Anatomy and
Physiology of The
Eyes
Dr.Nurcahya Ardian Bramantha,SpM
Ophthalmology Department
Kasih Ibu Hospital
TIK
MAMPU MENJELASKAN STRUKTUR ANATOMI ORBITA,
BULBUS OKULI DAN ORGAN AKSESORIUS SERTA
FUNGSINYA
Eye small very important
function
75% information visual
EYE
Surrounded by orbital
bones
Cushioned by pads of fat
Extraocular muscles help
move the eye in different
directions
ORBIT
Pyramid 4 dinding
Rim < lingkaran di
dlmnya proteksi
Bts anterior: Septum
Orbita
Ddg med & dsr orbita
tipis ruptur
herniasi
ORBITA
ORBITAL MARGIN FORMED BY :
FRONTAL
ZYGOMATIC
MAXILLA
SUPERIOR MARGIN FORMED BY OS. FRONTAL
SUPRAORBITAL FORAMEN
INFERIOR MARGIN FORMED BY OS. ZYGOMATIC & MAXILLA
INFRAORBITA FORAMEN
LATERAL MARGIN FORMED BY ZYMOMATIC PROC. OF FRONTAL
BONE & FRONTAL PROC. OF ZYGOMATIC BONE
MEDIAL MARGIN FORMED BY MAXILLA BONE
FOSSA SACCI LACRIMALIS
Orbital Wall
Orbital Roof:
Frontal bone klj lakrimal di fossa
lacrimalis
Sphenoid bone
Lateral Wall:
SPHENOID bone
Zygomatic bone strongest
Orbital Wall
Orbital Floor:
Formed by : Maxilla bone, zygomatic bone &
Palatine bone
Bts dg lateral fissura orbitalis infor
Lempeng orbital tlg Maxilla blowout fractures
Medial Wall:
Ethmoid bone paper thin ke antor menebal
Lacrimal bone
Frontal bone
Orbital Apex optic nerve canal
Blood Supply
Arteries:
Intracranial Internal Carotid a. 1st branch:
Ophthalmic a. passes beneath &
accompanies N II, branches as:
Central Retinal a. enters the N II, 8 15 mm
behind the globe
Lacrimal a. lacrimal glds & eyelid
Long & Short postor Ciliary a. uvea
Muscular branches antor Ciliary a.
Blood Supply
Arteries:
Short postor Ciliary a. N II + choroid
Long postor Ciliary a. ciliary body + major
arterial circle* of the iris (anastomose w/
antor Ciliary a.)
Antor Ciliary a. antor sclera, episclera,
limbus, conjunctiva, *
BLOOD SUPPLY
Veins:
Supor & Infor Ophthalmic v.
Communicate w/ Cavernous sinus & Pterygoid
venous
Drain the skin of the periorbital skin
lethal cavernous sinus thrombosis
(in cellulitis periorbital)
Antor Ciliary v.
Central Retinal v.
Annulus of Zinn
EYE BALL
CONJUNCTIVA
Transparent
Covers postor palp & antor
surface of sclera
Continuous w/:
o The lid margin
(mucocutaneous junc)
Palpebral conj
o Fornices (supor & infor)
o The limbus (corneal
epithelium) Bulbar
conj
CONJUNCTIVA
The Conjunctiva:
Palpebral Conj firmly
adherent to the tarsus
Bulbar Conj loosely
attached to Tenons
capsule
TENON CAPSULE
Fibrous membrane,
envelopes from limbus
to N II
Limbus Conj,
Tenon's, Episclera
fixed together
Posteriorly lies the
sclera, contact w/
orbital structure &
muscle cone
SCLERA & EPISCLERA
Fibrous (collagen)
Antor cornea; postor scleral foramen
(lamina cribrosa) pass the axon bundle of
the N II
Antor sclera episclera (thin, elastic, blood
vessels)
Inner surface lamina fusca (pigment, outer
layer of suprachoroidal space)
SCLERA & EPISCLERA
Thickness: 0,3 mm (at insertion of
muscle) 0,6 mm
Penetrated around the N II:
Short & long postor ciliary arteries
Short & long ciliary nerve
Long postor ciliary a. & long ciliary n.
pass in shallow groove at 3 & 9 oclock
meridians
4 antor ciliary a. & v. penetrate 4 mm
from limbus
Nerve supply: ciliary nerve
CORNEA
Transparant, avascular
Thick : 550 m (central)
vertical : 10.6mm
horizontal : 11.7mm
Nerve supply : V1
Corneal layers :
Epitel
Membr Bowman
Stroma
Membr Descemet
Endotel
UVEAL TRACT
IRIS
Pigmented, Extension of
ciliary body
Dividing the COA & COP
Central round aperture
Pupil balance of
parasympathetic (m.
