ANATOMY AND

PHYSIOLOGY OF THE EYE

INTRODUCTION

PALPEBRA : skin, muscle,

and fibrous tissue
Functions:
Mechanic protection,
Lipid production, and
Tears distribution

ANATOMY
Palpebra divided into 4 layers :
Skin, formed by epidermis and dermis.
Muscle , formed by orbicularis oculi muscle.
Tarsus contains Meibom gland.
Conjungtival mucous.

ANTERIOR PALPEBRA

MARGO PALPEBRA

VASCULARISATION

LYMPHATIC SYSTEM

PALPEBRAL INNERVATIONS
Motoric :
- N. Facialis (m. orbicularis oculi)
- N. Occulomotorius (m.levator palp)
- simpatis nerve (m. muller)
Sensory :
- N. ophtalmic (palp sup & forehead)
- N. Infratrochlearis (medial skin, medial cantus
lachrymal sac)
- N. zygomaticofacial (inf lat palp skin)
- N. infraorbitalis (central palp inf dan conj)
- N. maxillaris (inf palp & cheek)

INNERVATIONS OF PALPEBRA

THERE ARE 6 EXTRAOCULAR MUSCLE OF THE EYE:

4 M. Rectus :

M. Rectus Sup
M. Rectus Inf
M. Rectus Med

2 M. Oblique :

M. Rectus Lat
M. Obliqus Sup
M. Obliqus Inf

INSERTION OF EXTRAOCULAR MUSCLE & SPIRAL OF TILLAUX

EXTRAOCULAR MUSCLE

M. RECTUS SUPERIOR

M.RECTUS INFERIOR

M. RECTUS LATERAL

THE EYEBALL

A spherical globe with a diameter of 24.5mm.

THE CONJUNCTIVA

A transparent mucous membrane that lines the

inner surfaces of the eyelids and the front
surface of the eyeball.

THE CONJUNCTIVA IS
COMPOSED OF 3 SECTIONS
Palpebral

conjunctiva
(covers the posterior
surface of the eyelids).
Bulbar conjunctiva
(coats the anterior
portion of the eyeball).
Fornix (the transition
portion forming the
junction between the
posterior eyelid and
the eyeball).

CORNEA
The transparent dome which serves as the
window of the eye.
The primary (most powerful) structure focusing
light entering the eye.

CORNEA

Composed of 5 layers, from the front to the back:

Epithelium.
Bowmans

(anterior limiting) membrane.

Stroma (substantia propria).
Descemets (posterior limiting) membrane.
Endothelium (posterior epithelium).

HOW DOES THE CORNEA STAY

TRANSPARENT?
No blood vessels.
Transparent stroma with low level of fluids.

Endothelium

cells serves as a pump that supply

oxygen and remove fluids.

Tear film also supplies oxygen and keep corneal

surface smooth and clean.

SCLERA
The

white, opaque cover of the

eye.
Covers 80% of the eyes outer
layer.
Contains thick elastic collagen.
It provides protection.
Serves as an attachment for
the extra-ocular muscles which
move the eye.

UVEAL TRACT
Iris
Ciliary body
Choroid

IRIS AND ANTERIOR

COMPARTMENT

A thin diaphragm composed mostly of connective

tissue and smooth muscle fibers, than lies
between the cornea and the lens.

IRIS ANATOMY

The iris is composed of 3 layers, from the front to

the back:
Endothelium
Stroma

Epithelium

Stroma muscles
Dilator

- sympathetic innervation
Constrictor parasympathetic innervation

EYE COLOR (IRIS COLOR)

Determined

by the amount of pigment

present in iris.
No pigment - pink iris (albino), some
pigment blue iris, increasing amounts of
pigment- green>hazel> brown irides..
The pigments: melanin (chromosome 15)
and lipochrome (chromosome 19).
Heterochromia irides: when one iris has a
different color than the other iris.

PUPIL
Circular

hole in the middle of the iris.

Acts like the shutter of a camera:
In

darkness the iris dilator muscle causes the

pupil to dilate and allowing more light to
reach the retina.
In brightness, the iris sphincter muscle (which
encircles the pupil) constricts, causing the
pupil to constrict and allowing less light to
reach the retina.

Constriction

also occurs during

accommodation - the near reflex.

CILIARY BODY
Pars plana flat area
continuous with the
retina
Pars plicata contains
the ciliary processes
that secretes the
aqueous humor
Ciliary muscle runs
circularly around the
eye and controlles
accommodation

AQUEOUS HUMOR
Produced

by the
ciliary body.
Entering from the
posterior chamber, it
passes through the
pupil into the anterior
chamber and filtrates
through the angle
into the blood stream.
Serves to nourish
ocular structures.

ANTERIOR CHAMBER ANGLE

Iris-cornea junc.
Contains the trabecular
meshwork which acts like a
filter for the aqueous humor.
From the TM the humor drains
to schlems canal and then to
blood stream.

GLAUCOMA

CHOROID
The posterior segment of the uvea, between the
sclera and the retina.
Reach in blood supply, supplies oxygen and
nutrition to the outer two thirds of the retina.

LENS
Biconvex,

avascular,
transparent
structure.
Suspends behind the
iris by the zonules
which are connected
to the ciliary body.
Serves to converge
light onto the retina.

ACCOMMODATION

Ciliary muscle constrict

> zonular tension
decreases > lens
becomes more spherical
> more dioptric power
that converge light from
a near target onto the
retina.

PRESBYOPIA
With

age, lens is
less elastic > muscle
constriction
achieves less
accommodation.

CATARACT
With

age, lens
fibers are less
transparent
cataract
Lens is removed
and a plastic lens is
inserted instead

THE RETINA

The innermost layer of the eye, comparable to the

film inside of a camera.
It is composed of nerve tissue which senses the
light entering the eye.

RETINAL GROSS ANATOMY

Fovea:

area with the highest concentration of

photoreceptors.
Central retina: A circular field of
approximately 6 mm around the fovea.
Peripheral retina: stretching to the ora
serrata.

RODS AND CONES

Cones

Concentrated

in the fovea
Most active in daylight
Central vision

Rods

Mostly

in the peripheral retina

Most active in night vision
Peripheral vision

OPTIC NERVE
Consists of 1 million axons that arise from the
retina.
Leaves the eye through the sclera optic canal
into the cranium.

OPTIC PATHWAYS

VISUAL FIELD

HEMIANOPIA

THE EXTRA-OCULAR MUSCLES

OCULOMOTOR NERVE
Originates

from the brainstem

cavernous sinus divides into superior
and inferior divisions.
Superior division: supply the superior
rectus and levator palpebrae.
Inferior division supplies the inferior and
medial rectus and inferior oblique muscle.
In addition the oculomotor supplies the
pupillary muscles.

OCULOMOTOR PALSY
Exotropia
Hypotropia
Pupil dilation
Ptosis

TROCHLEAR NERVE

Dorsal surface of the brain stem decussates

cavernous sinus orbit supplies the superior
oblique.

TROCHLEAR PALSY
Hypertpia
Head tilt

ABDUCENS NERVE

Originates between the pons and medulla

cavernous sinus orbit lateral rectus

ABDUCENS PALSY

Esotropia

NYSTAGMUS
Involuntary movement of the eyes
May seriously reduces vision
Etiology:

Congenital
Vestibular

Neurologic

VESTIBULO-OCULAR REFLEX
Primitive reflex which aims to keep the eyes on a
target when the head moves
The extra-ocular muscles receive information from
the otolit organs and move the eyes in the opposite
direction