Anatomy of Vision

Anatomy of Vision
 Eye is an optical system which focuses light
through a lens on photo receptors and has a
system of nerves which conducts impulses
from the receptors to the brain.
 It is moved within the orbit by six color
muscles.
 Lens in an eye is a clear biconvex structure
behind the pupil held by circular lens ligament
known as zonule.
 Contd..
• Eye is a specialized sense organ that helps us
understand the environment.
• It is a sensory unit composed of 3 parts -
receptor, sensory path way and a brain center.
• Cornea is the transparent part of the eyeball.
• Rods and cones present in the inner most
layer are responsible for photoreception.
• Rods are extremely sensitive to light and
hence responsible for night vision.
 Contd..
• Rods give no information about color.
• Color vision depends on cones which work at
high intensity of light and are responsible for day
vision.
• There are 2 inputs to the central nervous system
– one from the rods and one from the cones.
• Retina is the inner most layer of the eye and it is
responsible for converting light into nerve
impulses.
 Contd..
• For color vision red, green and blue cones are
used.
• The image is formed by retraction of light by
cornea and lens of the eye and an inverted
image is formed on the retina of the eye.
• The response of a cone depends on how well
its pigment absorbs particular light.
Percentage of light absorption Vs wave length of
different colors of cones and rods
 Contd..
• Maximum light absorption of blue cone
occurs at 600nm while absorption in red and
green cone is at 500nm and 550nm.
• Each eyeball acts as a camera, it perceives the
images and relays the sensations to the brain
via virtual pathways which comprise optic
nerve, optic tract and optic radiations.
Blood supply to the eye
Muscles of the Eye
Contd..
 Electrophysiological Tests
• These tests of the eye allow evaluation of the
retinal functions.
• These include
ERG(Electroretinography)
EOG(Electrooculography
VER(Visually Evoked response)
 Electroretinography
• It is a measurement of response of the retina
of the eye to light. i.e changes in the resting
potential of the eye from darkness to fall of
light on the retina.
• ERG signals are more complex.
• The amplitude range of ERG signal is 0.5mV to
1mV and frequency is from DC to 20Hz.
• Electroretinogram is a composite electrical
activity of the photoreceptors.
 Contd..
• Normal record of ERG consists of the following
waves:
a-wave: Initial negative wave from photo
receptors
b-wave: Large cornea positive wave generated
by miller cells.
c-wave: Positive wave with low amplitude
representing metabolic activity of pigment
ERG signal
 Contd..
• Amplitude of a wave is measured from the
base line to the through of the a wave where
as that of b wave is measured from through of
a wave to peak of b wave.
• Latency is the time interval between the start
of light stimulus and beginning of a wave.
• Implicit time is from the start of light stimulus
to the minimum of b wave.
 Contd..
• In humans ERG signal is recorded with one
electrode fitted on the cornea and is normally
embedded in a contact lens and the other
electrode is reference electrode made of silver
chloride and is placed on the forehead.
• ERG is recorded in both light adapted and dark
adapted states.
• ERG is used for diagnosis of retinitis pigmentosa,
diabetic retinopathy, retical detachment, vascular
occlusions of the retina.
 Electrooculogram
• It records biopotentials generated by the
movement of eyeball.
• EOG signal amplitude is 50 µV to 4000 µV and
the frequency range is between 0.1 to 100 Hz.
• A pair of electrodes are required for
measurement where one of the reference
electrode is placed on the forehead and the
other surface electrode is placed on the left of
the eye.
 Contd..
• The EOG potential is zero with the eye
position is at zero degree.
• When the eye ball is shifted to the left or
right, the left and the right electrode becomes
more positive.
• EOG response has 2 components:
• Light peak: Potential rise due to light when
both rods and cones contribute.
 Contd..
• It represents the maximal height of the
potential in light.
• Dark Through: It is light insensitive component
and occurs from retinal pigment epithelium,
photo receptors and inner layer. It represents
the minimal height of the potential in
darkness.
 Contd..
