Anatomy of the eye

Deswaty Furqonita, SSi, MBiomed

Department Of Anatomy - FMUI
• Orbits
• Anatomy of the eye accessory
organs
• Anatomy of the eyeball
• Eye movement
• Pathways
• Clinical anatomy
• Bones of the orbit
• Neurovasculature of the orbit
• Topography of the orbit
• Orbit an eyelid
Orbit and its relation to other structure
What happen to this man?
What anatomical structure can be affected?
Blow-out fracture
Most common in the orbital floor and medial wall.
Maxillary sinus
Can damage the infraorbital nerves  loss of sensation to
the cheek and upper lips

Orbital cellulitis caused by infection of air

sinuses
Orbit and its relation to other structure
• Anterior part of orbit contain eyeball and accessory visual structure.
• Accessory visual structure consist of:
• Eyelids (palpebrae)
• Extra-ocular muscles
• Neurovascular structures
• Orbital fascia
• Conjunctiva
• Lacrimal apparatus
 Surface anatomy of the eye
Accessory Structures
of the Eye

Eyebrows
Eyelids
Conjunctiva
Lacrimal apparatus
Extrinsic eye muscles
Accessory Structures of the Eye
Eye: Orbital Region, Eyelids, and Conjunctiva
Blood supply by branch of
• Ophthalmic artery
• Facial artery
• Superficial temporal artery
Innervation:
The sensory nerves: all branches of the
trigeminal nerve [V].
Motor innervation is from:
the facial nerve [VII] palpebral part of the
orbicularis oculi;
the oculomotor nerve [III]  levator
palpebrae superioris muscle;
sympathetic fibers  the superior tarsal
muscle.
Structure of the eyelids
 The eyelid consists clinically of an outer and
an inner layer with the following
components:
 Outer layer: palpebral skin, sweat glands,
ciliary glands (modified sweat glands, Moll
glands), sebaceous glands (Zeis glands), and
two skeletal muscles, the orbicularis oculi and
levator palpebrae (upper eyelid only),
innervated by the facial nerve and the
oculomotor nerve, respectively.
 Inner layer: the tarsus ( brous connective
tissue plate), the superior and inferior tarsal
muscles (of Müller; smooth muscle
innervated by sympathetic bers), the tarsal or
palpebral conjunctiva, and the tarsal glands
(Meibomian glands).
 Structure of Conjunctiva
The conjunctiva (tunica conjunctiva) is a
vascularized, thin, serous mucous membrane
that is subdivided into:
1.the palpebral conjunctiva,
2.fornical conjunctiva, and
3.ocular conjunctiva

Functions of conjunctiva :
1. facilitating ocular movements,
2. enabling painless motion of the palpebral
conjunctiva and ocular conjunctiva relative to
each other (lubricated by lacrimal fluid), and
3. protecting against infectious pathogens
(collections of lymphocytes along the fornices).
Lacrimal apparatus
• The hazelnut-sized lacrimal gland is located in the lacrimal fossa of
the frontal bone and produces most of the lacrimal fluid.
• Smaller accessory lacrimal glands (Krause or Wolfring glands).
• the lacrimal gland, which normally is not visible or palpable, into an
orbital lobe (two-thirds of gland) and a palpebral lobe (one-third).
• The sympathetic fibers innervating the lacrimal gland originate from
the superior cervical ganglion and travel along arteries to reach the
lacrimal gland.
• The parasympathetic innervation of the lacrimal gland is complex.
Lacrimal apparatus
Innervation of lacrimal gland

• Sensory innervation: lacrimal branch

of ophthalmic nerve [V1]
• Parasymphatic (secretomotor)
innvervation: facial nerve [VIII]
• Sympathetic innervation: superior
cervical ganglion.
Eyelids and conjunctiva
Conjunctivitis
Dilatation of the vessels --> bright red appearence

Chalazion
Lump/swelling/nodule in the eyelid, due to blockage of tarsal
(meibomian) gland.
Redness and swolen eyelids, usually non painful.
Treatment: warm compresses, steroids, incision through the
conjunctival surface of eyelid
 Eyelids and conjunctiva
Hordeolum
External: an acute infection of a lash follicle/ sebaceous gland [Zeis]/
ciliary sweat gland [Moll]. Treatment: drain externally to the skin
surface of the lid.
Internal: an acute infection of tarsal gland. Treatment: drain through
the concjunctival surface of the lid.

