Anatomi dan Embriologi Mata

Julie D Barliana

Divisi Pediatri Oftalmologi
Departemen IK Mata FKUI/RSCM
Anatomi Bola Mata
Kornea
Iris
Badan siliar
Lensa
Retina
Koroid
N Optikus (NII)
Badan kaca (vitreus body)
Anatomi Bola Mata
Badan Kaca
(vitreus body)
Anterior
chamber
(Camera Oculi
Anterior)
Posterior Chamber
(Camera Oculi
Posterior)
Central Vessel Retina
Hyaloid Canal)
Development of the Eye
I. First noticeable ~ 22days
optic groovesdeveloping neural tube
Development of the Eye
II. As neural folds fuse (= forebrain formation)
optic vesiclesevaginations of forebrain
Development of the Eye
IIIa. Induction of lens placode (surface ectoderm)
IIIb. Formation of optic stalk and optic cup from
optic vesicle
Continued development of
optic cup and lens
Optic cup invagination of distal
optic vesicle to form doublewalled
cup

Optic (choroid) fissure sulcus on
ventral aspect optic cup/stalk
(allows passage of vasculature
to lens & layers of cup)

Lens placode ectodermal
Thickening

Lens pitinvaginates to form
lens vesicle
Development of the retina
outer & inner portions of the optic cup
Closure of choroid fissure ~ 6-7 weeks
Optic Cup
Inner layer neuroepithelium
neural retina
Outer layerretinal pigment
epithelium
Intraretinal space
Cavity of optic stalk filled
with axons of optic nerve
Fusion of inner and outer
portions of the optic cup
Lens Development

lens placode in surface
ectoderm
invaginates as lens
vesicle
supplied by hyaloid
artery
Aphakia absence of the lens (extremely rare) Moore and Persaud, 1998
Congenital cataracts(e.g., rubella virus)
Congenital galactosemiacataract formation within 2-3 weeks
of birth (galactose accumulation)
Development of Ciliary Body and Iris
both develop from anterior portions of the optic
cup and surrounding mesenchyme
Ciliary muscle smooth muscle derived from
mesenchyme near the margin of the optic cup
effects accommodation reflex
Iridial muscles dilator and sphincter pupillae
mm. Smooth muscles derived from
neuroectoderm of the optic cup control size of
pupillary aperture
Iris dan Badan Siliar
Some Ocular Anomalies
Retinal detachmentbetween inner and outer
portions of the optic cup derivatives
congenitalfailure of fusion
acquiredtrauma
Defects in closure of optic (choroid) fissure
retinal coloboma
iridial coloboma
Aniridia (rare) 1 in 75,000
Extraocular Muscles
Develop from somitomeres I-
IV (paraxial mesoderm cranial
to the occipital somites)
Innervated via CN III, IV, & VI
Coordinate movements between the two eyes
(usually conjugate, although some instances
of physiological vergence exist)
Extraocular mm.
Inferior oblique
Medial rectus
Superior oblique
Superior rectus
Levator palpebrae sup.
Lateral rectus
Inferior rectus
(not shown)
Oculomotor Nerve (CN III)
Somatic motor
(oculomotor nucleus):
Sup. rectus, Inf. rectus,
Med. rectus, Inferior oblique
& Levator palpebrae superior
mm.
Parasympathetic
(Edinger-Westphal nucleus):
Ciliary m. &
Constrictor pupillae m.
Trochlear Nerve (CN IV)
Somatic motor only
(trochlear nucleus):
Superior oblique m.
Abducens Nerve (CN VI)
Somatic motor only
(abducens nucleus):
Lateral rectus m.
Extraocular Muscle Anomalies (congenital)

Agenesis (single muscle usually)
Anomalous Attachments
misplaced
additional attachments
Adherence & Fibrosis Syndromes

**Failure to align visual axes (strabismus), thus
potentially resulting in diplopia (double-vision)
Amblyopiareduced/absent visual ability in one eye
lazy eye
VISUAL REFLEXES

Pupillary Light Reflexes: 30wks gestation
Constriction (parasympathetic)
Dilation (sympathetic)
Accommodation (4 months = well developed)
(The Near Reflex)
Visual Developmental Milestones

Pupillary Light Reaction30 wks gestation
(CN II/symp/parasymp integration)
Lid closure in response to bright light30 wks gest.
(CN IICN VII reflex)
Blink response to visual threat2-5months
(CN IICN VII reflex)
Visual Fixationbirth (well dev=6-9wks)
Visual Following3 months
Accommodation4 months
Resources
The Developing Human6th Edition K. L.
Moore & T. V. N. Persaud 1998
The EssentialsWalsh & Hoyts Clinical
Neuro-Ophthalmology5th Edition
EditorsN.R. Miller and N.J. Newman1999
Neuro-ophthalmology3rd Edition
EditorJ.S. Glaser1999
Growth and Developmental of
the Eye
Dimensions of the Eye
Most of growth of the eye takes place in the
first year of life
The axial length occurs in 3 phases
Phase I: rapid period of growth (6 mos)-AL
increases 4 mm
Phase II and III: (age 2-5 years) and (age 5-13
years) growth slows-about 1 mm
Keratometry
Cornea grows rapidly over the first several
months of life (6 mos)
Keratometry values change ,markedly in the
first year of life:
52 D at birth
Flattening to 46 D by 6 months
Reaching adult power of 42-44D by age 12

Corneal horizontal diameter
9.5-10.5 mm at newborns
12 mm in adulthood
Most of changes occurs in the first year of life

Lens Power
The power of the infant lens decreases
dramatically over the first several years of life,
an important fact to consider when implanting
intraocular lenses (IOLs) in children
undergoing cataract extraction in infancy and
early childhood
Refractive Errors
The refractive state of the eye changes as
The AL increases
The cornea and lens flatten
In general:
Infants are hyperopic at birth,
become slightly more hyperopic until age 7, and
a myopic shift until the eye reaches its adult size,
usually by about age 16

Visual acuity and Stereoacuity
Two major methods are used to determine VA in
preverbal infants and toddlers:
Visual evoked potentials (VEP)
Preferential looking (PL)
VEP shows improvement of vision from about
20/400 in infancy
20/20 by age 6-7 mos
PL studies estimate the vision of
a newborn infant 20/600,
20/120 by 3 mos and
20/60 by 6 mos.
20/20 at 3-5 years