• The results of EOG are interpreted by finding
the Arden ratio as:
Max height of light peak/max height of dark
through* 100
 EOG is affected in diseases such as
pigmentation, vitamin A deficiencies and
retinal detachment.
 VER
• It is an evoked potential caused by a visual
stimulus and the responses are recorded from
electrodes that are placed on the back of your
head.
• These responses usually originate from the
occipital cortex, the area of the brain involved
in receiving and interpreting visual signals.
 Ophthalmoscope
• It is a clinical examination of the interior of the
eye by means of ophthalmoscopy.
• Ophthalmoscope was invented by Von
Helmholtz in 1850.
• Three methods of examination are in use:
• Distant direct ophthalmoscope
• Direct ophthalmoscopy
• Indirect ophthalmoscopy
 Distant direct Ophthalmoscopy
• This can be performed with a simple plain
mirror with a hole in the center.
• The light is thrown in the patients eye sitting
in a semi dark room from a distance of 20-25
cm and the features of the red glow in the
pupillary area are noted.
• It helps in diagnosing the opacities (state of
the body that makes it impervious to rays of
light) .
Contd..
 Contd..
• For this the patient is asked to move the eyes
up and down while the doctor observes the
pupillary glow.
• Any defect can be identified as black shadow
in the red glow.
• This test is used to indicate a detached retina
or a tumor in the eye.
 Direct Ophthalmoscopy
• Most common method used for fundus
examination.
• A convergent beam of light is reflected to the
patient pupil shown by dotted lines.
• The emergent rays from any point on the patients
fundus reach the doctors retina through the hole
in the ophthalmoscope.
• The emerging rays from the patients eye are
parallel and brought to focus on the retina of the
patients eye, when accommodation is relaxed.
Direct Ophthalmoscope
Contd..
 Contd..
• This direct ophthalmoscopy should be performed
in a semi darkroom with the patient seated and
looking straight ahead slightly over the side of the
eye to be examined- patients right eye should be
examined by doctors right eye and let eye with
the left.
• The observer(doctor) should reflect beam of light
from the ophthalmoscope into patients pupil.
 Contd..
• Once the red reflex is seen the doctor should
move as close to the patients eye as possible.
 Indirect Ophthalmoscope
• This is a very popular method for examination
of the posterior segment of eye.
• The optical principle in this indirect
ophthalmoscopy is to make the eye highly
myopic by placing strong convex lens in front
of the patients eye so that the emerging rays
from an area of fundus are brought to focus as
a real inverted image between the lens and
the doctors eye which is then studied.
Indirect Ophthalmoscope
 Contd..
• The image formed in indirect ophthalmoscopy
is real, inverted and magnified.
• With a stronger lens the image will be smaller
but brighter and field of vision will be more.
• This should be done in dark room.
• The patient is made to lie on the table with a
pillow and using ophthalmoscope the doctor
projects light into patient eye.
 Contd..
• The doctor has to move around the head of
the patient to observe different quadrants of
fundus.
• The indirect ophthalmoscopy is essential for
the assessment and management of retinal
detachment and other retinal problems.
• This technique is difficult and cannot be
mastered with out practice.
 Tonometer for Eye Pressure
Measurement
• The intraocular pressure can be measured
with the help of an instrument called
tonometer.
• Two types of tonometer are available:
1.Identation(Schlotz) Tonometer
2.Applanation(Goldmann) Tonometer
 Identation(Schlotz) Tonometer
• It consists of handle for holding the vertical
position of the cornea.
• Consists of a foot plate which rests on the
cornea.
• A plunger which moves inside the foot plate.
• A bent lever whose short arm rest on plunger
and long arm acts as pointer needle.
• 5gm is permanently fixed to the plunger and is
increased to 7.5gm or 10gm.
Identation(Schlotz) Tonometer
 Contd..
• The eye whose ocular pressure has to be
measured is anesthized by topical xylocane ,
and patient is made to lie on a couch.