Sphincter pupillae, N III) &
sympathetic (m. Dilator
pupillae) activity
Blood supply: Major circle of
the iris
Nerve supply (sensory):
Ciliary nerve
Pars plicata ciliary process
aqueous formation
CORPUS
Pars planaCILIARIS
(4 mm,
posteriorly)
Epithelium: nonpigmented,
pigmented
Ciliary muscle:
Circular & radial fibers
contract & relax zonular fibers
Longitudinal fibers open
pore of TM
Blood & nerve supply:
= Iris, through Vortex
veins
ACCOMODATION
CHOROID
Between sclera retina
Dark brown
Pigmented , vascularized
Nutrision 1/3 outer retina,
vitreus, lens
Choroidal blood vessels:
Chorio-capillaris
Drainage: Vortex veins
Lens
4 mm thick, 9 mm ,
Biconvex, avascular,
colorless, almost completely
transparent
65% water, 35% protein +
trace minerals
Supported by zonule of Zinn
at equator corpus ciliaris
Capsule: semipermeable
membrane
Potassium >> in the lens
Ascorbic, Glutathione
Iridocorneal Angle
Aquous outflow
Junc of peripheral cornea
iris root
Schwalbe line Trabecular
meshwork can.schlemms
- 30 collector channels +
12 aqueous veins
episcleral venous system
Vitreus
Clear, avascular, gelatinous body (99% water, 1%
collagen + hyaluronic acid), 2/3 volume & weight of
the eyeball
Outer surface hyaloid membrane contact w/
postor lens capsule, zonular fibers, pars plana
epithelium, retina, N II head
Vitreous base (attachment): pars plana epithelium
& retina just behind the ora serrata
Semitransparent,
multilayered, 2/3 postor
inner aspect of globe
Ora serrata
anterior edge of retina
(ragged edge)
RETINA
6,5 mm behind SL
(temporal), 5,7 mm (nasal)
At the PN II & Ora Serrata
ret & RPE firmly bound
limiting ret detachment
Thickness: 0,1 mm at OS,
0,56 mm at postor pole
RETINA
Macula:
Postor pole,
5,5 6,0 mm
3 mm center macula
lutea w/ fovea centralis
Xanthophyll >>>,
photoreceptors >>>
1,5 mm center retinal
avascular zone
0,25 mm center foveola
(thinnest part of retina)
cone photoreceptor
RETINA
Blood supply:
Choriocapillaris:
1/3 outer + fovea irreparable damage when RD
Fenestrated
Blood barrier RPE
Central retinal artery
2/3 inner
Nonfenestrated blood retinal barrier
EXTRAOCULAR MUSCLES
INSERTION of RECT
MUSCLES
ACTIONS
MUSCLES
Medial
Rectus
Adduction
Lateral
Rectus
Abduction
Superior
Rectus
Elevation
Intorsion
Adduction
Inferior
Rectus
Depressio
n
Extorsion
Adduction
Oblique
Sup
Intorsion
Depressio
n
Abduction
Oblique
Inf
extorsion
Elevation
Abduction
EXTRAOCULAR MUSCLES
Blood Supply:
Ophthalmic artery (muscular branch)
Also:
Lateral rectus m. Lacrimal artery
Inferior Oblique m. Infraorbital artery
Nerve Supply:
N III SR, MR, IR, IO
N IV SO
N VI LR
OCULAR ADNEXA
EYEBROWS
EYELIDS
APPARATUS LACRIMALIS
OCULAR ADNEXA
EYEBROWS
The folds of thickened
skin
Covered w/ hair
The Glabella
hairless between 2
eyebrows
EYELIDS
Skin Layer
Orbicularis Oculi
Muscle (OOM)
Areolar Tissue
Tarsal Plate
Palpebral Conjunctiva
EYELID
1. Skin Layer:
Thin, loose, elastic
Few hair follicles
NO subcutaneous fat
2. OOM:
Concentric close the lids
Inside the lid: Pretarsal & Preseptal portion
Outside the lid: Spread around the orbital
margin (orbital portion)
Supplied by N VII
EYELI
D
3. Areolar Tissue:
Submuscular communicates w/
