PHYSIOLOGY OF THE EYE

by Khorrami Ph.D.
http://khorrami1962.spaces.live.com khorrami4@yahoo.com http://www.scribd.com/khorrami4

Eye References:

Clinical anatomy of the eye; R.S.Snell Clinical Neuro-ophthalmology; N.R.Miller Adlers physiology of the eye; W.M.Hart Grays anatomy Atlas of strabismus; G.K.V.Noorden Binocular vision & ocular motility; G.K.V.Noorden Ophthalmology; F.W.Newell Neuro-Ophthalmology; Burde Visual perception; S.H. Schwartz

Eye physiology, subjects

Structure of extra ocular muscles, classification & differences with other striated muscles. How the eyes move in directions & sights How is the importance of phenomena & Boeder, Listing, Sherrington & Donders law What is the composition of tear & the mechanisms that control lachrymal glands What are anterior chamber & posterior chamber and which mechanisms can control eye pressure. Iris, pupil & light reflex Composition of cornea & the mechanisms involved in its transparency Composition of lens & the mechanisms involved in its transparency, physiological age related changes of lens Vitreous cavity, entoptic Retina & how we can see in light & dark. Retina, cell architecture Which mechanisms can regulate light entrance & fixate subjects on retina The pathways where the visual signals pass through the brain How we can sense the colors How we can sense our environment as 3D How we can asses the functions of retina and neural pathways. Optic nerve, afferent & efferent pathways Electro-oculography, electro-retinography, evoked potential

As sensorimotor system

To see the sights

Sensory system

Vision Depth of vision Color vision Sense of movements

Motor system

Transforming the field of vision into fixation Object onto the fovea Maintenance of binocular vision Connection with vestibular system

TOPOGRAPHIC RELATIONSHIP OF EOM

Tenons capsule

Muscle characteristics

Diameter Length Mitochondria Reticulum sarcoplasmic, T.tubule Myoglobulin Glycogen Innervation Sensory compartments Fatigability Elastic fibers

Functions of extraocular muscles

Optostatic Optokinetic

Comparison with skeletal muscles

Index EOM Skeletal

Amplitude
Duration of AP Frequency Contraction time

20-150V
1-2ms 150 8ms

100-3000V
5-10ms 50 40-100ms

Innervations
All-or-none

even1-1
yes

1-125
No

Extraocular muscle classification

Kato(1938): based on diameter of fibers

Large
Small

Hess(1963): based on morphology

Fast

twitch( fibrillar type) Slow tonic (field type)

Denervation of EOM (Asmussen 1975)

Atrophy of fast (global) muscles Hypertrophy of slow (orbital) muscles

Extra ocular muscles

PEE & SEE Schiefferdecker:

Abundant

thick parallel elastic fibers Elastic bands

Types of EOM; Peachey(1971)

Connective tissue septa of EOM in orbit

Spiral of Tillaux

Spiral of Tillaux

Equatorial plane

Arc of contact

Muscle plane

Eye movements

Duction Version Vergence

Eye Movements and Extraocular muscles

Rectus Muscles
Superior and Inferior Oblique

Eye movements

Eye movements

Ocular movements

Extra ocular muscles

Attachment of eye muscles:

IO IR

Attachment of eye muscles:

SO 4th n. IO SR IR

MR

LR 6th n.

Right horizontal muscles

Relations of eye to pull of rectus & oblique muscles;RE

Right superior rectus muscle

Right inferior rectus muscle

Right superior oblique muscle

Left inferior oblique muscle

Oblique muscles

Muscle plane of vertical rectus & oblique muscles

Dual Actions of Superior Rectus

Dual Actions of Superior Oblique

Action of EOM from primary position

Saccadic eye movements

Fastest movements produced by the human body Quick, simultaneous movements of both eyes in the same direction Frontal and parietal lobes of the brain

Helmholtz description(1961)

If the eye has rotated from primary position, the axis of rotation of a muscle do not significantly change their position in space

Broad insertion of EOM

Boeders theory(1962)
Vertical movement of horizontal muscles is minimal Horizontal movement of vertical muscles is minimal

EOM; Boeders theory

EOM; Boeders theory

EOM; Boeders theory

EOM; Boeders theory

Donders law(1848)

Freedom around anterior-posterior axis is limited( cyclorotation) Orientation of the eye when looking in a specific direction is always the same The orientation is always the same irrespective of where the eye came from.

