
oblique and insert into the lower border of the tarsal plate
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Upper Eyelids
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Lower Lid Retractors
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Nerve Supply of the Eyelid
First and second division of the trigeminal nerve
Ophthalmic lacrimal, supraorbital,
supratrochlear,infratrochlear, external nasal nerves
Maxillary Infraorbital, zygomaticofacial,
zygomaticotemporal nerves
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Eyelids
Blood Supply lacrimal and ophthalmic areteries
Venous drainage ophthalmic vein
Lymphatic drainage Temporal eyelids - pre-auricular and
parotid nodes Nasal eyelids - submandibular nodes
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Lacrimal Apparatus
Lacrimal glandsaccessory lacrimal glands of Krauss
and WolfringPunctaCanaliculiLacrimal sacNasolacrimal duct
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Lacrimal Apparatus
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Lacrimal Gland
Blood supply - lacrimal arteryVenous drainage - ophthalmic veinLymphatic drainage - preauricular
lymph nodesNerve supply - lacrimal nerve, great
superficial petrosal nerve, sympathetic nerves
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Lacrimal Apparatus
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Optic Nerve
Consists of 1 million axons from ganglion cells of the retina
emerges from the sclera on the nasal portion of the globe
25 - 30mm long in the orbital segmentgoes through optic canal10mm intracranial coursejoins optic chiasm
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Optic Nerve
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Vascular Supply of the Optic Nerve
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Visual pathway
RetinaOptic nerveOptic chiasmOptic tractOptic radiationOccipital lobe (Visual center)
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Visual Pathway