Anatomy and Physiology of The Eye: Dr. Binto Akturusiano, SPM

Anatomy and Physiology
of
The Eye
Dr. Binto Akturusiano, SpM

ANATOMY OF THE EYE
ANATOMY OF THE EYE
• THE WALL OF THE EYE BALL IS COMPOSED OF A

DENSE, IMPER-FECTLY ELASTIC SUPPORTING
MEMBRANE
• THE ANTERIOR PART OF THE MEM-BRANE IS
TRANSPARENT THE CORNEA
• THE ANTERIOR PART OF THE SCLERA IS COVERED
BY MUCOUS MEMBRANE THE CONJUNGTIVA
THE CORNEA CONSIST OF FIVE
LAYERS :
- EPITHELIUM
- BOWMAN’S MEMBRANE
- STROMA OR SUBSTANTIA PROPIA
- DESCEMET’S MEMBRANE
- ENDOTHELIUM
• THE EPITHELIUM REGARDED AS THE CONTINUATION
OF THE CONJUNGTIVA OVER THE CORNEA
• THE SUBSTANTIA PROPIA REGARDED AS THE

CONTINUATION FORWARD OF THE SCLERA
• THE STROMA FORMING 90 % OF THE TOTAL CORNEAL

THICKNESS
• DESCEMET’S MEMBRANE IS A THIN ELASTIC MEMBRANE,
COVERED ON ITS POSTERIOR BY ENDOTHELIUM
• THE PRIMARY MECHANISME CONTROLLING STROMAL

HYDRATION IS A FUNCTION OF THE CORNEAL ENDOTHELIUM
• ENDOTHELIAL CELLS BECOME LESS IN NUMBER WITH AGE

AND INDIVIDUAL CELL ENLARGE TO COMPENSATE
• THE CORNEA IS SET INTO THE SCLERA LIKE A
WATCH GLASS SO THAT THE LATTER OVER-
LAPS THE CORNEA ALL AROUND THE PERI-
PHERY; THE JUNCTION OF THE TWO TISSUES
IS KNOWN AS THE LIMBUS
•THE CORNEA IS VERY RICHLY SUPPLIED WITH
NERVE FIBERS DERIVED FROM THE
TRIGEMINAL AND IT HAD NO BLOOD VESSEL
LINING THE INNER
ASPECT OF THE
SCLERA ARE TWO
STRUCTURES :
• THE HIGHLY
VASCULAR UVEAL
TRACT
CONCERNED
CHIEFLY IN
NUTRITION OF THE
EYE
• A NERVOUS
LAYER, THE TRUE
VISUAL NERVE
ENDING ONCERNED
IN THE RECEPTION
AND
TRANSFORMING OF
LIGHT STIMULL
CALLED THE
RETINA
THE UVEAL TRACT CONSIST OF THREE PARTS, WHICH
THE TWO POSTERIOR, THE CHOROID, AND CILIARY
BODY, WHILE THE ANTERIOR FORMS A FREE CIRCULAR
DIAPHRAGM : THE IRIS
THE APERTURE OF THE DIAPHRAGM IS THE PUPIL
SITUATED BEHIND THE IRIS AND IN CONTACT WITH THE

