Sense Organs

Eye and Ear

Eye anatomy:
Pupil:

• Central opening of the eye, surrounded by iris, through which light rays pass.
• It appears dark.
Iris:

• Colored (pigmented) layer that opens and closes to allow more or less light into the
eye.
• The central opening of the iris is the pupil. Iris is covered by transparent layer called
cornea.
Cornea:

• fibrous transparent layer of clear tissue that extends over the anterior portion of the
eyeball.
Sclera:

• white outer coat of the eyeball.

Conjunctiva:

• delicate membrane lining the undersurface of the eyelids and covering the anterior
eyeball.
Choroid:

• middle, vascular layer of the eye, between the retina and sclera.
• Brownish layer of the eye.
• It contains many blood vessels that supply nutrients to the eye.
Choroid, iris, and ciliary body are known as “Uvea of the eye.”
Ciliary body:

• structure surrounding the lens that connects the choroid and iris.
• It contains ciliary muscles, which control the shape of the lens and it secretes the
aqueous humor.
Anterior chamber:

• area behind the cornea and in front of the lens and iris.
• It contains aqueous humor.
Aqueous humor:

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 • fluid produced by ciliary body and found in the anterior chamber.
Vitreous humor:

• soft, jelly-like material behind the lens in the vitreous chamber;

• helps to maintain the shape of the eye ball.
Retina:

• light-sensitive nerve cell layer of the eye containing photoreceptor cells (rods and
cones).
Rods:

• photoreceptor cells of the retina essential for vision in dim light and for peripheral
vision.
• Approximately 120 million rods in the retina are present.
Cones:

• photoreceptor cells of the retina that transforms light energy into a nerve impulse.
• Cones are responsible for color and central vision.
• Approximately 6.5 million cones are present.
Optic Disc:

• region at the back of the eye where the optic nerve meets the retina.
• It is the blind spot of the eye because it contains only nerve fibers, no rods or cones,
and
• is thus insensitive to the light.
Optic nerve:

• cranial nerve carrying impulses from the retina to the brain.

Refraction:

• bending of light rays by the cornea, lens, and fluids of the eye to bring the rays into
focus on the retina.
Optic chiasm –

• point at which optic nerve fibers cross in the brain.

Macula:

• yellowish region on the retina lateral to and slightly below the optic disc.
• It contains fovea centralis, which is the area of clearest vision.
Fovea centralis:

• tiny depression in the retina that is the region of clearest vision.

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Pathway of light rays from the cornea of the eye to the cerebral cortex of brain:
Cornea → Anterior Chamber and Aqueous Humor → Pupil → Lens →Vitreous Chamber and
Vitreous Humor → Retina (Rods and Cones) → Optic Nerve Fibers →Optic Chiasm → Thalamus
(relay center) → Cerebral Cortex (Occipital Lobe)
Opia -vision
Opsia – vision
Tropia – to turn

Errors of Refraction:
1. Astigmatism: Defective curvature of the cornea or lens of the eye.
2. Hyperopia (hypermetropia): farsightedness. Convex lens
3. Myopia: nearsightedness. Concave lens
4. Presbyopia: Impairment of vision as a result of old age.

Pathology of Eye:
1. Cataract: Clouding of the lens, causing decreased vision.
2. Chalazion: small, hard, cystic mass (granuloma) on the eyelid.
3. Diabetic retinopathy: Retinal effects of diabetes mellitus include microaneurysms,
hemorrhages, dilation of retinal veins, and neovascularization (new blood vessels form
in the retina).
4. Glaucoma: Increased intraocular pressure results in damage to the retina and optic
nerve with loss of vision.
5. Hordeolum (stye or sty): localized, purulent, inflammatory staphylococcal infection of
a sebaceous gland in the eyelid.
6. Macular degeneration: Progressive damage to the macula of the retina.
7. Nystagmus: Repetitive rhythmic movements of one or both eyes.
8. Retinal detachment: Two layers of the retina separate from each other.
9. Strabismus: abnormal deviation of the eye.
10. Esotropia – one eye turns inward
11. Exotropia – one eye turns outward
12. Hypertropia – upward deviation of eye
13. Hypotropia – downward deviation of eye

In children, strabismus may lead to amblyopia (partial loss of vision or lazy eye).
When strabismus develops in an adult, diplopia (double vision) is a common problem.

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Abnormalities of Eye
1. Blepharitis – inflammation of eyelid, causing redness, crusting, and swelling along lid
margins.
2. Dacryocystitis – blockage, inflammation, and infection of nasolacrimal duct and
lacrimal sac, causing redness and selling in the region between nose and lower lid.
3. Ptosis – drooping of upper lid margin as a result of neuromuscular problems or trauma.
4. Xanthelasma – raised yellowish plaque on eyelid caused by lipid disorder.
5. Ectropion – outward sagging and eversion of the eyelid leading to improper
lacrimation and corneal drying and ulceration.
6. Entropion – inversion of the eyelid, causing lashes to rub against the eye; corneal
abrasion may result.

