ANATOMY AND

PHYSIOLOGY
OF THE EYE
ANTONY HALIM
I4061162030
The orbit
• The orbital cavity is schematically represented as a pyramid of four walls that
converge posteriorly. The medial walls of the right and left orbit are parallel
and are separated by the nose.
• The orbital cavity is the protective bony socket for the globe together with the
optic nerve, ocular muscles, nerves, blood vessels, and lacrimal gland. These
structures are surrounded by orbital fatty tissue.

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• The roof consists of two bones: the lesser
wing of the sphenoid and the orbital
plate of the frontal bone.
• The lateral wall consists of two bones:
the greater wing of the sphenoid and
the zygomatic.
• The floor consists of three bones: the
zygomatic, maxillary and palatine.
• The medial wall consists of four bones:
maxillary, lacrimal, ethmoid and
sphenoid.
• The superior orbital fissure, between
the greater and lesser wings of the
sphenoid bone; through it pass numerous
important structures.
• The inferior orbital fissure lies between
the greater wing of the sphenoid and
the maxilla.

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• The principal arterial supply of the orbit and its structures derives from
the ophthalmic artery, the first major branch of the intracranial portion
of the internal carotid artery.
• The venous drainage of the orbit is primarily through the superior and
inferior ophthalmic veins, into which drain the vortex veins, the anterior
ciliary veins, and the central retinal vein. The ophthalmic veins
communicate with the cavernous sinus via the superior orbital fissure and
the pterygoid venous plexus via the inferior orbital fissure

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THE EYELIDS
 Palpebra protecting eyes from injury
and excessive light
 At the superficial, palpebra covered
with skin and in the inside covered
with mucosa membrane called
conjungtiva
 Cilia grow at the edge of palpebra.

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Superficial layer :
• Thin, well vascularized layer of skin.
• Sweat glands
• Glands of Moll (cilliary glands)
• Glands of Zeis (sebaceous glands)
• Orbicularis oculi muscle that actively
closes the eye

Deep layer:
• Tarsal plate, gives the eyelid firmness
and shape
• Tarsal muscle (levator palpebrae)
• Palpebral conjunctiva, firmly attached
to the tarsal plate
• Glands of Meibomian

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Lacrimal drainage system
• The puncta are located at the
posterior edge of the lid margin,
• The canaliculi pass vertically from
the lid margin for about 2 mm
(ampullae).
• The lacrimal sac is 10–12 mm long
and lies in the lacrimal fossa
between the anterior and posterior
lacrimal crests.
• The nasolacrimal duct is 12–18 mm
long and is the inferior continuation
of the lacrimal sac.

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Tear film
•Tears secreted by the main and accessory lacrimal
glands pass across the ocular surface.
•Tears flow along the upper and lower marginal
strips, pooling in the lacus lacrimalis medial to the
lower puncta, then entering the upper and lower
canaliculi by a combination of capillarity and
suction.
•With each blink, the pretarsal orbicularis oculi
muscle compresses the ampullae, shortens and
compresses the horizontal canaliculi, and closes
and moves the puncta medially, resisting reflux.
Simultaneously, contraction of the lacrimal part of
the orbicularis oculi creates a positive pressure
that forces tears down the nasolacrimal duct and
into the nose,
•When the eyes open, the canaliculi and sac
expand, creating negative pressure that draws
tears from the canaliculi into the sac

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The conjungtiva
The conjunctiva is the thin, transparent
mucous membrane that covers the
posterior surface of the lids (the palpebral
conjunctiva) and the anterior surface of the
sclera (the bulbar conjunctiva). It is
continuous with the skin at the lid margin (a
mucocutaneous junction) and with the
corneal epithelium at the limbus.
Function of the conjunctival sac:
1. Motility of the eyeball.
2. Articulating layer.
3. Protective function.

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 The Eyeball
The eyeball contains the optical apparatus of the visual system. The eyeball has three layer; the three
layers of the eyeball are:
1. Fibrous layer (outer coat), consisting of the sclera and cornea.
2. Vascular layer (middle coat), consisting of the choroid, ciliary body, and iris.
3. Inner layer (inner coat), consisting of the retina, which has both optic and non-visual parts.

