Head and Neck

The Eye
Alessandro Buizza, 5.3.18, Cerri

Anatomy
The Eye’s structure is divided by the Lens in an Anterior segment and in a Posterior segment.
The anterior segment itself is divided by the iris into an
anterior chamber and a posterior chamber that contain the
aqueous humour; this substance is produced by the papillary
network within the ciliary bodies. The aqueous humour is kept
at an appropriate pressure in order to allow the cornea to keep
its shape; it is also responsible for the delivery of nutrients to
the cornea via diffusion (as it is not perfused by vessels).
The posterior segment instead contains the vitreous humour,
it is responsible mainly for the maintenance of the eye shape.

The lenses of the eye are structures that allow us to focus an image on the retina (dioptric devices), in the
specific on the fovea, that is the point of the retina with the higher concentration of receptors (rods and
cones) that grant a higher acuity than the rest of the retina. A focus that do not coincide with the retina result
in sight defects

Light behaviour
First of all is important to say that the amount of light that is allowed to enter the eye is tightly controlled by
the iris, as the appropriate amount must enter in order to produce a comprehensible image.
The functioning of the iris resembles that of a camera in which a diaphragm increases or decreases its
diameter in order to regulate the light amount. In the iris what modulate the pupillary size are 2 specific
muscles: the radial and the constrictor. Those are not voluntary muscles, but instead are controlled by the
Autonomic nervous system (ANS), in the specific
-The Parasympathetic will be responsible of the activation of the constrictor and so of the decrease in
light entrance. This is the process responsible for the pupillary reflex (elicited in the clinic to assess the
brainstem status) that consist in the exposure of one eye to a light and the subsequent ipsi- and
contralateral (consensual) iris constriction. The circuitry responsible for this reflex do not reach the
occipital cortex but bring the visual information to the pretectal nuclei in the brainstem from which
are conveyed to the Edinger-Westphal nuclei that project preganglionic fibres reaching the ciliary
ganglion that will ultimately connect to the iris muscles to trigger its contraction.
-The Sympathetic instead is responsible of the activation of the radial muscles and so of an increase in
the light entrance. A massive sympathetic activation may elicit the pupil dilation.

The light is an electromagnetic wave, different wavelength code for different colours. White light is the sum
of all the wavelengths, in fact if we let white light pass into a prism the different diffractions will separate the
light rays in the 7 colours of the rainbow. That said, the colour of an object is actually the only colour
(wavelength) that is reflected by that object, while all the other are absorbed by the object itself.
For example, a black object is one that absorb all kind of wavelength.
The visible spectrum of wavelength is comprehended in 400 nm and 700 nm.
The amount of light (luminance) reflected by an object is crucial in determining our capability of discerning
different colours and the object itself. In fact in case of extremely low or absent light we are not able to see
nothing; and at dim light instead we start to see objects (not really much the colours as cones require more
light to work) and at optimal light we can see very well both colours and objects.

Now we must consider the modification to the light rays’ direction that the eye applies:
The lenses are able via Refraction to redirect the rays in order to be able to focus them on the retina.

Refraction
is a phenomenon that, in a nutshell, happens every time a wave changes the media in which it travels. The
result of refraction is a change in direction of the wave, in our case the light rays.
The degree of direction change depends on 3 variables: the difference in the densities of the 2 medias, the
angle at which the wave reaches the interface of the 2 media and the curvature at the interface of the 2
media. An increase in those parameters result in a greater degree of deviation.
Refraction is measured in Dioptres and is calculated as 1/focal distance.

There are different lenses and media responsible for this phenomenon in the eye:
the first one the light met is the cornea then we have the aqueous humour, then the Lens (that actually
account for 2 as the light bend as it enters and as it exits the Lens) and finally the Vitreous humour.
The 2 humours are considered to have an irrelevant refractory power so we will exclude them in our further
examples.
The 2 lenses capable of a refractive power sufficient to focus the light rays into a point are the cornea and
the Lens. The cornea is a very powerful refractor and is capable of a refractive power of 59 diopters and a
focal distance of 17 mm

In order to simplify the examples let’s consider now on that

the light source is punctiform.

Looking at the source we see that it produces divergent rays, then

according to the distance of the eye from the object the rays that
reaches the cornea may be almost parallel (in case of a far object) or quite divergent (in case of a close object).
The threshold for far vision is ideally set to 6 mt. The difference in the angle of the rays reaching the cornea
determine a different focal point. So,
for example a far object will have a
shorter focal point compared to the
focal point of a near object. This is not
acceptable as we have to have the
focal point always at the same distance
(at the retina). So, in order to be always
able to focus them on the retina we
need to be able to change the
refractory power of one of the 2
lenses; this is achieved by the Lens.
The Lens
Is a convex lens (Remember that convex lenses are able
to converge while concave lenses are able to diverge)
that via a specific muscular apparatus is able to change
its curvature and so its refractive power, this feature of
the Lens is called “Accommodation”: in case of a close
object, which light rays are very divergent the Ciliary
muscles contract relaxing the suspensory ligament and
allowing the Lens to become thicker in the middle and
with a greater curvature resulting in a stronger refractive
power, sufficient to regulate the focal point on the retina. So, for near vision 3 processes are required:
Accommodation, constriction of Pupil (to prevent the entrance of excessively divergent rays that would
disgorge the image) and Convergence (to keep both foveae on the point of interest).
The opposite is valid in case of a far object for which the light rays will be almost parallel the ciliary muscles
relaxes pulling the suspensory ligament and so flattening the Lens that will have a lower refractive power
sufficient to focus the image on the retina.

We have said that the refractive power of just cornea is 59 dioptres, with Accommodation we can have a
maximum of 73 dioptres of refractive power. These proprieties allow us to have a emmetropic vision (image
always focused on the retina).

What happens when the focal point is not at the retina like in case of a failure in accommodation? The point
is not that an image can’t be seen (as the light reaches anyway the retina), instead the image forms, but it
will appear as blurred. This is due to the fact that one source of light will be recorded by more than one spot
of the retina. 2 main problems can result in this blurred vision: one is in case the focal point falls before the
retina meaning that there is a too powerful refractive power applied to light rays, the other is in case the
focal point falls posterior to the retina meaning that there is a too weak refractive power applied to light
rays.

The receptors
responsible for the conversion of photons in electrical signals are located in the posterior retina. Each
receptor gives information about the light that it receives working like a pixel, so reconstructing all the info
that reaches all the receptor we can create an image on the retina and then on the calcarine cortex of the
occipital lobe.

Focus
The movement responsible for the focus of the image on the retina in the fovea are divided in the Saccades
and the small pursue movement.
-Saccades are the movement that explore the object they occur as most of the time the whole image of
an object, that we are observing cannot fit completely in the fovea and so we have to change multiple
time the portion focused on the fovea in order to “reconstruct” the whole image a bit per time.
-An example of a pursue movement is the convergence, it occurs when an object is approaching us, it
consist in a non-consensual movement of the two eyes that will move both toward the nose in order to
keep the object in the foveae of the 2 eyes.
The Saccades are not random, especially when we are looking at someone’s else face the saccades are mostly
concentrated in those areas of the face that help us in understanding the emotional status of that person.