Listings law

Listing's law specifies what this orientation is Each movement of the eye from primary position to any other position involves a rotation around a single axis lying in the equatorial plane

Meridians in eyes

Eye movements

Pair muscles Yoke muscles

Yoke muscles
Direction Up & right(A) Yoke muscles
RSR + LIO

Right
Down & right(C)

RLR + LMR
RIR + LSO

Down & left(D)

Left Up & left(B) Elevation Depression

RSO + LIR
RMR + LLR RIO + LSR RSR & RIO+LSR & LIO RSO & RIR+LSO & LIR

Herings law(1868)

Common innervations
For

movements of both eyes in the same direction, the corresponding agonist muscle receive approximately similar innervations

Sherringtons law

Reciprocal innervations
Impulses

to contract an agonist muscle inhibit contractions of antagonist muscles

Severed nerves III and IV in right eye Retraction(Duanes) syndrome

Narrowing

of palpebral fissure on adduction Impaired reciprocal innervations Co-contraction of antagonistic muscles

Asymmetric convergence

Lacrimal cells

Light( K cells)
Contain small, electrolucent granules Mucous May function autonomously

Medium

Mixed

Dark( G cells)
Contain large, electron dense granules Serous Cholinergic supply

Lacrimal gland

Tear secretion stimulated by:

Lacrimal nucleus of VII(Ach)

Nicotinic

& muscarinic Emotional Psychic

More

protein-based hormones PRL, ACTH, and leucine enkephalin

Maxillary branch of V(Ach)

Sensory

pathway of reflex
Find & explain

Superior cervical ganglion(sym)

Innervate

mainly blood vessels

Tear layers

Anterior lipid layer(0.2-0.9)

Meibomean,

Zeis & Moll

Middle aqueous layer(6.5-7.5)

Krause,

Wolfring
of cornea

Moistening

Mucinous(0.5 )
Goblet

cells & lacrimal glands

Name

Container(s)

Secretors

Functions coats the aqueous layer; provides a hydrophobic barrier that retards evaporation and prevents tears spilling onto the cheek. These glands are found among the tarsal plates. Thus, the tear fluid deposits and between the eye proper and oil barriers of the lids.[2]

Lipid layer

Oils

Meibomian glands(or tarsal glands)

Aqueous layer

Water and other substances such as proteins (e.g. tear lipocalin, lactoferrin, lysozyme, and llactirin)

Lacrimal gland

promotes spreading of the tear film; promotes the control of infectious agents; promotes osmotic regulation

Mucous layer

Mucin

conjunctival goblet cells

coats the cornea provides a hydrophilic layer; allows for even distribution of the tear film; covers the cornea

Blinking

Shortens canaliculi Expands lacrimal sac Vacuum tears into lacrimal sac Pumping the lacrimal glands Involuntary blinking spreads tear Each 5sec, for 0.3sec Infants have not blinking Infrequent blinking in hyperthyroidism & parkinsonism

Tear inflow & drainage

Drainage of tear

Tears secretion

Normal: 0.9-2.2 l/min Maximum drainage capacity: 30 l/min Crying: 100 l/min Evaporation: 0.85 l/min

Tear composition
Lipid layer

Wax esters: 35% Cholesterol esters: 30% Phospholipids: 16% Triglycerides: 4% FFA: 2% Free sterols: 2%

Tear composition
Aqueous phase

Water:98% Na, Hco3: as plasma K, Cl: as plasma Urea,A.A.: as plasma Glucose: less Lymphocyte, phagocyte Proteins: less, 7mg/ml, decrease with aging

Tear alb, Immunoglobins

IgA: neutralize viruses, inhibits adherence of bacteria IgG: phagocytosis, bacterial lysis(complements) IgE: in allergies

lysozyme, complements, IFN, lipocalin, lactoferrin, hormones, lacritin,..

