The Human Eye

Anatomy, Diseases, Disorders,

and Treatment.

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 Acknowledgements
Some material used in this presentation was
obtained from St. Lukes Cataract and Eye Institute
(www.stlukeseye.com), and The Northeastern Eye
Center (www.drrozakis.com)

Further information regarding the Anatomy of the

eye and eye pathology may be obtained at these
web sites.

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 Introduction
In this presentation, we will study the Anatomy and
Physiology of the Human eye. We shall also examine the
various simple Refractive Disorders of the eye, as well as
Pathologic Diseases which affect our vision.
Please click on the link below to view the area you are
interested in.

Anatomy Pathologic
Diseases
Refractive
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Disorders 3
 Anatomy of the Eye
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 A Review of the Eye,
its Function, and
Common Disorders

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01/26/22 6
 How the eye functions
When you look at an object, light rays are reflected from the
object to the Cornea, which is where vision begins. The light
rays are bent, refracted and focused by the Cornea, Lens, and
Vitreous. The Lens’ job is to make sure the image comes to a
sharp focus on the Retina. The resulting image on the Retina is
upside down. The Retina converts the light rays to electrical
impulses and transmits this information to the brain via the Optic
Nerve. The brain translates this information and perceives the
image as upright.

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 Conjunctiva

The Conjunctiva is the

thin, transparent tissue
that covers the outer
surface of the eye. It
begins at the outer edge
of the Cornea, covers the
visible portion of the eye,
and lines the inner surface
of the eyelid.

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 Cornea

The Cornea is the

transparent, dome shaped
window which covers the
front of the eye. It is a
powerful refracting
surface, providing 2/3 of
the focusing ability of the
eye.
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 Iris

The Iris is the colored

portion of the eye. It
controls light levels in the
eye. It contains muscles
which dilate (widen) or
constrict (narrow) to
control the amount of light
entering the eye. The
opening at the center is
known as the Pupil.

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 Pupil

The Pupil is the black

opening in the center of
the Iris. Under the control
of the Iris, it opens and
closes to control the
amount of light which is Pupil
allowed to enter the eye.

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 Lens

The Lens provides 1/3 of

the focusing ability of the
eye, and serves to focus
light entering the eye to
the Fovea. It is
suspended in the eye and
held in place by tiny “guy
wires” called Zonules.

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 Vitreous
The Vitreous is the “fluid”
portion of the eye. It is
actually a thick,
transparent substance,
comprised mainly of
water. It accounts for
about 2/3 of the total eye
volume.
In children, the vitreous is
about the consistency of
raw egg white. As we age,
the vitreous becomes
thinner. It is attached to
the retina at certain
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 Retina

The Retina is a very thin

layer of tissue which lines
the inner surface of the eye.
It functions much like film
in photography, capturing
the light rays entering the
eye.

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 Macula

The Macula is located in

the approximate center of
the Retina, temporal
(towards the temple) to
the optic nerve. It is a
small and highly sensitive
area of the retina
responsible for detailed
central vision.

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 Fovea

The Fovea is the very

center of the Macula and
is the most highly
sensitive area of the eye.

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 Optic Nerve

The Optic Nerve transmits

electrical impulses from
the Retina to the brain. It
connects to the back of
the eye near the Macula.
The visible portion of the
Optic Nerve is known as
the Optic Disc.

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 Optic Disc

The Optic Disc has no

sensory receptors. This is
the area known as the
“blind spot”.

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 Sclera

The Sclera is the tough,

opaque tissue known as
the “white of the eye”.
It serves as the eyes
protective outer coat.

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 Choroid

The Choroid lies between

the Retina and the Sclera,
and is composed of layers
of blood vessels which
nourish the back of the eye.

Back to Menu

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 Refractive Disorders
Click on the Disorder you wish to view

Myopia

Hyperopia

Astigmatism

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 Myopia (Nearsightedness)

Light entering the eye is focused in front of the Retina. It is

caused by a steeper than normal Cornea, or an eye that is
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 Myopia (Nearsightedness)

A person with Myopia will see near objects clearly, while

objects at a greater distance will appear blurry.
Myopia is a result of heredity, and is usually treated by the
application of corrective lenses or contact lenses. This type
of treatment is only temporary in nature.
Laser surgery is another, more permanent form of treatment.
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 Hyperopia (Farsightedness)

Light entering the eye is focused behind the Retina. It is

caused by a flatter than normal Cornea, or an eye that is
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 Hyperopia (Farsightedness)

A person with Hyperopia will see far objects clearly, while

nearby objects will appear blurry.
Hyperopia is a result of heredity, and is usually treated by the
application of corrective lenses or contact lenses. This type
of treatment is only temporary in nature.
Laser surgery is another, more permanent form of treatment.

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 Astigmatism

A person with Astigmatism has a cornea that is shaped more

like a football than a sphere. It usually has a steeper slope
and a flatter slope, resulting in light rays being focused in two
parts of the eye. This causes blurry vision and can be seen in
Myopic or Hyperopic people.
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 Astigmatism

A person with Astigmatism exhibits symptoms of Myopia AND

Hyperopia, resulting in blurred or distorted vision at all
distances
Astigmatism can be caused by heredity, scarring of the
Corneal tissue, or Keratoconus. The usual forms of treatment
are glasses, contact lenses, or laser surgery.

