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The Eye and its Appendages




                             1
The Eyeball




              2
-    the peripheral organ of
    vision, is situated in a skeletal
    cavity, the orbit


- 1 inch in diameter, 8g. in
  weight


- The eyeball is embedded in
  orbital fat, separated from it
  by a thin fascial sheath
  (capsule of Tenon)


                                        3
Cavities of the Eyeball




                          4
1. Anterior Cavity
- further divided into
anterior chamber and
posterior chamber due to
the position of the iris.

- contains the acqueous
humor produced by the
     ciliary process.




                                      5
2. Posterior Cavity

- located behind the lens

- contains the vitreous
humor enclosed in
hyaloid membrane




                                     6
Layers of the Eyeball




                        7
The Layers of the Eyeball

1. Fibrous coat - sclera and cornea

2. Vascular coat - choroid, ciliary body and the
   iris

3. Neural coat - retina

                                               8
Sclera
1. The Fibrous Coat
          Cornea




                      9
A. The Sclera
- relatively hard consistency, is a dense layer which, when
distended by intraocular pressure, maintains the shape of
the eyeball

- external surface is white and smooth and is in contact
with the inner surface of the fascial sheath of the eyeball

- provides passage for nerves of the cornea and vascular
autonomic nerves and attachment for extrinsic eye muscles




                                                              10
B. The Cornea

- is the anterior, projecting transparent part of the
external tunic, and

- its tear film cover is the major site of refraction of
light entering the eye.




                                                      11
Choroid
The Vascular Coat
       Ciliary Body
            Iris




                      12
a. The Choroid
- The choroid is a thin, highly
vascular, dark brown tissue
which lines almost the
posterior five-sixths of the eye;

- it is pierced behind by the
optic nerve and is firmly
adherent to the sclera;

- it is thicker posteriorly;

- internally it is firmly attached
to the retinal pigmented layer.




                                            13
b. The Ciliary Body

- The ciliary body is directly
continuous with the choroid
behind and with the iris in front

- Internally it shows a scalloped
periphery where it is continuous
with the choroid and retina,
termed the ora serrata.

- The ciliary body is concerned
with the suspension of the lens
and with accommodation

- It is also a major source of
aqueous fluid for the anterior
segment of the eye

                                         14
c. The Iris
- is an adjustable
diaphragm around a
central aperture

- the pupil, which
controls the amount of
light entering the eye


- The concentration of
melanocytes is the main
factor determining the
hue of the iris.

                                       15
Muscles of the Iris
1. Sphincter Pupillae

   - This is a flat annulus of smooth
   muscle about 0.75 mm wide and
   0.15 mm thick.

 - Its densely packed fusiform
   myocytes are often arranged in
   small bundles, as in the ciliary
   muscle, and pass
   circumferentially around the
   pupil.




                                            16
Muscles of the Iris
2. Dilator Pupillae

   - A thin stratum lying
   immediately anterior to the
   epithelium of the posterior iridial
   surface,

   - its fibers are in fact the
   muscular processes of the
   anterior layer of this epithelium,

   - their apical processes form the
   epithelium itself.


                                          17
Retina
The Neural Coat




                  18
The Retina
- is the neural, sensory stratum of the eyeball

- It is thin, being thickest near the optic disc

- contains a variety of cell types. They include the
photoreceptors (rod and cone cells),

- Near the centre of the retina is an oval, yellowish area, the
macula lutea which has a central depression, the fovea
centralis, where visual resolution is highest.



                                                                  19
Optic Disc
- This region, where retinal
tissues meet the neural
elements of the optic nerve

- Besides being the exit
point for the optic nerve
fibres, it also provides a
point of entry and exit for
the retinal circulation.

- superomedial to the
posterior pole of the eye

                                    20
Rods and Cones
Cone cells

  - chiefly responsible for high spatial resolution and colour
  vision in good lighting conditions (photopic vision),

  - highly concentrated at the fovea centralis, but they
  populate the whole retina, intermingled with rods


  Three types according to their maximum spectral sensitivities:
  red, green and blue


                                                                 21
Rods and Cones
Rods

 - provide high monochromatic sensitivity to a much wider
 range of illumination down to much lower intensities
 (scotopic vision) although with relatively low spatial
 discrimination because of their different neural connections.

 - Rods are excluded from the fovea.




                                                                 22
The Refractive of the eye which
  The components Media
      transmit and refract light




                                   23
Composed of:

1.   Cornea,
2.   Acqueous humor,
3.   Lens,
4.   Vitreous humor.



                       24
Aqueous Humour

- The total quantity of aqueous humour is small, filling the
  anterior and posterior chambers.

- The ciliary processes are responsible for its production


- is an avenue for nutrients, and metabolic exchange for the
  avascular tissues of the cornea and lens.