Lipocalin

As carrier protein A protein that carry hydrophobic molecules

steroids,

bilins, retinoids and lipids

Associated with immune response, prostaglandin secretion

Lacritin

A glycoprotein in tears and saliva Produced by meibomian gland, corneal & conjunctival epithelial cells Promotes epithelial cell proliferation Mitogen effect Down regulated in dry eye

Accessory lacrimal glands

Meibomean; sebaceous
10-15

acini

Zeis; sebaceous, connected with follicles Moll; sweat gland Krause; serous, in fornices Wolfring; mucin

Meibomean glands

Prevents the over flow of tears on the cheek Makes possible an airtight closure of eyelids Prevents rapid evaporation of tears Provides external layer of the precorneal tear film(?)

Conjunctiva
Areas

Layers

Palpebral
Marginal tarsal Orbital

Stratified columnar epithelium

5-7 layers in corneoscleral 2 layers in tarsal Connective tissue Muscle fibers Blood vessels Nerve, glands Macrophage, mast cells

Sup. & inf. Fornices

Semilunar folds Lacrimal caruncles

Lamina propria

Bulbar

Loosely attached

Corneal layers

Stratified epithelium(10% of tissue thickness)

Consists 1000s tiny nerve endings(very sensitive) Oxidative metabolism Necessary for healing Collagen
Water(78%) + collagen(16%), no blood vessels

Bowman layer

Stroma(Substantia propria), contain keratocytes(90%)

Decemet membrane(single layer)

Collagen, barrier against infection & injuries

Dehydration

Endothelium, microvilli for nourishment

Repair of injury: 6 weeks

Collagen fibers in cornea

Type I collagen fibers, uniform diameter, gathered in lamella Enmeshed in GAG

Keratan

sulfate(glucosamine 60%) Chondroitin sulfate(galactoseamine 40%)

Corneal structure

Consistency Least astigmatism aberration As a specific filter for electromagnetic

Electromagnetic transmit

Wavelengths: 300(UV) 2500nm(IR)

400nm: 80% transmitted 500- 1200nm: 100% Larger than 1000nm cannot stimulate retina

Transparency of the cornea

Anatomic structure Lack of pigments and vessels Cellular arrangements Nucleus and other organelles in periphery Non-keratinized epithelial cells Tight junction, impermeable to aqueous solution Dynamic balance between ions & water Corneal dehydration

Endothelial cells of the cornea

Active transport Passive transport

Epithelial cells of the cornea

35%

65%

Aqueous humor

Production: 2l/min Total volume: 125l By nonpigmented epithelial cells of cilliary body Helps maintain the IO pressure Nourishment of cornea, zonules, lens, iris, cornea & trabecular meshwork Washing the metabolites Blood-aqueous barrier: 104 nm

Tight junction in pigment epithelial cells Iris Iris blood vessels

Aqueous humor composition

Na+, K+, Mg2+ as plasma Ca2+ half of plasma Chloride more than plasma Bicarbonate less than plasma Ascorbic acid more than plasma Glutathione more than plasma

Trabecular meshwork

Aqueous humor circulation

Applanation tonometer.

Schiotz' tonometer.

Variations of the intraocular pressure.