PUPILLARY MARGIN IS THE CRYSTALLINE LENS
THE ANTERIOR CHAMBER IS A SPACE FILLED
WITH FLUID, THE AQUEOUS HUMOR; IT IS
BOUNDED IN FRONT BY THE CORNEA, BEHIND BY
THE IRIS AND THE PART OF THE ANTERIOR
SURFACE OF THE LENS WHICH IS EXPOSED IN THE
PUPIL
ITS PERIPHERAL RECESS IS KNOWN AS
THE ANGLE OF THE ANTERIOR
CHAMBER, BOUNDED POSTERIORLY BY
THE ROOT OF THE IRIS AND THE
CILIARY BODY AND ANTERIORLY BY
THE CORNEOSCLERA
IN THE INNER LAYER OF THE SCLERA AT
THIS PART THERE IS A CIRCULAR VENOUS
SINUS, SOME TIMES BROKEN UP INTO
MORE THAN ONE LUMEN CALLED THE
CANALIS SCHLEMM - GREAT IMPORTANT -
IN THE DRAINAGE OF THE AQUEOUS
HUMOR
AT THE PERIPHERY OF
THE ANGLE BETWEEN
THE CANAL SCHLEMM
AND THE RECESS OF THE
ANTERIOR CHAMBER
THERE LIES A LOOSELY
CONSTRUCTED
MESHWORK OF TISSUES,
THE CORNEO-SCLERAL
TRABECULAE
THERE ARE TWO UNSTRIPED MUSCLE WHICH
CONTROL THE MOVEMENTS OF THE PUPIL
• THE SPHINCTER PUPILAE

A CIRCULAR BUNDLE RUNNING ROUND THE PUPILLARY
MARGIN; IS SUPPLIED BY MOTOR NERVE FIBERS DERIVED
FROM THE OCULOMOTOR NERVE
•THE DILATATOR PUPILLAE

ARRANGED RADIALLY NEAR THE ROOT OF THE IRIS. THE
MOTOR NERVE FIBRES ARE DERIVED FROM THE CERVICAL
SIMPHATHETIC CHAIN
THE INNER SURFACE OF THE CILLIARY BODY
IS DIVIDED INTO TWO REGION
• THE PARS PLICATA

THE ANTERIOR PART WHICH IS CORRUGATED WITH A
NUMBER OF FOLDS
• THE PARS PLANA

THE POSTERIOR PART WHICH IS SMOOTH
THE CHIEF MASS OF THE CILLIARY BODY IS
COMPOSED OF THE UN-STRIPED MUSCLE FIBERS -
CALLED - THE CILLIARY MUSCLE
THE CILLIARY BODY EXTENDS BACK WARD AS FAR

AS THE ORA SERRATA, AT WHICH POINT THE
RETINA BEGINS ABRUPTLY
THE CHOROID IS EXTREMELY VASCULAR MEMBRANE IN
CONTACT EVERY WHERE WITH THE SCLERA.
ALTHOUGH NOT FIRMLY ADHERENT TO IT SO THERE IS
A POTENTIAL SPACE BETWEEN THE TWO STRUCTURE -
CALLED - THE EPICHOROIDAL SPACE
ON THE INNER SIDE THE CHOROID IS COVERED BY A
THIN ELASTIC MEMBRANE - CALLED- THE LAMINA
VITERA OR MEMBRANA OF BRUCH
THE RETINA CONSISTS OF 10 LAYERS
1. PIGMEN EPITHELIUM
2. LAYER OF ROD AND CONES
3. EXTERNAL LIMITING
MEMBRANE
4. OUTER NUCLEAR LAYER
5. OUTER PLEXIFORM LAYER
6. INNER NUCLEAR LAYER
7. INNER PLEXIFORM LAYER
8. GANGLION CELL LAYER
9. OPTIC NERVE FIBER
LAYER
10. INTERNAL LIMITING
MEMBRANE
AT THE POSTERIOR
POLE OF THE EYE
WHICH IS SITUATED
ABOUT 3 MM TO THE
TEMPORAL SIDE OF
THE OPTIC DISC, A
SPECIALLY
DIFFEREN-TIATED
SPOT IS FOUND IN
THE RETINA, THE
FOVEA CENTRALIS, A
DEPRESSION OR PIT,
AND IN HERE ONLY
CONES ARE PRESENT
IN THE NEURO
EPITHELIAL LAYER
THE FOVEA IS THE
MOST SENSITIVE PART
OF THE RETINA, AND IT
IS SURROUNDED BY A
SMALL AREAS, THE
MACULA LUTEA OR
YELLOW SPOT.
WHICH ALTHOUGH NOT
SO SENSITIVE, ITS
MORE SENSITIVE THAN
OTHER PARTS OF THE
RETINA
AT THE OPTIC DISC THE