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 Pathologic Diseases
Click on the Link to view information about the disease.
Cataracts

Glaucoma

Diabetic Retinopathy

Floaters

Macular Degeneration

Dry Eye

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 Cataracts
A Cataract is a clouding of
the natural lens of the eye.
Cells within the lens
capsule die and are
trapped.

Cataracts are the

leading cause of
loss of vision for
adults over 55.

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 Cataracts

Almost all adults will at some time during their lives, develop
Cataracts. The formation of cataracts differs greatly between
individuals. Some of the leading causes of cataracts are:
Normal Aging
Diabetes
Heredity
Trauma to the eye
Glaucoma
Smoking
UV radiation

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 Cataracts
Some of the early signs of cataracts are:
Blurry vision
Difficulty seeing at night
The appearance of “halos” when looking at a light
Frequent eyeglass prescription changes
Faltering depth perception
Difficulty in seeing colors
Loss of sight with age
Visual difficulty in reading
These conditions can be symptomatic of other conditions as
well, and are not related solely to cataracts.
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 Cataracts

Diagnosis and Treatment of Cataracts

Diagnosis
A simple contrast test can be administered to determine the
presence and extent of a possible cataract.

Treatment
There is no known medicinal treatment to prevent or cure
cataracts. Once the cataract begins to form, the only
treatment methodology is cataract surgery.

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 Glaucoma

Glaucoma occurs as a result of increased intraoccular

pressure caused by a malformation or malfunction of the
eyes drainage system. This increases pressure on the
optic nerve, and causes progressive, permanent loss of
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 Glaucoma
Open Angle Glaucoma is caused when the normal drainage
system of the eye becomes partially blocked, causing
pressure to build within the eye.

Normal Eye Pressure builds when the drainage system

is blocked. This increasing pressure
presses against the Optic Nerve and
causes a loss of sight.
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 Glaucoma
Open Angle Glaucoma
Symptoms
In the very early stages there are NO symptoms.
Mild pain in the eye, increasing gradually over time.
“Halos” appearing around lights.
Gradual loss of Peripheral vision.
Loss of night vision

Who is at risk?
Patients with a family history of Glaucoma
African Americans
Patients suffering from Myopia
Patients suffering from Diabetes
People over 35 years of age
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 Glaucoma
Open Angle Glaucoma
Diagnosis
Tonometry is often used to diagnose Glaucoma. The Tonometer is gently
pressed against the eyeball, and the resistance (internal pressure) is
measured. This requires that the eye be numbed prior to the test.

Perimetry is another method used to determine if there is any loss of the

visual field.

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 Glaucoma
Open Angle Glaucoma
Treatment
Medication
Laser Surgery
Filtration Surgery

Medications Laser surgery Filtration

are available in can reduce the Surgery
several forms. need for creates a new
medications drainage
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channel
 Glaucoma
Narrow Angle Glaucoma (Sometimes referred to as Closed
Angle is caused when the normal drainage system of the eye
becomes suddenly blocked, causing pressure to build within
the eye at a very rapid rate. Complete blindness can occur in
as little as 3 to 5 days!

Normal Eye Sudden blockage causes pressure to build

rapidly.

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 Glaucoma
Narrow Angle Glaucoma
Symptoms
Severe Pain
Pressure over the eye
Cloudiness to the Cornea
Eye extremely sensitive to light
Halos seen around lights.
Nausea and/or vomiting

Who is at risk?
Patients with a family history of Glaucoma
African Americans
Patients suffering from Myopia
Patients suffering from Diabetes
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People over 35 years of age
 Glaucoma
Narrow (Closed) Angle Glaucoma
Diagnosis
As with Open Angle Glaucoma, Tonometry is often used as a diagnostic tool.
The Tonometer is gently pressed against the eyeball, and the resistance
(internal pressure) is measured. This requires that the eye be numbed prior to
the test.

Gonioscopy can be used to determine if the angle where the iris meets the
cornea is open or closed.

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 Glaucoma
Open Angle Glaucoma
Treatment
Laser Iridotomy
Filtration Surgery

Filtration Surgery
creates a new drainage
channel

In Laser
Iridotomy, a
small hole is
cut in the Iris
01/26/22 Diseases Index 41
 Diabetic Retinopathy

Retinal arteries become weak from

Diabetes and begin to leak. This can
cause increased pressure.
Secondary arteries form, often
hemorrhage, and cause spots or
“floaters” to occur.
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 Diabetic Retinopathy
Symptoms
In the early stages there are no symptoms
Floaters
Double Vision
Diseases Index
Difficulty in doing close work or reading

Who is at risk?
Anyone who has diabetes, and especially those who have had diabetes for
10 years or more.

Diagnosis
Often diagnosis is very difficult, especially in the early stages. By the time
Diabetic Retinopathy manifests itself, the symptoms are severe. A test called
Flourescein Angiography is performed to determine the extent of the
condition, if any.