                                                               25
Vitreous Body

- fills the vitreous chamber, occupying about four-fifths of the
  eyeball.

- It is colourless, consisting of approximately 99% water, and
   although apparently structureless, a sparse but organized
   cellular and fibrous content is present.




                                                                   26
Lens
-   is a transparent, encapsulated,
    biconvex body, placed between
    the iris and the vitreous body.

- encircled by the ciliary processes,
   to which it is attached by the
   zonular fibres collectively forming
   the zonule holding the lens in
   place and transmitting the forces
   stretching the lens except in
   visual accommodation.




                                             27
CONDITIONS OF THE EYE


                        28
Emmetropia


• Ideal state of the eye in
  which no refractive
  error is present




                                   29
Myopia
• Also known as
  nearsightedness, is a
  condition in which a person
  can see near objects more
  clearly than distant objects.

• Light focusses in front of the
  retina




                                   30
Hyperopia

• Also known as
  farsightedness, is a
  condition in which a person
  can see distant objects more
  clearly than near objects.

•    light focusses behind the
    retina




                                         31
Presbyopia

• Normal part of aging.

• It develops as the lens of the eye becomes less flexible and
  loses its ability to focus on near objects.




                                                                 32
Lens become thicker when viewing near objects




                                                33
The lens in the presbyopic eye cannot change shape to
                 focus on near objects




                                                    34
Astigmatism
• A condition in which objects, both near and
  far, appear blurred.

• Often occurs in combination with myopia nad
  hyperopia.




                                                35
Cataract

• Is a cloudiness or
  opacificationin the
  normally clear and
  transparent lens of the
  eye.




                                       36
THE ACCESSORY STRUCTURES
OF THE EYE

                           37
• 1. The Eyelids

• 2. The Lacrimal Apparatus

• 3. The Eye Muscles




                              38
Functions:

  1. provide protection,
  2. lubrication, and
  3. support




                           39
The Eyelids




              40
- 2 movable folds, with the upper being more larger and
  movable, due to the presence of the levator palpebra
  superioris.
- covered by skin, externally, and mucous membrane (palpebral
  conjunctiva) in the deep aspect.

Functions :

  1. provide protection when firmly closed
  2. keep the surface of the eyeball lubricated with its continual
  blinking.



                                                                41
Layers of the Eyelid




                       42
Layers of the Eyelid
1.   Skin
2.   Loose subcutaneous tissue
3.   Muscular layer
4.   Submuscular layer
5.   Tarsal plates
6.   Conjunctiva



                                   43
1. Skin
- eyelashes
- sebaceous glands (glands of Zeis)
     Sty - infection of the glands of Zeis
- sweat glands (glands of Moll)




                                             44
2. Loose subcutaneous tissue
   - extremely loose and easily
   distended by blood and
   fluid

3. Muscular layer
   - orbicularis oculi muscle

4. Submuscular layer
   - contains sensory nerves



                                  45
5. Tarsal plates
  - 2 thin plates of dense connective tissue
  - forms and supports the eyelid
  - presence of lateral and medial tarsal ligaments
  - receives the levator palpebra superioris

6. Conjunctiva
  - mucous membrane that attaches the eyeball to
      the eyelid ( palpebral and bulbar)



                                                      46
STRUCTURES PRESENT IN THE EYELIDS



                                    47
1.   Palpebral fissure

 2. Palpebral commissures (canthi)
     a. lateral - more acute, placed
     directly against the      globe
     b. medial - lacrimal lake, lacrimal
     caruncle, lacrimal papilla, lacrimal
     punctum




                                            48
The Lacrimal Apparatus




                         49
Composed of the following
  structures:
  1. lacrimal gland, which
  secretes a complex fluid
  (tears) and whose excretory
  ducts convey fluid to the
  surface of the eye,
  2. the paired lacrimal
  canaliculi,
  3. the lacrimal sac and
  4. the nasolacrimal duct, by
  which the fluid is collected
  and conveyed into the nasal
  cavity.

                                 50
1. Lacrimal Gland

-   located superolaterally
    along the orbit

-   secretion empties in
    the pocket between
    the eyeball and the
    eyelid

- secretes tears which are
   alkalinic, watery, and
   contain lysozyme


                                       51
2. Lacrimal Canaliculi


- superior and
   inferior
- conducts the
   tears to the
   lacrimal sac




                                      52
3. Lacrimal Sac


- located in the
  lacrimal fossa

- presents a fundus




                                        53
4. Nasolacrimal Duct

- 3/4 of an inch in
  length

- drains into the
  inferior nasal
  meatus




                                    54
The Orbit




            55
The Orbit
- contains the eyeball in its
  anterior part and the
  posterior part is filled
  with fat, fascia, muscles,
  blood vessels and nerves
- Capsule of Tenon
  separates the anterior
  and posterior
- Periorbita lines the orbit
  and is continuous with
  the dura mater of the
  brain
                                    56
The Eye Muscles




                  57
The Eye Muscles

- Composed of the 7 muscles of the eye

- Lateral rectus is supplied by the Abducent N.