• The tonometer is held in the left hand and
foot plate is made to rest on the cornea.
• The reading on the scale is recorded by the
needle when it becomes steady.
 Contd..
• The advantage is that it is very handy.
• The disadvantage is that it cannot be used in
abnormal high pressure.
 Applanation(Goldmann) Tonometer
• This is the most popular and accurate
tonometer.
• It consists of a double prism mounted on a slit
lamp.
• The prism applanates(horizontally expands)
the cornea in an area of 3.06mm diameter.
• For measuring eye pressure, the cornea is
anesthized with a drop of xylocane and the
patient is asked to sit in front of the slit lamp.
Applanation(Goldmann) Tonometer
 Contd..
• The cornea and biprisms are illuminated with
the cobalt blue light from the slit lamp.
• Biprism is then advanced until it just touches
the open of the cornea.
• At this point 2 fluorescent semicircles are
viewed through the prism.
• The applanation force against cornea is
adjusted until the inner edges of the
semicircles just touch.
 Clinical Laboratory Instruments
• Patient specimen analysis is done in the
clinical laboratory.
• It provides information to aid in the diagnosis
of disease and evaluate the effectiveness of
therapy.
• Clinical laboratory is also known as clinical
pathology department.
• Chemistry, hematology and microbiology are
the sections of this department.
 Contd..
• Blood, urine and cerebrospinal fluid and other
fluids are analyzed in chemistry section to find
the content of various clinically important
substances.
• The determination of numbers and
characteristics of the formed elements in the
blood i.e red blood cells, white blood cells and
platelets and also other functions of the system
like blood clotting are done in hematology
section.
 Contd..
• The microbiology section helps in studies on
various body tissues and fluids to determine
whether pathological microorganisms are
existing.
• Electronic automation is quite common.
• The fast response, accuracy and precision are
essential requirements.
1.Spectrophotometry
 Contd..
• Spectrophotometry is a method to measure
how much a chemical substance absorbs light
by measuring the intensity of light as a beam
of light passes through sample solution.
• Substances of clinical interest selectively
absorb or emit electromagnetic energy at
different wave lengths.
• Most of the instruments operate in the visual
range(400-700nm).
 Contd..
• Flame Photometers: A photoelectric flame
photometer is a device used in inorganic
chemical analysis to determine the concentration
of certain metal ions such as sodium, potassium,
lithium, and calcium.
• Atomic Emission: Atomic emission
spectroscopy (AES) is a method of chemical
analysis that uses the intensity of light emitted
from a flame, plasma, arc, or spark at a particular
wavelength to determine the quantity of
an element in a sample.
 Contd..
• Atomic Absorption: is a spectro analytical
procedure for the quantitative determination of
chemical elements using the absorption of optical
radiation (light) by free atoms in the gaseous
state. Atomic absorption spectroscopy is based
on absorption of light by free metallic ions.
• Fluorometry: Fluorescence spectroscopy (also
known as fluorimetry or spectrofluorometry) is a
type of electromagnetic spectroscopy that
analyzes fluorescence from a sample.
2.Chromatology
 Contd..
• This method is used for the detection of
complex substances such as drugs and
hormones.
• This method helps in determining which drug
have been taken in overdose.
• It is based on separating a mixture of
substances into component parts.
• It consists of injector, carrier gas, column and
recorder.
 Contd..
• Patient sample along with solvent is injected.
• It is a inert gas carrier which sweeps the
evaporated sample and solvent gas down the
column.
• Column helps in the analysis of the sample.
 3.Electrophoresis
• It is used for the separation of
DNA(Deoxyribonucleic acid )molecules.
• Electrophoresis is the movement of a solid
phase with respect to a liquid. i.e buffer
solution.
• Mobility is directly related to temperature.
Rate of migration increases with temperature.
• The distance of migration is directly related to
time.
Contd..
Contd..
 4.Hematology
• These are the devices which measure
characteristics from red blood cells, white
blood cells and platelets.
 5.Kymograph
• Kymograph is an instrument for recording of
heart beats, muscle contraction and
respiratory events.