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 The cornea
◦ Transparent, dome-shaped window
covering the front of the eye (normally
clear with a shiny surface) Responsible for
about three-quarters of the optical power
of the eye and for protection
◦ Extremely sensitive
◦ More nerve endings than anywhere else
in the body

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cornea
 The corneal tissue consists of five layers
1. The surface of the cornea is formed by stratified
nonkeratinized squamous epithelium that regenerates
quickly when injured.
2. A thin basement membrane anchors the basal cells of the
stratified squamous epithelium to Bowman’s layer. This layer
is highly resistant but cannot regenerate. As a result, injuries
to Bowman’s layer usually produce corneal scarring.
3. Beneath Bowman’s layer, many lamellae of collagen fibrils
form the corneal stroma. The stroma is a highly bradytrophic
tissue. As avascular tissue, it only regenerates slowly.
4. Descemet’s membrane is a relatively strong membrane. It
will continue to define the shape of the anterior chamber
even where the corneal stroma has completely melted
The five layers of the cornea have few cells membrane, lost tissue is regenerated by functional
endothelial cells.
and are unstructured and avascular. Its
5. The corneal endothelium is responsible for the
metabolism is slow, which means that healing
transparency of the cornea. A high density of epithelial cells
is slow.
is necessary to achieve this. The corneal endothelium does
Nutrients are supplied and metabolic not regenerate; defects in the endothelium are closed by cell
products removed mainly via the aqueous enlargement and cell migration.
humour posteriorly and the tears anteriorly.
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 The sclera
• The sclera and the cornea form the rigid outer covering of the eye. All
six ocular muscles insert into the sclera.
• Fibrous, whitish opaque, and consists of nearly acellular connective
tissue with a higher water content than the cornea.
• The site where the fibers of the optic nerve enter the sclera is known as
the lamina cribrosa. In the angle of the anterior chamber, the sclera
forms the trabecular network and the canal of Schlemm. The aqueous
humor drains from there into the intrascleral and episcleral venous
plexus through about 20 canaliculi.

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The sclera is normally dull white like porcelain. Altered color suggests
one of the following changes:
Conjunctival and/or ciliary injection and inflammationwill give the
sclera a red appearance.
A sclera that is very thin will appear blue because of the underlying
choroid
In jaundice, the sclera turns yellow.
The uvea
The uveal tract consists of the following structures:
• Iris
• Ciliary body
• Choroid.

The uveal tract lies between the sclera and retina.

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 The iris
The iris consists of two layers:
• The anterior mesodermal stromal layer.
• The posterior ectodermal pigmented epithelial layer.
The posterior layer is opaque and protects the eye against excessive incident light. The
anterior surface of the lens and the pigmented layer are so close together near the pupil that
they can easily form adhesions in inflammation.

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When bright light stimulates
the eye, parasympathetic
fibers of the oculomotor (III)
nerve stimulate the circular
muscles (sphincter pupillae)
of the iris to contract,
causing a decrease in the size
of the pupil (constriction).
In dim light, sympathetic
neurons stimulate the radial
muscles (dilator pupillae) of
the iris to contract, causing
an increase in the pupil’s size
(dilation).
The Ciliary body
The ciliary body extends from the root of the iris to the ora serrata, where it
joins the choroid. It consists of anterior pars plicata and the posterior pars
plana, which lies 3.5 mm posterior to the limbus. Numerous ciliary processes
extend into the posterior chamber of the eye. The suspensory ligament, the
zonule, extends from the pars plana and the intervals between the ciliary
processes to the lens capsule.
Function: The ciliary muscle is responsible for accommodation. The double
layered epithelium covering the ciliary body produces the aqueous humor.

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• The ciliary muscle is composed of a combination of longitudinal, circular, and
radial fibers. The function of the circular fibers is to contract and relax the
zonular fibers. This alters the tension on the capsule of the lens, giving the
lens a variable focus for both near and distant objects in the visual field.
 The choroid
Position and structure: The choroid is the middle tunic of the
eyeball. It is
bounded on the interior by Bruch’s membrane. The choroid is highly
vascularized,
containing a vessel layer with large blood vessels and a capillary
layer.
The blood flow through the choroid is the highest in the entire body.
Function: The choroid regulates temperature and supplies
nourishment to
the outer layers of the retina.

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 The Pupil
• The pupil refers to the central opening in the iris. It acts as an aperture to improve the
quality of the resulting image by controlling the amount of light that enters the eye.
• Normal pupil size: Pupil size ranges from approximately 1mm (miosis) to approximately
8mm (mydriasis).
• Pupils tend to be wider in joy, fear, or surprise due to increased sympathetic tone, and
when the person inhales deeply.
• Pupils tend to be narrower in the newborn due to parasympathetic tone, in the elderly due
to decreased mesencephalic inhibition and sympathetic diencephalic activity, in light,
during sleep, and when the person is fatigued (due to decreased sympathetic activity).

