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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
- BOWMANS MEMBRANE
- STROMA OR SUBSTANTIA PROPIA
- DESCEMETS MEMBRANE
- ENDOTHELIUM

THE EPITHELIUM REGARDED AS THE CONTINUATION


OF THE CONJUNGTIVA OVER THE CORNEA
THE SUBSTANTIA PROPIA REGARDED
CONTINUATION FORWARD OF THE SCLERA

AS

THE

THE STROMA FORMING 90 % OF THE TOTAL CORNEAL


THICKNESS

DESCEMETS 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 OVERLAPS THE CORNEA ALL AROUND THE PERIPHERY; 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

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 NERVEFIBER 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 MOVEMENT 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 CORNEOSCLERAL 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 CONJUNGTIVA TARSI. THEY
CONTAIN MUSCLES,
GLANDS, BLOOD VESSELS,
AND NERVES. ALL BOUND
TOGETHER BY CONNECTIVE
TISSUE WHICH IS PARTICULARY 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
ZEISSS GLANDS AND
THE SWEAT GLANDS
ARE KNOWN AS MOLLS
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 KRAUSES GLANDS

THE LACRIMAL PASSAGES CONSISTS OF :

THE
THE
THE
THE

LACRIMAL PUNCTA
CANALICULI
LACRIMAL SAC
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
BRUCHS MEMBRANE
AND THE RETINAL 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 BRUCHS 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 LIPOIDSOLUBILITY 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