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
Mata kecil memiliki fungsi sangat
penting
75% information visual
75% infomasi penglihatan
EYE
Surrounded by orbital bones
Dikelilingi oleh tulang mata
Cushioned by pads of fat
Dilindungi oleh bantalan lemak
Extraocular muscles help move the
eye in different directions
Otot mata luar membentu
pergerakan mata pada arah yang
berlawanan
ORBIT
Pyramid 4 dinding
Ø Rim < Ø 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
Tenon’s 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 o’clock meridians
– 4 antor ciliary a. & v. penetrate 4 mm from limbus
– Nerve supply: ciliary nerve
CORNEA
• Transparant, avascular
• Thick : 550 μm (central)
• Φvertical : 10.6mm
• Φhorizontal : 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
CORPUS CILIARIS
• Pars plicata ciliary process
aqueous formation
• Pars plana (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 Ø, 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.schlemm’s - ±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
RETINA
Semitransparent, multilayered, 2/3
postor inner aspect of globe
Ora serrata
anterior edge of retina (ragged edge)
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 Ø
•3 mm Ø center macula lutea w/ fovea
centralis Xanthophyll >>>,
photoreceptors >>>
•1,5 mm Ø center retinal avascular
zone
•0,25 mm Ø 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 Elevation Intorsion Adduction
Rectus
Inferior Depression Extorsion Adduction
Rectus
Oblique Sup Intorsion Depression 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 EYELIDS
The folds of thickened skin Skin Layer
Covered w/ hair Orbicularis Oculi Muscle (OOM)
The Glabella hairless Areolar Tissue
between 2 eyebrows 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
EYELID
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
• Muller’s 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 Main Lacrimal glds
• The Accessory Lacrimal glds
• The Canaliculi
• The Lacrimal sac
• The 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 supor 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 Horner’s 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 Ø
The Intra orbital:
25 – 30 mm; 3 mm Ø
The Optic Chiasm:
Near the top of sella tursica
Decussation
The Retrochiasmatic
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