FIBERS OF THE NERVE-
FIBER LAYER PASS INTO
THE OPTIC NERVE
THE LENS IS A BICONVEX MASS OF PECULIARLY
DIFFERENTIATED EPITHELIUM, IT IS SURROUNDED BY A
HYALINE MEMBRANE, THE LENS CAPSULE, IT IS HELD IN
PLACE BY THE SUSPENSORY LIGAMENT OR ZONULES OF
ZINNI CONSISTS BUNDLE OF STRANDS WHICH PASS FROM
THE SURFACE OF THE CILLIARY BODY TO THE CAPSULE
THERE IS A TRIANGULAR SPACE BETWEEN THE BACK OF
THE IRIS AND THE ANTERIOR SURFACE OF THE LENS AND
ITS BOUNDED ON THE OUTER SIDE BY THE CILLIARY BODY
- CALLED - THE POSTERIOR CHAMBER AND CONTAINS
AQUEOUS HUMOR
BEHIND THE
LENS THERE IS
LARGE VITREUS
CHAMBER
CONTAINING THE
VITREUS
HUMOR, A JELLY
LIKE MATERIAL,
CHEMICALLY OF
THE NATURE OF
INNERT GEL
CONTAINING A
FEW CELLS AND
WANDERING
LEUCOCYTES
THE EXTRA OCULAR MUSCLES
A TEAM OF SIX MUSCLES
CONTROLS THE MOVE-
MENT OF EACH EYE
• THE RECTUS MUSCLE
- THE MEDIAL RECTUS
- THE LATERAL RECTUS
- THE SUPERIOR RECTUS
- THE INFERIOR RECTUS
• THE OBLIQUE MUSCLE
- THE SUPERIOR
OBLIQUE
- THE INFERIOR
OBLIQUE
THE RECTUS
MUSCLES HAVE THE
GENERAL ACTION
OF ROTATING THE
EYE IN FOUR
CARDINAL
DIRECTIONS : UP,
DOWN, OUT AND IN
THE OBLIQUE
MUSCLES HAVE THE
PRIMARY FUNCTION
OF ROTATION OF
THE GLOBE
THE MEDIAL
RECTUS IS
INSERTED INTO
THE SCLERA,
ABOUT 5 MM TO
THE NASAL SIDE
OF THE CORNEO-
SCLERAL MARGIN.
THE INFERIOR
RECTUS 6 MM
BELOW
THE LATERAL
RECTUS 7 MM TO
THE TEMPORAL
SIDE
THE SUPERIOR
RECTUS 8 MM
ABOVE
THE LIDS
THE LIDS ARE COVERED

ANTERIORLY BY SKIN AND
POSTERIORLY BY MUCOUS
MEMBRANE - THE CON-
JUNGTIVA TARSI. THEY
CONTAIN MUSCLES,
GLANDS, BLOOD VESSELS,
AND NERVES. ALL BOUND
TOGETHER BY CONNECTIVE
TISSUE WHICH IS PARTI-
CULARY DENSE AT THE
POSTERIOR PART WHERE IT
FORMS A STIFF PLATE -
THE TARSUS
THE SKIN OF THE LIDS
IS PECULIAR IN
ITS THINNES AND ITS
LOOSE ATTACH-MENT
THE CILIA OR
EYELASHES ARE
STRONG SHORT
CURVED HAIRS,
ARRANGED IN TWO OR
MORE CLOSELY SET
ROWS
THE SEBACEOUS
GLANDS ARE CALLED
ZEISS’S GLANDS AND
THE SWEAT GLANDS
ARE KNOWN AS MOLL’S
GLANDS
THE TARSUS
CONSISTS OF
DENSE
FIBROUS
TISSUE; IT
CONTAINS
NO
CARTILAGE,
EMBEDDED
IN IT ARE
SOME
ENORMOUSL
Y
DEVELOPED
SEBACEOUS
GLAND : THE
MEIBOMIAN
GLANDS
THE ORBICULARIS
PALPEBARUM OCCUPIES
THE SPACE BETWEEN THE
TARSUS AND THE SKIN
THE MAIN CENTRAL BOND