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 The lens
• The lens is a biconvex, avascular, colorless, and almost completely
transparent structure
• About 4 mm thick and 9 mm in diameter.
• It is suspended behind the iris by the zonule, which connects it with the
ciliary body. Anterior to the lens is the aqueous; posterior to it, the
vitreous.
• The epithelium of the lens helps to maintain the ion equilibrium and
permit transportation of nutrients, minerals, and water into the lens. This
type of transportation, referred to as a “pump-leak system,” permits
active transfer of sodium, potassium, calcium, and amino acids

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• The lens is nourished by diffusion from the aqueous humor. In this
respect it resembles a tissue culture, with the aqueous humor as its
substrate and the eyeball as the container that provides a constant
temperature.
 Accommodation
Accommodation mechanisms:
Accommodation involves the lens, zonule
fibers, and ciliary muscle.
•Lens: The soluble proteins of the lens are
surrounded by a thin elastic capsule.
The intrinsic elasticity of the lens capsule
tends to make the lens assume a spherical
shape. However, in the unaccommodated
state this is prevented by the pull of the
zonule fibers. The elasticity of the inner
tissue of the lens progressively decreases
with age due to deposits of insoluble
proteins.
Zonule fibers: The radiating zonule fibers insert into the equator of the lens
and connect it to the ciliary body. They hold the lens securely in position and
transmit the pull of the ciliary muscle to the lens.
Ciliary muscle: Contraction of the ring-shaped ciliary muscle decreases the
tension in the zonule fibers. The lens can then approach the spherical shape . As
the ciliary muscle relaxes, the tension on the lens increases and the lens flattens.

The ciliary muscle is innervated by the short ciliary nerves, postganglionic

parasympathetic fibers of the oculomotor nerve. Parasympatholytics such as
atropine, scopolamine, and cyclopentolate inhibit the function of the ciliary
muscle and therefore prevent accommodation
The aqueous
Aqueous humor is
produced by the ciliary
body. Entering the
posterior chamber, it
passes through the pupil
into the anterior chamber
and then peripherally
toward the anterior
chamber angle.

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 The anterior chamber angle
The anterior chamber angle lies at the junction of the peripheral cornea and the root of the iris. Its
main anatomic features are Schwalbe's line, the trabecular meshwork (which overlies Schlemm's
canal), and the scleral spur.
Schwalbe's line marks the termination of the corneal endothelium. The trabecular meshwork is
triangular in cross-section, with its base directed toward the ciliary body. It is composed of perforated
sheets of collagen and elastic tissue, forming a filter with decreasing pore size as the canal of Schlemm
is approached.
 The vitreous
• The vitreous is a clear, avascular, gelatinous body that
comprises two-thirds of the volume and weight of the eye. It
fills the space bounded by the lens, retina, and optic disk.
• Composition of the vitreous body: The gelatinous vitreous
body consists of 98% water and 2% collagen and hyaluronic
acid. It fills the vitreous chamber which accounts for
approximately two-thirds of the total volume of the eye.

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 The retina
• The retina is a thin, semitransparent, multilayered
sheet of neural tissue that lines the inner aspect of
the posterior two-thirds of the wall of the globe.
• Extends almost as far anteriorly as the ciliary body,
ending at that point in the ora serrata
• The retina is 0.12 mm thick at the ora serrata and
0.56 mm thick at the posterior pole.
• The macula lutea is a flattened oval area in the
center of the retina approximately 3–4mm(15
degrees) temporal to and slightly below the optic
disk. Its diameter is roughly equal to that of the optic
disk (1.7–2 mm). The macula appears yellow when
examined under green light, hence the name macula
lutea (yellow spot).

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Moving inward along the path of incident
light, the individual layers of the retina are
as follows :

