ANATOMY AND

PHYSIOLOGY OF THE EYE

Department of Ophthalmology
Fatima College of Medicine
ORBIT

 BONY CAVITY WHICH HOUSES THE

EYEBALL
 4 WALLS - ROOF,FLOOR, MEDIAL AND
LATERAL WALL
 30 mL in volume
 HAS AN APEX WHERE NERVES AND
VESSELS EMERGE
Orbital Walls
ORBITAL WALLS

 ROOF
 COMPOSED OF THE LESSER WING OF THE
SPHENOID, AND ORBITAL PLATE OF THE
FRONTAL BONE
 INTIMATELY RELATED TO THE FRONTAL
SINUS
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
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
ORBITAL WALLS

 MEDIAL WALL
 INTIMATELY RELATED TO THE ETHMOID
AND SPHENOID SINUSES
 COMPOSED OF THE ETHMOID BONE,
SPHENOID BONE, LACRIMAL BONE AND
MAXILLA
ORBITAL APEX

 SERVES AS A PORTAL FOR NERVES AND

VESSELS
 SITE OF ORIGIN OF ALL EOMS EXCEPT
INFERIOR OBLIQUE
Orbital Apex
SUPERIOR ORBITAL
FISSURE

 LATERAL PORTION
 SUPERIOR OPHTHALMIC VEIN
 LACRIMAL NERVE
 FRONTAL NERVE
 TROCHLEAR NERVE
 MEDIAL PORTION
 SUPERIOR AND INFERIOR DIV. OF
OCULOMOTOR NERVE
ORBITAL APEX

 OPTIC CANAL
 TRANSMITS OPTIC NERVE AND OPHTHALMIC
ARTERY
 SUPERIOR ORBITAL FISSURE
 ALSO TRANSMITS THE INFERIOR
OPHTHALMIC VEIN
BLOOD SUPPLY OF THE
ORBIT

 OPHTHALMIC ARTERY
 CENTRAL RETINAL ARTERY
 LACRIMAL ARTERY
 MUSCULAR BRANCHES
 LONG AND SHORT POSTERIOR CILIARY
ARTERY
 MEDIAL PALPEBRAL ARTERIES
Blood Supply of the Eyeball
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
BLOOD SUPPLY

 Anterior ciliary artery

 derived from muscular branches of the rectus
muscles
 anterior sclera, episclera, limbus, conjunctiva
Venous Drainage of the
Orbit

 Superior and Inferior Ophthalmic Veins

 Vortex veins
 Anterior Ciliary Veins
 Central retinal Veins
Venous Drainage of the
Eyeball
Venous Drainage
 The 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
Eyeball

 Roughly spherical
 approximately 24.5 mm (less than an
inch) in length
 about 5mL in total volume
Eyeball
Histological Cross Section
of the Eyeball
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
Conjunctiva

 Blood Supply
 anterior ciliary artery
 palpebral aretries
 Nerve Supply
 first division of the trigeminal nerve
Upper Eyelids
Lower Lid Retractors
Tenon’s Capsule

 A fibrous membrane that envelopes the

globe from the limbus to the optic nerve
 continuous with the EOM’s
 thickens to form check ligaments
Sclera

 Fibrous outer protective coating of the eye

 composed of dense bands of well
hydrated connective tissue
Episclera

 Fine elastic tissue containing blood vessels

and covers the anterior surface of the
sclera
Cornea
 Transparent tissue which accounts for most of
the refractive power of the eye
 thicker at the limbus, and thinner at the center
 5 layers
 epithelium
 Bowman’s layer
 Corneal stroma
 Descemet’s layer
 Endothelium
Cornea
Cornea
Uveal Tract

 Iris
 Ciliary Body
 Choroid
Posterior View of Uveal
Tissue
Iris

 Flat anterior extension of the ciliary body

 has a central round aparture known as
the pupil
 divides the anterior from the posterior
chamber
Iris
Ciliary Body