 6.Galvanic Skin Disease
• It is the change in skin resistance due to
sweating.
• The emotional state such as fear, panic or
alertness indication can be achieved through
this technique.
• An active electrode is fixed on the palm of the
hand and a second neutral electrode is placed
on the wrist.
 Contd..
• Constant current of 10mA is passed through
the electrodes and GSR is measured.
• This GSR measurement is also used in the lie
detection test.
Diathermy
Contd..
Contd..
Contd..
 Contd..
• Diathermy equipment for physiotherapy are:
1. Short wave diathermy
2. Microwave diathermy
3. Ultrasonic therapy unit
 Short wave diathermy
• It produces deep heating via conversion of
electromagnetic energy to thermal energy.
• In diathermy for physiotherapy the patient
body also becomes a part of the electrical
circuit and the heat is produced with in the
body and transferred through the skin.
• Advantage of diathermy is that the treatment
can be controlled precisely.
 Contd..
• The duration of the treatment is adjusted by
providing an independent timing circuit in the
machine which controls the On/Off of the
machine.
• The most common use of short wave
diathermy is to operate in
• Inductor method
• Capacitor method
2.Microwave Diathermy
 3.Ultrasonic Therapy unit
• Here the heating is produced due to the
absorption of the ultrasonic energy by the
tissues.
• The effect of ultrasonic energy into tissue is
high speed mechanical vibration which is
nothing but micro massage of soft tissues.
• The electrical power required in most of the
applications is usually less than 3W.
 Contd..
• The transducer comes into contact with the part
of the body to be treated.
• The transducer through which the ultrasonic
energy is applied to the patient is made of
piezoelectric crystal.
• A high frequency alternating current of 0.75 to
3.4MHz is applied to the crystal where the
acoustic vibration causes the mechanical
vibration of the transducer lead, which itself is
located directly in front of the crystal.
 Contd..
• These mechanical vibrations then passes
through a metal cap and into the tissues
through a coupling medium.
• Applicator(Transducer) range varies from 70 to
130cm in diameter.
• The larger the diameter of the applicator, the
lesser is the penetration of the energy.
 Diathermy in surgery
• In surgical diathermy the freq of current is in
the range of 1 to 3 MHz.
• Two electrodes are used: passive and active
• Due to difference in current density between
2 electrodes, tissues below the passive
electrode heat up slightly and the tissues
below active electrode are heated to destroy
the cell.
 Biomaterials
• A biocompatible material is used to construct
artificial organs, rehabilitation devices, or
prostheses and replace natural body tissues.
• In surgery, a biomaterial is a synthetic or natural
material used to replace part of the living system
or to function in intimate contact with living
tissues.
• Biomaterial is defined as a material intended to
interface with biological systems to evaluate,
tract augment or replace any tissue, organ or
function of the body.
 Contd..
• Artificial hips, vascular stands, artificial
pacemakers and catheters are all made from
different biomaterials.
• For eg: The calcium hydroxyapatite coating
found on many artificial hips is used as a bone
replacement that allows easier attachment of
the implant to the living system.
 Classification of Biomaterials
S.No Classification Materials Application

1 Ceramics Aluminum oxide Dental and

Orthopedic
2 Composites Carbon-Carbon fibers Heart valves and
joint implants

3 Metals Aluminum, gold, Joint replacements,

titanium, iron Pace makers and
electrodes
4 Polymers Nylon, Synthetic Replacement of
Rubber soft tissues like
skin, blood vessels,
cartilage
Examples
• Synthetic polymers constitute the vast
majority of biomaterials used in humans.
• Synthetic polymers are made by 2 processes:
• Addition polymerization
• Condensation polymerization
 Most commonly used polymers and
their applications
• 1. Polyethylene:
Low density: Bags, tubing
High density: Catheter
Ultra high molecular: Orthopedic &
facial implants
2. Polymethy-methacrylate: intraocular lens,
dentures.