Anesthesizing the eyelids.

The sensory nerves to the eyelidsrun in the aeolar tissue beneath the orbicularis oculi
muscle. To block these nerves, local anesthetic must be injected deep to the muscle.
EYEBALL
 WALLS OF THE EYEBALL
Wall of the eyeball consist of three layers:
• The outer fibrous layer consists of the sclera posteriorly and the cornea anteriorly.
• The middle vascular layer consists of the choroid posteriorly and is continuous with the ciliary
body and iris anteriorly.
• The inner layer consists of the optic part of the retina posteriorly and the nonvisual retina that
covers the internal surface of the ciliary body and iris anteriorly.
EYEBALL
Fibrous layer of the eyeball
• The fibrous layer of the eyeball consists of two components-the sclera covers
the posterior and lateral parts of the eyeball, about 5/6 of the surface, and
the cornea covers the anterior part (1/6 of the surface).
• Sclera
• The sclera is an opaque layer of dense connective tissue that can be seen anteriorly
through its conjunctival covering as the 'white of the eye'.
• It is pierced by numerous vessels and nerves, including the optic nerve posteriorly, and
provides attachment for the various muscles involved in eyeball movements.
• The fascial sheath of the eyeball covers the surface of the sclera externally from the
entrance of the optic nerve to the corneoscleral junction while internally the surface of
the sclera is loosely attached to the choroid of the vascular layer.
• Cornea
• Continuous with the sclera anteriorly is the transparent cornea. It covers the anterior
one-sixth of the surface of the eyeball and, being transparent, allows light to enter the
eyeball.
 Lens
Eye : Cornea and Lens
Vascular layer of the eyeball
• The vascular layer of the eyeball consists of three continuous parts-
the choroid, the ciliary body, and the iris from posterior to anterior.
• Choroid
• The choroid is posterior and represents approximately two-thirds of the
vascular layer.
• It is a thin, highly vascular, pigmented layer consisting of smaller vessels
adjacent to the retina and larger vessels more peripherally.
• It is firmly attached to the retina internally and loosely attached to the sclera
externally.
 Vascular layer of the eyeball
• Ciliary body
• Extending from the anterior border of the choroid is the ciliary body. This triangular-shaped
structure, between the choroid and the iris, forms a complete ring around the eyeball.
• Its components include the ciliary muscle and the ciliary processes.
• The ciliary muscle consists of smooth muscle fibers arranged longitudinally, circularly, and
radially.
• Controlled by parasympathetics traveling to the orbit in the oculomotor nerve [III], these
muscle fibers, on contraction, decrease the size of the ring formed by the ciliary body.
• The ciliary processes are longitudinal ridges projecting from the inner surface of the ciliary
body. Extending from them are zonular fibers attached to the lens of the eyeball, which
suspend the lens in its proper position and collectively form the suspensory ligament of the
lens.
• Contraction of the ciliary muscle decreases the size of the ring formed by the ciliary body.
This reduces tension on the suspensory ligament of the lens. The lens therefore becomes
more rounded (relaxed) resulting in accommodation of the lens for near vision.
• Ciliary processes also contribute to the formation of aqueous humor.
Vascular layer of the eyeball
• Iris
• Completing the vascular layer of the eyeball anteriorly is the iris. This circular
structure, projecting outward from the ciliary body, is the colored part of the
eye with a central opening (the pupil). Controlling the size of the pupil are
smooth muscle fibers within the iris.
• Fibers arranged in a circular pattern make up the sphincter pupillae muscle,
which is innervated by parasympathetics-contraction of its fibers decreases or
constricts the pupillary opening
• Fibers arranged in a radial pattern make up the dilator pupillae muscle, which is
innervated by sympathetics-contraction of its fibers increases or dilates the
pupillary opening.
Structure of the iris
The lens and ciliary
body
PUPIL
 Intraocular muscles
Muscle Location Innervation Function
Ciliary Muscle fibers in the Parasymphatetics from Constrics ciliary body,
ciliary body the occulomotor nerve relaxes tension on the
[III] lens, lens become
rounded