 Extends from the choroid to the iris

 divided into the pars plicata and pars
plana
 point of suspension of the lens
 produces aqueous humor
Aqueous Flow
Choroid

 Posterior segment of the uveal tract in

between the retina and sclera
 joins the ciliary body anteriorly
 choroidal blood vessels nourish outer
portion of the retina
Ora Serrata
Choroidal Circulation
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
Lens Accommodation
Lens in the Young
Lens in the Aged
Anterior Chamber Angle

 Schwalbe’s line
 Schlem’s canal
 Trabecular meshwork
 Scleral spur
Anterior Chamber Angle
Trabecular Meshwork
Aqueous Flow
Optic Nerve Cupping
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
Fundus
Posterior Pole
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
Retinal Layers
Macula

 Center of the posterior retina

 responsible for fine central vision
 has yellow pigment (xantophyll)
 histologically empty space tends to the
accumulation of extracellular material
that cause thickening
Photoreceptors
Blood Supply of the Retina

 Choriocapillaries
 outer third of the retina
 Central Retinal Artery
 inner two thirds of the retina
Embryonic Eye
Embryonic Eye
Vitreous

 Clear, avascular, gelatinous body

 comprises 2/3 of the volume of the eye
 99% water ; 1% hyaluronic acid and
collagen
 firmly attached to the pars plana and ora
serrata
Eyeball
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 limbus
 Pars plicata - 2-3 mm from the limbus
Extraocular Muscles

 Rectus Muscles
 superior rectus
 inferior rectus
 medial rectus
 lateral rectus
 Oblique Muscles
 Superior oblique
 Inferior oblique
Extraocular Muscles
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
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
Ocular Adnexa

 Eyebrows
 thickened skin covered with hair
 Eyelids
 modified folds of skin
 closes to protect the eyeball
 blinks to lubricate cornea
Eyelids
Eyelids

 Skin Layer
 Orbicularis Oculi
 Areolar tissue
 Tarsal plate
 Palpebral conjunctiva
Orbicularis Muscle
Lid Margins

 Eyelashes
 Glands of Zeis
 Glands of Moll
 Meibomian glands
 lacrimal punctum
Palpebral Fissure

 Elliptical space between the two eyelids

 terminates at the lateral and medial canthi
Orbital septum

 Fascia behind the portion of orbicularis

muscle and serves as a barrier between
the lid and the orbit
Eyelids
Eyelid Anatomy
Lid retractors

 Responsible for opening the eyelids

 levator palpebrae superioris muscle
 aponeurosis
 meuller’s muscle
 Lower lid retractor
 inferior rectus, extends with the inferior oblique
and insert into the lower border of the tarsal plate
Upper Eyelids
Lower Lid Retractors
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
Eyelids

 Blood Supply
 lacrimal and ophthalmic areteries
 Venous drainage
 ophthalmic vein
 Lymphatic drainage
 Temporal eyelids - pre-auricular and parotid
nodes
 Nasal eyelids - submandibular nodes
Lacrimal Apparatus

 Lacrimal glands
 accessory lacrimal glands of Krauss and
Wolfring
 Puncta
 Canaliculi
 Lacrimal sac
 Nasolacrimal duct
Lacrimal Apparatus
Lacrimal Gland

 Blood supply - lacrimal artery

 Venous drainage - ophthalmic vein
 Lymphatic drainage - preauricular lymph
nodes
 Nerve supply - lacrimal nerve, great
superficial petrosal nerve, sympathetic
nerves
Lacrimal Apparatus
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 segment
 goes through optic canal
 10mm intracranial course
 joins optic chiasm
Optic Nerve
Vascular Supply of the
Optic Nerve
Visual pathway

 Retina
 Optic nerve
 Optic chiasm
 Optic tract
 Optic radiation
 Occipital lobe (Visual center)
Visual Pathway