Clinical Procedures – Eye

1. Fluorescein Angiography – Intravenous injection of fluorescein followed by serial
photographs of the retina through dilated pupils.
2. Ophthalmoscopy – Visual examination of the interior of the eye.
3. Slit Lamp Microscopy – examination of anterior ocular structures under microscopic
examination.
4. Tonometry – measures intraocular pressure to detect glaucoma.
5. Visual Acuity Test: Clarity of vision is assessed.
6. Visual Field Test: Measurement of the area (peripheral and central) within which
objects are seen when the eyes are fixed, looking straight ahead without movement
of the head.

Treatment
1. Enucleation: Removal of entire eyeball.
2. Keratoplasty: also known as corneal transplant procedure. Surgical repair of the
cornea.
3. Laser Photocoagulation: Intense precisely focused light beam (argon laser) creates an
inflammatory reaction that seals retinal tears and leaky retinal blood vessels.
4. LASIK (Laser In Situ Keratomileusis): Use of a laser to correct errors of refraction.
5. Phacoemulsification: Ultrasonic vibrations break up the lens, which then is aspirated
through the ultrasonic probe.
6. Scleral buckle: suture of a silicone band to the sclera over a detached portion of retina.
7. Vitrectomy: Removal of vitreous humor.

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Abbreviations of Eye:
AMD – age-related macular degeneration
HEENT: head, eyes, ears, nose, and throat
IOL – intraocular lens
IOP – intraocular pressure
OD - right eye
OS – left eye
OU – both eyes
PERRLA – pupils equal, round, reactive to light and accommodation.
POAG – primary open-angle glaucoma
PRK – photorefractive keratectomy
VA – visual acuity
VF – visual field.

Anatomy of Ear:
Outer Ear:
a. Pinna – auricle; flap of the ear.
b. External Auditory Canal – channel that leads from the pinna to the eardrum.
c. Eardrum: also called as tympanic membrane. Membrane between the outer and
middle ear.

Middle ear:
a. Ossicle: small bone of the ear; which includes malleus, incus, and stapes.
o Malleus: First ossicle of the middle ear. Malleus means hammer.
o Incus: second ossicle of the middle ear; incus means anvil.
o Stapes: third ossicle of the middle ear. Stapes means stirrup.
b. Oval Window: membrane between the middle and inner ear.

Inner Ear:
a. Cochlea – snail shell-shaped, spirally wound tube in the inner ear, contains hearing
sensitive receptor cells.
b. Perilymph – fluid contained in the labyrinth of the inner ear.
c. Endolymph – fluid within the labyrinth of the inner ear.

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 d. Labyrinth: maze-like series of canals of the inner ear. This includes cochlea, vestibule,
and semicircular canals.
e. Organ of Coti: sensitive auditory receptor area found in the cochlea of the inner ear.

Auditory Nerve Fibers:

• Carry impulses from the inner ear to the brain (cerebral cortex).
• These fibers compose the vestibulocochlear nerve (cranial nerve VIII).
Auditory tube:

• also called as Eustachian tube.

• Channel between the middle ear and the nasopharynx.
Cerumen:

• Waxy substance secreted by the external canal.

• Also called earwax.
Semicircular Canals:

• passages in the inner ear associated with maintaining equilibrium.

Vestibule:

• central cavity of the labyrinth, connecting the semicircular canals and the cochlea.
• The vestibule contains 2 structures, the saccule and utricle that help to maintain
equilibrium.

Pathology of Ear:
Acoustic neuroma:

• Benign tumor arising from the acoustic vestibulocochlear nerve (8th cranial nerve) in
the brain.
• tinnitus – ringing in the ears
Cholesteatoma:

• Collection of skin cells and cholesterol in a sac within the middle ear.
Deafness:

• Loss of the ability to hear.

Meniere disease:

• Disorder of the labyrinth of the inner ear; elevated endolymph pressure within the
cochlea (cochlear hydrops) and semicircular canals (vestibular hydrops).

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Otitis Media:

• Inflammation of the middle ear.

• Suppurative Otitis Media – bacterial infection which causes pus formation in the
middle ear.
• Serous Otitis Media – Noninfectious inflammation with accumulation of serous fluid.
Otitis Externa –

• inflammation of the outer ear.

Otosclerosis:

• hardening of the bony tissue of the middle ear.

Tinnitus:

• Sensation of noises (ringing, buzzing, whistling, booming) in the ears.

Vertigo:

• Sensation of irregular or whirling motion either of oneself or of external objects.

Clinical Procedures
1. Audiometry: Testing the sense of hearing.
2. Cochlear Implant Procedure: Surgical insertion of a device that allows sensorineural
hearing – impaired persons to understand speech.
3. Ear Thermometry: Measurement of the temperature of the tympanic membrane by
detection of infrared radiation from the eardrum.
4. Otoscopy: Visual examination of the ear canal with an otoscope.
5. Tuning Fork Test: Test of ear conduction using a vibration source (tuning fork).

Abbreviations of Ear
1. AD – right ear
2. AOM – acute otitis media
3. AS – left ear
4. EENT- eyes, ears, nose, and throat
5. ENG – electronystagmography
6. ETD – eustachian tube dysfunction
7. PE tube – pressure equalizing tube
8. SOM – serous otitis media
9. AU – both ears
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