Sphincter pupillae Circularly arranged Parasymphatetics from Constrics pupil

fibers in the iris the occulomotor nerve
[III]

Dilator pupillae Radially arranged fibers Symphatetics form the Dilates pupil
in the iris superior cervical
ganglion (T1)
 Intraocular muscles
The activation of the ciliary muscle changes the shape of the lens (via zonule) to adjust its refractive state and
focus the image to the retina, accommodation.
The lost of accommodation: produces blurring vision on near vision, presbyopia, or a loss of distant acuity,
myopia

Elaine n Marieb, Patricia Brady Wilhem & Jon Mallat. Human Anatomy. 6th ed. Benjamin Cummings. 2012.
Eye: Iris and Ocular Chambers
Normal drainage of aqueous humor
Obstruction of aqueous drainage and
glaucoma
 Vascularisation of the eyeball
• The arterial supply to the eyeball is from several sources:
• The short posterior ciliary arteries are branches from the ophthalmic artery
• The long posterior ciliary arteries, usually two, anastomose with the anterior ciliary
arteries;
• The anterior ciliary arteries are branches of the arteries supplying the muscles.
• The central retinal artery that has traversed the optic nerve and enters the area of
the retina at the optic disc.
• Venous drainage of the eyeball is primarily related to drainage of the
choroid layer. Four large veins (the vorticose veins) are involved in this
process.
• They exit through the sclera from each of the posterior quadrants of the eyeball and
enter the superior and inferior ophthalmic veins. There is also a central retinal vein
accompanying the central retinal artery.
Artery of the orbit Opthalmic Vein
The artery supplying the inner part of the retina (central retinal
artery) and the choroid
 Inner layer of the eyeball
• The inner layer of the eyeball is the retina. It consists of two parts.
• Posteriorly and laterally is the optic part of the retina, which is sensitive to light.
• Anteriorly is the nonvisual part, which covers the internal surface of the ciliary
body and the iris.
• The junction between these parts is an irregular line (the ora serrata).
Optic part of the retina
• The optic part of the retina consists of two layers:
• An outer pigmented layer is firmly attached to the choroid and continues
anteriorly over the internal surface of the ciliary body and iris.
• an inner neural layer, which can be further subdivided into its various neural
components, is only attached to the pigmented layer around the optic nerve and
at the ora serrata.
• It is the neural layer that separates in the case of a detached retina.
• Several obvious features are visible on the posterior surface of the optic
part of the retina.
Transverse section through
the eyeball, attachment of
vitreous body
 Optic part of the retina
• The optic disc is where the optic nerve leaves the retina. It is lighter
than the surrounding retina and branches of the central retinal artery
spread from this point outward to supply the retina. As there are no
light-sensitive receptor cells in the optic disc it is referred to as a blind
spot in the retina.
• Lateral to the optic disc a small area with a hint of yellowish coloration
is the macula lutea with its central depression the fovea centralis. This
is the thinnest area of the retina and visual sensitivity here is higher
than elsewhere in the retina because it has fewer rods (light-sensitive
receptor cells that function in dim light and are insensitive to color) and
more cones (light-sensitive receptor cells that respond to bright light
and are sensitive to color).
Eye : Retina
Optic disk, macula lutea dan fovea centralis
Ophthalmoscopic view of
posterior chamber of the
eye
EXTRA-OCULAR MUSCLES
 Extra-ocular muscles and
their movement