- Superior oblique is supplied by the Trochlear N.

- The rest is supplied by the Oculomotor N.



                                                     58

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The Eye: Structure, Function and Common Conditions

  • 1. The Eye and its Appendages 1
  • 3. - the peripheral organ of vision, is situated in a skeletal cavity, the orbit - 1 inch in diameter, 8g. in weight - The eyeball is embedded in orbital fat, separated from it by a thin fascial sheath (capsule of Tenon) 3
  • 4. Cavities of the Eyeball 4
  • 5. 1. Anterior Cavity - further divided into anterior chamber and posterior chamber due to the position of the iris. - contains the acqueous humor produced by the ciliary process. 5
  • 6. 2. Posterior Cavity - located behind the lens - contains the vitreous humor enclosed in hyaloid membrane 6
  • 7. Layers of the Eyeball 7
  • 8. The Layers of the Eyeball 1. Fibrous coat - sclera and cornea 2. Vascular coat - choroid, ciliary body and the iris 3. Neural coat - retina 8
  • 9. Sclera 1. The Fibrous Coat Cornea 9
  • 10. A. The Sclera - relatively hard consistency, is a dense layer which, when distended by intraocular pressure, maintains the shape of the eyeball - external surface is white and smooth and is in contact with the inner surface of the fascial sheath of the eyeball - provides passage for nerves of the cornea and vascular autonomic nerves and attachment for extrinsic eye muscles 10
  • 11. B. The Cornea - is the anterior, projecting transparent part of the external tunic, and - its tear film cover is the major site of refraction of light entering the eye. 11
  • 12. Choroid The Vascular Coat Ciliary Body Iris 12
  • 13. a. The Choroid - The choroid is a thin, highly vascular, dark brown tissue which lines almost the posterior five-sixths of the eye; - it is pierced behind by the optic nerve and is firmly adherent to the sclera; - it is thicker posteriorly; - internally it is firmly attached to the retinal pigmented layer. 13
  • 14. b. The Ciliary Body - The ciliary body is directly continuous with the choroid behind and with the iris in front - Internally it shows a scalloped periphery where it is continuous with the choroid and retina, termed the ora serrata. - The ciliary body is concerned with the suspension of the lens and with accommodation - It is also a major source of aqueous fluid for the anterior segment of the eye 14
  • 15. c. The Iris - is an adjustable diaphragm around a central aperture - the pupil, which controls the amount of light entering the eye - The concentration of melanocytes is the main factor determining the hue of the iris. 15
  • 16. Muscles of the Iris 1. Sphincter Pupillae - This is a flat annulus of smooth muscle about 0.75 mm wide and 0.15 mm thick. - Its densely packed fusiform myocytes are often arranged in small bundles, as in the ciliary muscle, and pass circumferentially around the pupil. 16
  • 17. Muscles of the Iris 2. Dilator Pupillae - A thin stratum lying immediately anterior to the epithelium of the posterior iridial surface, - its fibers are in fact the muscular processes of the anterior layer of this epithelium, - their apical processes form the epithelium itself. 17
  • 19. The Retina - is the neural, sensory stratum of the eyeball - It is thin, being thickest near the optic disc - contains a variety of cell types. They include the photoreceptors (rod and cone cells), - Near the centre of the retina is an oval, yellowish area, the macula lutea which has a central depression, the fovea centralis, where visual resolution is highest. 19
  • 20. Optic Disc - This region, where retinal tissues meet the neural elements of the optic nerve - Besides being the exit point for the optic nerve fibres, it also provides a point of entry and exit for the retinal circulation. - superomedial to the posterior pole of the eye 20
  • 21. Rods and Cones Cone cells - chiefly responsible for high spatial resolution and colour vision in good lighting conditions (photopic vision), - highly concentrated at the fovea centralis, but they populate the whole retina, intermingled with rods Three types according to their maximum spectral sensitivities: red, green and blue 21
  • 22. Rods and Cones Rods - provide high monochromatic sensitivity to a much wider range of illumination down to much lower intensities (scotopic vision) although with relatively low spatial discrimination because of their different neural connections. - Rods are excluded from the fovea. 22
  • 23. The Refractive of the eye which The components Media transmit and refract light 23
  • 24. Composed of: 1. Cornea, 2. Acqueous humor, 3. Lens, 4. Vitreous humor. 24