OF THE LEVATOR
PALPEBRAE SUPERIORIS
IS INSERTED INTO THE
UPPER BORDER OF THE
TARSUS
THE THIRD NERVE

SUPPLIES THE LEVATOR
PALPEBRAE
THE SEVENTH SUPPLIES

THE ORBICULARIS
THE LACRIMAL APPARATUS
THE LACRIMAL APPARATUS CONSISTS OF

•THE LACRIMAL GLANDS
•THE LACRIMAL PASSAGES
THE LACRIMAL GLAND OF EACH EYE
CONSISTS OF :
• THE SUPERIOR OR ORBITAL GLAND
• THE INFERIOR OR PALPEBRAE GLAND
• THE ACCESSORY LACRIMAL
GLANDS OR KRAUSE’S GLANDS
THE LACRIMAL PASSAGES CONSISTS OF :
• THE LACRIMAL PUNCTA
• THE CANALICULI
• THE LACRIMAL SAC
• THE NASAL DUCT
PHYSIOLOGY OF THE EYE
BLOOD - AQUEOUS BARRIER
The System of semipermeable

membranes separating the
blood from the ocular cavity
IN THE
POSTERIOR
SEGMENT
IT IS FORMED BY
THE WALLS OF THE
RETINAL
CAPILLARIES AND BY
BRUCH’S MEMBRANE
AND THE RE-
TINAL EPITHELIUM
IN THE CILLIARY
REGION
IT IS FORMED BY
THE TWO-LAYERED
CILLIARY
EPITHELIUM
IN THE IRIS
BY THE WALL OF THE CAPILLARIES IN
THIS TISSUE WHICH ARE FREELY EXPOSED
TO THE ANTERIOR CHAMBER
THE PECULIAR IMPERMEABILITY OF
THE RETINAL CAPILLARIES AND
THE BRUCH’S MEMBRANE PIGMENT
EPITHELIAL BARRIER, WHILE
NECESSARY FROM OPTICAL POINT
OF VIEW, FORBIDS THE READY
PASSAGE OF LARGE SIZE
MOLECULES INTO THE EYE
SUCH THERAPEUTIC SUBSTANCES AS
PENICILLIN WHEN ADMINISTERED
SYSTEMICALLY HAVE LITTLE VALUE IN
OCULAR THERAPEUTICS
SUBSTANCES WITH A HIGH LIPOID-

SOLUBILITY WHICH EASLY PENETRATE
LIVING CELLS, TRANSVERSE THE BARRIER
MUCH MORE RAPIDLY (SULPHONAMIDES,
CHLORAMPHE-NICOL, ETC)
THE INCREASE IN PERMEABILITY MAY BE
BROUGHT BY INFLAMMATORY
CONDITIONS, SUCH AS IRIDOCYCLITIS OR
CHOROIDITIS, AND ALSO IF THE
CAPILLARY WALLS ARE MECHANICALLY
STRETCHED BY SUDDENLY LOWERING THE
INTRA OCULAR PRESSURE
SUCH A TWO-WAY TRANSVERENCE OF FLIUD
ACROSS THE CAPILLARY WALLS WOULD TEND TO
STAGNATION
TO IT IS ADDED A SECRETORY PROCESS CONDUCTED