A.Normal variation. B.Occasional high pressure values

Intra-Ocular pressure

12-20mmHg greater than Atmosphere 2-5mmHg daily fluctuations

Intra-Ocular pressure depends on:

Formation of aqueous humor Trabecular meshwork resistance

75%

of total resistance

Schlemm canal resistance Pressure in episcleral vein(10mmHg)

Blood

pressure Osmotic pressure of blood

Lens

10 4 mm Dioptric power
At

birth: 15 At 40: 7-8 At 60: 1-2

Refractive index:
1.386

at periphery 1.406 at core

Lens capsule

Homogenous, smooth and acellular Thicker capsule anteriorly Secreted anteriorly by epithelial cells Posteriorly by cortical fibers Continuously renewed Permeable to water and small molecules No metabolic or enzymatic activity

Lens layers

Lens; solute movements

Lens metabolism

Glycolysis 85%

Aerobic 5-7% but 25% of ATP

Hexose monophosphate shunt 5-7%

Lens proteins

33% of wet weight of the lens Water soluble, mainly crystallins 80%
Structural Active

signal in lens development

Water insoluble 20%

Cytoskletal
Urea

insoluble

Membrane
Soluble

structural

in 8M urea

Water soluble proteins

Alpha
600-4000kDa
Consist

of 20kDa polypeptides Hydrophobic & H+ bonds

eta 55% of W.soluble

40-200kDa

Gamma
18-20kDa In

embryonic nucleus

Water insoluble proteins

Major intrinsic polypeptide(MIP)

28kDa In gap junctions In differentiating lens fibers Breakdown with aging 28 to 22kDa At ages 20-30 at equal abundance

Glucose on lens
Hyperglycemia

Hypoglycemia

Glycolysis Reduce hexokinase path Shift to sorbitol path Fructose Lens is impermeable to sorbitol and fructose Osmotic pressure Cataract Glycosylation

Reduce ATP Calcium accummulation Protein aggregation Cataract

Calcium on lens(100nm/L)
Actions

Maintained by

Activation of proteases As second messenger Signal transduction Control of cell proliferation

Ca ATPase Na-Ca ATPase Binding proteins

Transparency of lens

Is not dependent on oxygen But depends on glucose level in aqueous humor Na+-K+ ATPase activity Fibrillar junctions, sutures Fibrillar proteins Orderly packing of lens fibers Calcium ATPase Na+-Ca2+ exchanger
Finely granular and evenly dense cytoplasm and no organelles

Absence of blood vessels, lymph and nerve Special proteins Dehydration Special metabolism

Uvea

Uva means grape Iris + ciliary body + choroid Sandwiched between the sclera and the retina

Cell layers of Iris

Contraction of Iris

Ciliary muscle

Mid-sagittal section of the eye

Pupil

2-8mm Miosis<2mm Midriasis>6mm Should be round, regular and equal

Pupil

Regulate light entrance Increase depth of focus Minimize spherical and chromatic aberration Minimize astigmatism

Miosis stimulated by:

Light Near Sleep (REM) Coma Stimulation of cornea(sub-p) Meningitis & encephalitis

Midriasis stimulated by:

Emotion Fear Pain Vestibular stimulation Hypoxia of midbrain Anesthesia Sleep in stages I & II Increase CSF pressure

Light reflex

Latent period: 0.18s Max constriction in 1s

Accommodation

Ciliary muscle & accommodation

Visual pathways

REVIEW: Autonomic NS Effect on the Eye

RECEPTOR ACTIVATION WILL: IRIS, Circular Fibers IRIS, Radial Fibers CILIARY MUSCLES TO LOWER IOP, AIM FOR:

mAchR : Constrict Pupil 1 R : Dilate Pupil mAchR : Contract for Accomodation 2 R : Relax for Far Vision

Activity Activity Activity Activity

Modified from: http://pharma1.med.osaka-u.ac.jp/textbook/Autonomic/Autonomic.html

Horners syndrome
Sympathetic dysfunction Small pupil(miosis) Minor ptosis Loss of sweating on the affected side Direct and consensual light response intact; following dilation slowed

Sclera

The tough, white, outer layer (coat) of the eyeball made up of connective tissue fibers With the cornea, it forms the outer wall or coat of the entire eyeball Six tiny muscles connect to the sclera around the eye and control the eye's movements The optic nerve penetrates the sclera at the very back of the eye The sclera is covered by the episclera, a thin layer of tissue containing many blood vessels that nourish the sclera At the front of the eye, the episclera is covered by theconjunctiva.