ANATOMY & PHYSIOLOGY

OF THE EYEBALL

Department of Ophthalmology
Brawijaya University
2008

School Rules
Pay Attention
Be Silent

External landmark of the eye

Orbital section of lid

Tarsal section
of lid
Lateral canthus

Medial canthus

Limbus

Internal part of the eye

The Conjunctiva
Transparent mucous membrane :
Palpebral conjunctiva
Posterior surface of the eyelid

Bulbar conjunctiva
Allows eye movement

Fornices conjunctiva
Junction between palpebral conjunctiva
and bulbar conjunctiva

The Conjunctiva

Bulbar conjunctiva
Fornices conjunctiva
Palpebral conjunctiva

The conjunctiva
Histology :
Conjunctival epithelium :
Surface epithelial : mucous secreting
goblet cells proper dispersion
precorneal tear film
Basal epithelial

Conjunctival stroma :
Adenoid layer : follicle-like structure
Fibrous layer : papillary reaction

The Conjunctiva

Papillary reaction

Follicular reaction

The conjunctiva
Blood supply :
Artery : Anterior cilliary & palpebral
Anastomose with vein

Nerve supply :
N. Trigeminus, ophthalmic division

Lymphatics :
Join with eyelids lymphatics

The Sclera & Episclera

Sclera :
collagen

Episclera :
Blood vessel to nourish sclera

Blood supply :
Artery posterior cilliary (short & long)

Nerve supply :
Cilliary nerve

The Cornea
Transparent :
Uniform structure
Avascularity
Desturgence

The Cornea

The Cornea
Source nutrition for the cornea :
Vessel of the limbus
Aqueus humor
Tears

Sensory nerve :
N. Trigeminal, ophthalmic division

Uveal tract
Uvea : Iris, Cilliary body, Choroid
Iris :
Control the amount of light entering the pupil

Cilliary body :
Formation of the aqueus

Choroid :
Between retina and sclera
Blood vessel

Uveal Tract

Cari gbr lain

The Lens
Biconvex
Avascular
Colorless
Transparent
Thick : 4 mm
: 9 mm
Suspended by
zonula zinii

The Lens
Lens has ability adjust its focus from
distance to near object because lens
has ability to change shaped

Accomodation

The vitreous
Clear, avascular,gelatinous body
Vitreous contains water (99%), collagen,
hyaluronic acid
Vitreous base : straddles the ora serrata
Vitreous body : central & cortex vitreous
Outermost part of the vitreous (hyaloid) :
Vitreous cortex, divided into anterior
cortex & posterior cortex

The vitreous

The Retina
Thin membranous structure that lines
the posterior aspect of the eye
Divided : central zone & peripheral
zone
Retinal base : anterior ora serrata
posterior N. opticus
Retinal cells are stratisfied in 10 layers

The Retina

The Retina

Internal limiting membrane

Nerve fiber layer
Ganglion cell layer
Inner plexiform layer
Inner nuclear layer
Outer plexiform layer
Outer nuclear layer
Photoreceptor cell (rod &
cone)
Retinal pigment epithelium
(RPE)
Bruch membrane

Photoreceptors of the retina

ROD :
Perifer >>
Scotopic vision
(vision in dim light

CONE :
Central >>
Photopic vision
(vision in bright &
color)

The Optic Nerve (N. II)

Part of anterior
visual pathway
(optic nerve, optic
chiasm, optic tract)
Light retina
optic nerve brain

RED EYE
Department of Ophthalmology
Brawijaya University
2008

Various types of red eye

Conjunctival injection
dilatation of posterior conjunctival
vessel
Fornices limbus
Bright red
Epinephrine test ( + )

Various types of red eye

Perilimbal (circumcorneal) dilatation :
cilliary flush
Limbus fornix
Epinephrine test ( - )

Various types of red eye

Episcleral injection Dilatation of episcleral
vessel
Pink-purple

Various types of red eye

Scleral injection dilatation of deeper episcleral
vessel
Purple bluish discoloration

Various types of red eye

Subconjunctival bleeding rupture of the
vessel ( extravasation of the blood )
Bright homogenous localized red eye

Common causes of red eye

Mild irritation of the eye

Acute conjunctivitis
Acute anterior uveitis
Acute glaucoma
Corneal trauma or infection

Mild irritation of the eye

Symptom :
Red eye
No pain
No visual
disturbance
No discharge

Sign :
Conjunctival
injection diffiuse,
more toward fornices
Others : within
normal limit

Acute Conjunctivitis
Symptom :
Red eye
Foreign body
sensation
Itch
No visual
disturbance
Discharge :
moderate to copious

Sign :
Conjunctival
injection diffiuse,
more toward fornices
Discharge
Papillary reaction
Follicular reaction
Cornea : clear

Acute Conjunctivitis

Acute Anterior Uveitis

Symptom :
Red eye
Pain : moderate
Visual disturbance :
slightly blurred
No discharge

Sign :
Conjunctival
injection diffuse,
mainly
circumcorneal
Cornea : usually
clear
Pupil size : small

Acute Anterior Uveitis

Acute Glaucoma
Symptom :

Red eye
Pain : severe
Nusea, vomiting
Visual disturbance :
markedly blurred
No discharge

Sign :
Conjunctival injection
diffiuse
Cornea : Steamy
Pupil : moderately
dilated & fixed
Intra ocular pressure

Acute Glaucoma

Corneal infection and Trauma

Symptom :
Red eye
Pain : severe to
moderate
Discharge : watery or
purulent
Visual disturbance :
usually blurred

Sign :
Conjunctival
injection diffuse
Cornea : change in
clarity related to
cause
Pupil : normal

Corneal infection

Corneal trauma