• Keith L Moore, Arthur F Dalley & Anne MR Agur. Clinically Oriented Anatomy 7th ed. Lippincott Williams & Wilkins. 2014
Extra-ocular muscles and their movement

• Keith L Moore, Arthur F Dalley & Anne MR Agur. Clinically Oriented Anatomy 7th ed. Lippincott Williams & Wilkins. 2014
 Extra-ocular muscles and their movement

• Keith L Moore, Arthur F Dalley & Anne MR Agur. Clinically Oriented Anatomy 7th ed. Lippincott Williams & Wilkins. 2014
Extrinsic eye muscles

Mnemonic: LR6(SO4)3  TrOboS AbduReL

Clinical testing of extra-ocular muscles

• Keith L Moore, Arthur F Dalley & Anne MR Agur. Clinically Oriented Anatomy 7th ed. Lippincott Williams & Wilkins. 2014
Clinical testing of extra-ocular muscles

• Keith L Moore, Arthur F Dalley & Anne MR Agur. Clinically Oriented Anatomy 7th ed. Lippincott Williams & Wilkins. 2014
 This is Normal condition???

Right eye Left eye

Keith L. Moore, Arthur F. Dalley & Anne M. Agur. Clinically oriented Anatomy. 7th ed. Lippincott Williams & Wilkins. 2015
 Visual pathway
The fibers of the optic tract crossed and uncrossed at the optic chiasm.
• Fibers of the medial root:
• Superior colliculus, provide for automatic scanning (reading).
• Relayed from the superior colliculus to the pulvinar of the thalamus (the extra-
geniculate pathway) to the visual association cortex.
• Pretectal nucleus and serve the pupillary light reflex
• Fibers of the lateral root:
• Lateral geniculate body (LGB) of thalamus  optic radiation (geniculocalcarine tract)
primary visual cortex
Visual field and pathway
Consist of:
• Binocular zone: both eyes
• Monocular zone: seen only
by corresponding eyes (left
or right eyes
• Each visual field is divided
into nasal and temporal
halves, hemifields
• Each hemifields is divides
into upper and lower parts (
into quadrants)

Elaine n Marieb, Patricia Brady Wilhem & Jon

Mallat. Human Anatomy. 6th ed. Benjamin
Cummings. 2012.
Visual defects following various
lesions of the visual pathways
Accomodation reflex
Focusing on a near or
distance object

Optic tract
LGB

Note:
Parasympathetic nucleus of Occulomotor
nerve = Nucleus of Edinger-Westphal

Richard S Snell. Clinical neuroanatomy for Medical Students. 7th ed. Lippincott Williams &
Wilkins. 2010
 Direct & consensual light
reflex
Constriction of the pupil

Optic tract

LGB
Note:
Parasympathetic nucleus of Occulomotor
nerve = Nucleus of Edinger-Westphal

Richard S Snell. Clinical neuroanatomy for Medical Students. 7th ed. Lippincott Williams &
Wilkins. 2010
Corneal reflex
Light touching of the cornea or conjunctiva results in blinking of both
side of the eyelids

Medial
longitudinal
fasciculus
• Elaine n Marieb, Patricia Brady Wilhem & Jon Mallat. Human Anatomy. 6th
ed. Benjamin Cummings. 2012
• Keith L Moore, Arthur F Dalley & Anne MR Agur. Clinically Oriented
Anatomy 7th ed. Lippincott Williams & Wilkins. 2014
• Richard L. Drake, A. Wayne Vogl & Adam W.M. Mitchell.Gray's Anatomy for
Students, 8th , 2015
• Richard S Snell. Clinical neuroanatomy for Medical Students. 7th ed.
Lippincott Williams & Wilkins. 2010
• Schuenke, M., Schulte, E., and Schumacher, U. Thieme Atlas of Anatomy:
Head, Neck and Neuroanatomy. Thieme. 2016