3. Polyvinyl chloride: Blood bags, catheters
 Contd..
• 4. Polyethylene terephthalate: Heart valves
• 5. Polyesters: Bioresporable sutures & surgical
products
• 6. Polyamides: Catheter
• 7. polyurethanes: Film, Coat Implants
 Properties of Biomaterials
• Should be non toxic, non allergenic, functional
for its lifetime and biocompatible.
• Polymers may loose some of the properties
with time, process called degradation.
• Polymers exhibit reasonable cost and can be
manufactured in various shapes and sizes
having desirable mechanical and physical
properties.
 Biocompatibility
• Biocompatibility is the acceptance of an
artificial device by the surrounding tissues and
the body as a whole.
 Stimulators
• Stimulators are used for pain relief.
• The electrical impulses are used to block the
path ways of the transmission of pain.
• These electrical impulses are produced in a
battery powered pulse generator.
• The pulses are passed on to the effected
portion of the body through a pair of
electrodes.
 Contd..
• These electrical impulses are applied to the
skin overlying any painful area of the body.
• The electrodes provide mild electrical
stimulation.
• These signals abstract the pain signals
travelling along the nerve pathways before
they can reach the brain.
 Transcutaneous electrical nerve
stimulator
• It provides electrical impulses required for
electrotherapy to tract the pain.
• The square wave or spike wave are equally
effective in relieving pain.
• Adjustable settings are provided for
controlling amplitude of stimulation.
• Electrodes are placed at specific sites on the
body for treatment of pain.
 Contd..
• Transcutaneous or skin surface application of
electrical stimulus is achieved by application
of pads to various trigger zone areas or
peripheral nerves.
• This stimulation is based on 500ms spike pulse
having an adjustable amplitude of 0 to 75mA
and an adjustable frequency of 12 to 100
pulses per second.
 Contd..
• In TENS the electrodes are commonly
moulded from silicon rubber loaded with
carbon particles to provide proper
conductance.
 Muscle stimulators
• These stimulators are used for physical therapy
for exercising the muscle to regain function of
paralyzed muscles, to gain ability to grasp in case
of paralytic hand, gaining control to stand, walk
etc..
• The different types of currents used for different
applications are:
1. Galvanic current: A steady flow of DC is passed
through the skin(tissue) producing a chemical
effect used in the treatment of paralysis and
disturbance of blood flow.
 Contd..
2. Faradic Current: A sequence of triangular
pulses with pulse duration of about 1ms to
20ms is used for the treatment of muscle
weakness.
3. Faradic Surging Current: High peak current
intensity applied to patient increases or
decreases rhythmically at a slow rate. Such
currents are used in the treatment of
functional paralysis in spasm.
 Contd..
• 4. Exponentially progressive current:
Sequence of triangular pulses with pulse
duration of .01 to 1000 ms are used. This is
used in the treatment of severe paralysis by
providing selective stimulation.
 Spinal cord Stimulator
• This stimulation is provided by placing the
electrodes close to the spinal cord for the relief of
pain.
• The electrodes are placed close to spinal cord by
surgery through skin.
• The applied electrical impulses develop an
electrical field in and around spinal cord which
then causes activation of the part of the neural
system resulting in physiological changes.
 Bladder Stimulators
• The bladder stimulators are used when
emptying the bladder is not possible due to
urinary tract infection, paraplegia and chronic
infection.
• The stimulus is provided in the form of
biphasic pulse with a preset pulse with 0.2 ms,
a pulse intensity of 0.5 to 25 V and a pulse
rate of 10 to 50 Hz.
 Cerebellar Stimulators
• The cerebellar stimulation is useful in the
treatment of epilepsy.
• Stimulation to cerebellum is provided by
transcutaneous inductive coupling through an
antenna fixed subcutaneously on the chest.
 UNIT-VI

SHOCK HAZARDS AND

PREVENTION
Physiological Effects and Electrical current
Shock hazards from electrical equipment
Isolated power distribution system
Methods of Accident Prevention