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Vascular supply to the retina
The inner layers of the retina (the inner limiting membrane through the inner
nuclear layer) are supplied by the central artery of the retina.
This originates at the ophthalmic artery, enters the eye with the optic nerve, and
branches on the inner surface of the retina.
The central artery is a genuine artery with a diameter of 0.1mm. It is a terminal
artery without anastomoses and divides into four main branches
Vascular supply to the retina
The outer layers (outer plexiform layer through the pigment epithelium)
contain no capillaries. They are nourished by diffusion primarily from the richly
supplied capillary layer of the choroid.
The retinal arteries are normally bright red, have bright red reflex strips that
become paler with advancing age, and do not show a pulse.
The retinal veins are dark red with a narrow reflex strip, and may show
spontaneous pulsation on the optic disk.
Venous diameter is normally 1.5 times greater than arterial diameter.
Capillaries are not visible.
Nerve supply to the retina
The neurosensory retina has no sensory supply.
Disorders of the retina are painless because of the absence of sensory supply.
 Release of Neurotransmitter by
Photoreceptors
In darkness, sodium ions (Na) flow into photoreceptor
outer segments through ligand-gated Na channels
The ligand that holds these channels open is
cyclic GMP (guanosine monophosphate) or cGMP.
The partial depolarization during darkness triggers continual release of
neurotransmitter at the synaptic terminals. The neurotransmitter in rods, and
perhaps in cones, is the amino acid glutamate (glutamic acid). At synapses
between rods and some bipolar cells, glutamate is an inhibitory
neurotransmitter: It triggers inhibitory postsynaptic potentials (IPSPs) that
hyperpolarize the bipolar cells and prevent them from sending signals on to
the ganglion cells.
When light strikes the retina and cis-retinal undergoes
isomerization, enzymes are activated that break down cGMP.. It turn off the
release of an inhibitory neurotransmitter (decreases the release of
glutamate). The excited bipolar cells subsequentlystimulate the ganglion
cells to form action potentials in their axons.
The optic nerve
The optic nerve extends from the posterior pole of the eye to the optic chiasm. After this
characteristic crossing, the fibers of the optic nerve travel as the optic tract to the lateral
geniculate body. Depending on the shape of the skull, the optic nerve has a total length of 35 ・
55 mm. The nerve consists of:
An intraocular portion.
An intraorbital portion.
An intracranial portion.

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•The intraocular portion of the optic nerve is visible on
ophthalmoscopy as the optic disk. All the retinal nerve fibers
merge into the optic nerve here, and the central retinal vessels
enter and leave the eye here.
•The intraorbital portion begins after the nerve passes through
lamina cribrosa.
•After the optic nerve passes through the optic canal, the short
intracranial portion begins and extends as far as the optic
chiasm.
•Like the brain, the intraorbital and intracranial portions of the
optic nerve are surrounded by sheaths of dura mater, pia, and
arachnoid.

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The anatomy of the visual pathway may be divided into six separate parts :
1) Optic nerve: This includes all of the optic nerve fiber bundles of the eye.
2) Optic chiasm: This is where the characteristic crossover of the nerve fibers of both optic nerves occurs.
3) Optic tract: This includes all of the ipsilateral optic nerve fibers and those that cross the midline.
4) Lateral geniculate body: The optic tract ends here.
5) Optic radiations (geniculocalcarine tracts)
6) Primary visual area (striate cortex or Brodmann’s area 17 of the visual cortex):

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Sheaths of the optic nerve
The fibrous wrappings that ensheathe the optic nerve are continuous with the meninges. The
pia mater is loosely attached about the nerve near the chiasm and only for a short distance
within the cranium, but it is closely attached around most of the intracanalicular and all of the
intraorbital portions.
The arachnoid comes in contact with the optic nerve at the intracranial end of the optic canal
and accompanies the nerve to the globe, where it ends in the sclera and overlying dura.
The dura mater lining the inner surface of the cranial vault comes in contact with the optic nerve
as it leaves the optic canal.
The subdural space is between the dura and the arachnoid; the subarachnoid space is between
the pia and the arachnoid. Both are more potential than actual spaces under normal conditions
but are direct continuations of their corresponding intracranial spaces.
The extraoccular
muscle
Rectus muscle
◦ The four rectus muscles originate
at a common ring tendon (annulus
of Zinn) surrounding the optic
nerve at the posterior apex of the
orbit.
◦ The principal action of the
respective muscles is thus to
adduct, abduct, depress, and
elevate the globe.

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Oblique muscle
◦ The two oblique muscles control primarily torsional movement and, to a
lesser extent, upward and downward movement of the globe. The superior
oblique is the longest and thinnest of the ocular muscles. It originates
above and medial to the optic foramen and partially overlaps the origin of
the levator palpebrae superioris muscle. The superior oblique has a thin,
fusiform belly (40 mm long) and passes anteriorly in the form of a tendon
to its trochlea, or pulley.
◦ The inferior oblique muscle originates from the nasal side of the orbital
wall just behind the inferior orbital rim and lateral to the nasolacrimal duct.
It passes beneath the inferior rectus and then under the lateral rectus
muscle to insert onto the sclera with a short tendon.

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THANK YOU

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