aponeurotic layers
4. Tarsal Plate:
Main supporting structure of the lids
dense fibrous & elastic tissue
Lateral & medial attached to orbital
margins by palpebral ligaments
Upper & Lower thin fascia (Orbital
Septum)
5. Palpebral Conjunctiva:
Adhere firmly to the tarsal plate
The Lid Margins:
GRAY LINE mucocutaneous junction
Anterior Margin:
Eyelashes upper, upward; lower, downward
Glands of Zeis sebaceous glds at base of
eyelashes
Glands of Moll sweat glds
Posterior Margin:
Small orifices of meibomian / tarsal glds
Lacrimal Punctum:
Medial end of the postor margins
Palpebral Fissure:
Lateral canthus 0,5 cm from orb rim
Medial canthus more elliptic, surround
lacrimal lake:
Lacr caruncle modf. sweat & sebaceous glds
Plica semilunaris 3rd eyelid of lower animal
sp
Epicanthus:
Normal in Asian population & Young infants
Hiding caruncle
Orbital Septum:
Lies between Orb rim & tarsus
Serves as barrier
Pierced by:
the several vessels & nerves (lacrimal,
supra/infratrochlear, supraorbital)
Levator palp superior muscle (LPSM)
Blends w/:
Supor: Tendon of LPSM & supor tarsus
Infor: infor tarsus
Lid Retractors:
Musculofacial complex (striated &
smooth muscles) Opening the eyelids
Upper lid m. Levator Palp Supor,
divided into:
Aponeurosis (antor) elevate antor lamella
Mullers muscle (smooth m. fibers) elevating
postor lamella
inserting supor eyelid into postor surface of
OOM upper lid skin crease
Lower lid m. Rectus Infor
Smooth muscle innervated by
sympathetic nerves
Striated muscle innervated by N III
OCULAR ADNEXA
Blood Supply & Lymphatics:
Arteries:
Lacrimal & Ophthalmic arteries (lat & med
branches) anastomoses: submusc. Areolar
tissue
Veins:
Arranged in pre & post tarsal plexuses
Into Ophthalmic veins
Lymphatics:
Lateral side preauricular & parotid nodes
Medial side submandibular l.n.
OCULAR ADNEXA
The Lacrimal Apparatus:
The lacrimal complex:
The
The
The
The
The
Main Lacrimal glds
Accessory Lacrimal glds
Canaliculi
Lacrimal sac
Nasolacrimal duct
The Main Lacrimal Glands:
Orbital portion:
In the lacrimal fossa
Separated from palp. portion by lateral horn of
m. Levator Palp
Palpebral portion:
Just above the temporal segment of the sup or
conj fornix
Secretory ducts w/ 10 orificies connects orb &
palp portion to the supor conj fornix
The Accessory Lacrimal Glands:
Krause & Wolfring glds subs propria palp
conj
Drainage of tear:
Lacr lake upper/lower puncta canaliculi
lacr sac nasolacr duct meatus nasal
cavity
Mechanism: capillary attraction, gravity,
blinking & pumping action by Horners
muscle
Lacrimal Apparatus
Tear secretion.
Layers of precorneal tear film.
Drainage of tear.
Blood & Lymphatic supply:
Arteries: Lacrimal artery
Veins: joins w/ Ophthalmic vein
Lymph drainage: joins w/ conj lymphatic
preauricular l.n.
Nerve supply:
Sensory: Lacrimal nerve (1st div of N V)
Secretory: Great Petrosal nerve (from supor
salivary nucl)
Sympathetic nerve: accompanying the
Lacrimal artery & nerve
OPTIC NERVE
The Intra ocular:
1,5 mm
The Intra orbital:
25 30 mm; 3 mm
The Optic Chiasm:
Near the top of sella
tursica
Decussation
The Retrochiasmatic
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