BY THE METABOLIC ACTIVITY OF THE CELLS OF THE
CILLIARY EPITHELLIUM.
95 % OF TOTAL QUANTITY OF AQUEOS

CIRCULATION OF THE
AQUEOUS HUMOR
AS THE GREATER
PART OF FLUIDS IS
FORMED IN THE
CILLIARY REGION,
IT IS SECRETED
INTO POSTERIOR
CHAMBER, IT FLOWS
FROM THE
POSTERIOR
CHAMBER THROUGH
THE PUPIL INTO
THE ANTERIOR
CHAMBER AND
ESCAPES THROUGH
THE DARINAGE
CHANNELS AT THE
ANGLE, AND THEN
INTO THE
EPISCLERAL VEIN
THE INTRA OCULAR PRESSURE
(IOP)
PROLONGED CHANGES ARE ESSENTIALLY

CAUSED BY TWO FACTORS :
• AN ALTERATION IN THE FORCES
DETERMINING THE FORMATION OF THE
AQUEOUS
• ALTERATIONS IN THE RESISTANCE TO ITS
OUTFLOW
FROM THE CLINICAL POINT OF VIEW, THE
LATTER IS THE MORE IMPORTANT
A RISE IN THE IOP MAY BE CAUSED BY AN
INCREASE IN THE PRESSURE IN THE
EPISCLERAL VEIN OR BY ANY PROCESS
WHICH BLOCKS THE SEEPAGE OF AQUEOUS
INTO THE CANAL OF SCHLEMM, SUCH AS
SCLEROSIS OF THE TRABECULAE OR THEIR
OBSTRUCTION BY EXUDATES OR ORGANIZED
TISSUE GLAUCOMA
THE PRINCIPAL FACTORS
DETERMINING PROLONGED
CHANGES IN THE IOP
1. VARIATION IN THE HIDROSTATIC PRESSURE IN

THE CAPILLARIES
2. AN INCREASE IN PERMEABILITY OF THE
CAPILLARIES
3. A CHANGE IN OSMOTIC PRESSURE OF THE BLOOD
4. VOLUMETRIC CHANGES
5. A BLOCKAGE IN CIRCULATION OF THE AQUEOUS
a. AT THE PUPIL
b. AT THE ANGLE OF THE ANTERIOR CHAMBER
THE IOP PRESSURE
THE IOP NORMALLY

VARIES FROM 10 TO 20
MM HG
•IT IS ACCURATELY
MEASURED BY A
MANOMETER
•CLINICALLY BY
TONOMETRY

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Anatomy and Physiology

Dr. Binto Akturusiano, SpM

• THE WALL OF THE EYE BALL IS COMPOSED OF A

• THE SUBSTANTIA PROPIA REGARDED AS THE

• THE STROMA FORMING 90 % OF THE TOTAL CORNEAL

• THE PRIMARY MECHANISME CONTROLLING STROMAL

• ENDOTHELIAL CELLS BECOME LESS IN NUMBER WITH AGE

THE APERTURE OF THE DIAPHRAGM IS THE PUPIL

SITUATED BEHIND THE IRIS AND IN CONTACT WITH THE

• THE SPHINCTER PUPILAE

•THE DILATATOR PUPILLAE

• THE PARS PLICATA

• THE PARS PLANA

THE CILLIARY BODY EXTENDS BACK WARD AS FAR

AT THE OPTIC DISC THE

THE LIDS ARE COVERED

THE MAIN CENTRAL BOND

THE THIRD NERVE

THE SEVENTH SUPPLIES

THE LACRIMAL APPARATUS CONSISTS OF

BLOOD - AQUEOUS BARRIER

The System of semipermeable

SUBSTANCES WITH A HIGH LIPOID-

TO IT IS ADDED A SECRETORY PROCESS CONDUCTED

95 % OF TOTAL QUANTITY OF AQUEOS

PROLONGED CHANGES ARE ESSENTIALLY

1. VARIATION IN THE HIDROSTATIC PRESSURE IN

THE IOP NORMALLY

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