  • 25. Aqueous Humour - The total quantity of aqueous humour is small, filling the anterior and posterior chambers. - The ciliary processes are responsible for its production - is an avenue for nutrients, and metabolic exchange for the avascular tissues of the cornea and lens. 25
  • 26. Vitreous Body - fills the vitreous chamber, occupying about four-fifths of the eyeball. - It is colourless, consisting of approximately 99% water, and although apparently structureless, a sparse but organized cellular and fibrous content is present. 26
  • 27. Lens - is a transparent, encapsulated, biconvex body, placed between the iris and the vitreous body. - encircled by the ciliary processes, to which it is attached by the zonular fibres collectively forming the zonule holding the lens in place and transmitting the forces stretching the lens except in visual accommodation. 27
  • 29. Emmetropia • Ideal state of the eye in which no refractive error is present 29
  • 30. Myopia • Also known as nearsightedness, is a condition in which a person can see near objects more clearly than distant objects. • Light focusses in front of the retina 30
  • 31. Hyperopia • Also known as farsightedness, is a condition in which a person can see distant objects more clearly than near objects. • light focusses behind the retina 31
  • 32. Presbyopia • Normal part of aging. • It develops as the lens of the eye becomes less flexible and loses its ability to focus on near objects. 32
  • 33. Lens become thicker when viewing near objects 33
  • 34. The lens in the presbyopic eye cannot change shape to focus on near objects 34
  • 35. Astigmatism • A condition in which objects, both near and far, appear blurred. • Often occurs in combination with myopia nad hyperopia. 35
  • 36. Cataract • Is a cloudiness or opacificationin the normally clear and transparent lens of the eye. 36
  • 38. • 1. The Eyelids • 2. The Lacrimal Apparatus • 3. The Eye Muscles 38
  • 39. Functions: 1. provide protection, 2. lubrication, and 3. support 39
  • 41. - 2 movable folds, with the upper being more larger and movable, due to the presence of the levator palpebra superioris. - covered by skin, externally, and mucous membrane (palpebral conjunctiva) in the deep aspect. Functions : 1. provide protection when firmly closed 2. keep the surface of the eyeball lubricated with its continual blinking. 41
  • 42. Layers of the Eyelid 42
  • 43. Layers of the Eyelid 1. Skin 2. Loose subcutaneous tissue 3. Muscular layer 4. Submuscular layer 5. Tarsal plates 6. Conjunctiva 43
  • 44. 1. Skin - eyelashes - sebaceous glands (glands of Zeis) Sty - infection of the glands of Zeis - sweat glands (glands of Moll) 44
  • 45. 2. Loose subcutaneous tissue - extremely loose and easily distended by blood and fluid 3. Muscular layer - orbicularis oculi muscle 4. Submuscular layer - contains sensory nerves 45
  • 46. 5. Tarsal plates - 2 thin plates of dense connective tissue - forms and supports the eyelid - presence of lateral and medial tarsal ligaments - receives the levator palpebra superioris 6. Conjunctiva - mucous membrane that attaches the eyeball to the eyelid ( palpebral and bulbar) 46
  • 47. STRUCTURES PRESENT IN THE EYELIDS 47
  • 48. 1. Palpebral fissure 2. Palpebral commissures (canthi) a. lateral - more acute, placed directly against the globe b. medial - lacrimal lake, lacrimal caruncle, lacrimal papilla, lacrimal punctum 48
  • 50. Composed of the following structures: 1. lacrimal gland, which secretes a complex fluid (tears) and whose excretory ducts convey fluid to the surface of the eye, 2. the paired lacrimal canaliculi, 3. the lacrimal sac and 4. the nasolacrimal duct, by which the fluid is collected and conveyed into the nasal cavity. 50
  • 51. 1. Lacrimal Gland - located superolaterally along the orbit - secretion empties in the pocket between the eyeball and the eyelid - secretes tears which are alkalinic, watery, and contain lysozyme 51
  • 52. 2. Lacrimal Canaliculi - superior and inferior - conducts the tears to the lacrimal sac 52
  • 53. 3. Lacrimal Sac - located in the lacrimal fossa - presents a fundus 53
  • 54. 4. Nasolacrimal Duct - 3/4 of an inch in length - drains into the inferior nasal meatus 54
  • 55. The Orbit 55
  • 56. The Orbit - contains the eyeball in its anterior part and the posterior part is filled with fat, fascia, muscles, blood vessels and nerves - Capsule of Tenon separates the anterior and posterior - Periorbita lines the orbit and is continuous with the dura mater of the brain 56
  • 58. The Eye Muscles - Composed of the 7 muscles of the eye - Lateral rectus is supplied by the Abducent N. - Superior oblique is supplied by the Trochlear N. - The rest is supplied by the Oculomotor N. 58