Treatment
Pan-Retinal Photocoagulation can be performed, which uses a laser to destroy
the dead areas of the retina. When this is done, the retina ceases to
01/26/22 manufacture new blood vessels. 43
 Floaters and Flashes
Flashers and Floaters can be quite alarming.
Normally they are considered harmless and require
no treatment.
Floaters are merely particles of Vitreous fluid or tissue. As we
age, the Vitreous fluid in the eye thins from a very thick
substance to a more watery condition. As a result, these
particles may drift within the eye and cast shadows on the retina.

As particles within the vitreous move around, we see them as shadows

upon the retina.
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 Floaters and Flashes
Flashers and Floaters can be quite alarming.
Normally they are considered harmless and require
no treatment.
Flashes, like Floaters, are due to the normal aging process, and
are a result of the thinning of the Vitreous fluid within the eye.

As particles within the vitreous move around, we may see them as sudden
flashes of light.
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 Floaters and Flashes

Symptoms
Seeing small floating spots
Seeing bright flashes of light

Who is at risk?
Everyone, especially those over the age of 55.

Diagnosis
A regular Eye examination will enable the physician to determine if any
noticeable Floaters are serious.

Treatment
Unless the floaters are a result of a retinal tear or some other treatable
pathology, there is no specific treatment for Floaters and Flashes.

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 Macular Degeneration

Dry Macular Degeneration is caused by hardening of the

arteries that nourish the Retina. It is the most common
form of this condition.
Wet Macular Degeneration occurs when new blood
vessels form to nourish the deprived Retina. They are
01/26/22 delicate and often break, causing bleeding to occur. 47
 Macular Degeneration

Symptoms
Difficulty in reading. Normally, extra lighting and/or magnification are
needed to read properly.
Objects become distorted or blurred, sometimes being abnormal in color,
size and shape.
Objects tend to “jump” when you look right at them.
Details become fuzzy and hard to see.
Blind spots develop in what we see.

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distorted or observed
 Macular Degeneration

Who is at risk?
These are some of the causes or contributing factors to Macular
Degeneration. The root causes are still unknown. Women tend to be
more at risk than Men:
Infection
Age (especially those 65 and older)
Head Injury
Heredity
Diabetes
Overexposure to the sun
Smoking
Hypertension
High Blood Pressure

01/26/22 High Cholesterol 49

Bad diet
 Macular Degeneration

Diagnosis
Amsler Grid test
Angiography
Optical Coherence Tomography

Treatment
In most cases, Macular Degeneration is untreatable. However; these methods
may be implemented to slow the effects.
Diet and Vitamins
Low vision aids, such as magnifying glasses, large print books, books on
tape, talking clocks, and other such devices.
Laser Treatments for rare cases of Wet Macular Degeneration.
Photodynamic Therapy, or PDT.

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 Dry Eye
The condition commonly referred to as “dry eye” can be very confusing. In
actuality, the symptom of “dry eye” is excessive watering of the eye!
There are actually two forms of tears:
1. Lubricating Tears
2. Reflex Tears
Lubricating tears are a precise balance of oil, mucous, water, nutrients, and
antibodies.
Lubricating tears are produced constantly, and act to protect and nourish the
front surface of the eye.

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 Dry Eye
Reflex Tears, on the other hand, have no specific lubricating value. They are
produced as a result of irritation or trauma to the eye. They “flood” the
eye with fluid to try and remove the irritation. We have all had something
such as a small piece of dirt get in our eyes, and have experienced the
flood of reflex tears. When reflex tears form, they are in quantities much
too large for the normal drainage system of the eye, and they spill over
onto the cheek.
If the eye is not producing sufficient lubricating tears, reflex tears will form to
try and help lubricate the eye. This causes the eyes to appear to be wet all
of the time, when the root cause is that they are too dry as a result of
insufficient lubricating tears.

Symptoms
Watery eyes
A feeling that there is something in your eye, i.e. “sand” in your eye.
Irritated eyes that produce a discharge, red eyes
Vision that becomes blurred after reading, watching television, or using a
computer for extended periods.
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 Dry Eye
Causes of Dry Eye
Age
Diabetes
Hormonal changes, such as Menopause
Some prescription medications
Smoking
High altitude
Contact lenses
Eye Surgery
Lasik
Inflammation

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 Dry Eye
Treatment of Dry Eye
Artificial teardrop products

Antibiotic Medications

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 Dry Eye
Treatment of Dry Eye
Punctual Occlusion – This involves closing off of the small funnel – like
drain holes located in the inner corner of the upper and lower eyelids.
These drain holes are called “Punctums”. By inserting “Punctum plugs”,
the drainage of the small amount of lubricating fluids that IS produced by
a patient can be maximized. Punctual Occlusion can be temporary, or
made permanent by sealing with a laser.

Diseases Index

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 Conclusions
By now you should have a basic
understanding of the Anatomy and
Physiology of the Human Eye, as well as the
common refractive disorders, and other
diseases of the eye.

Exit

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