Anatomi dan Fisiologi

Mata
DYANA T. WATANIA

ORBIT
Pear shaped

Volume: 30 cc
Height: 35 mm
Width: 45 mm

Depth: 40 45 mm
Influenced by: race and sex

ORBIT
7 bones:

1.
2.
3.

4.
5.
6.

7.

Frontal
Zygomatic
Maxillary
Ethmoidal
Sphenoid
Lacrimal
Palatine

ORBIT

ORBIT
Orbital margin
Superior:

Frontal bone

Medial:
Frontal bone
Post lacrimal crest of lacrimal bone
Ant lacrimal crest of maxillary bone

Inferior:
Maxillary bone
Zygomatic bone

Lateral:
Zygomatic bone
Frontal bone

ORBIT

ORBIT
Roof:
Orbital plate of Frontal bone
Lesser wing of Sphenoid bone
Lateral wall:
Zygomatic bone
Greater wing of Sphenoid bone

ORBIT
Floor:
Maxillary bone
Palatine bone
Orbital plate of Zygomatic
Medial wall:
Frontal process of Maxilla
Lacrimal bone
Orbtial plate of Ethmoid bone
Lesser wing of Sphenoid bone

ORBIT

ORBIT

ORBIT

ORBIT

ORBIT
Foramina:
1.
Optic foramen
2.
Supraorbital foramen
3.
Anterior ethmoidal foramen
4.
Posterior ethmoidal foramen
5.
Zygomatic foramen
Duct: nasolacrimal duct
Canal: infraorbital canal

ORBIT
Fissures:

Superior:
Outside the annulus of Zinn
1.
Lacrimal N.
2.
Frontal N.
3.
Troclear N.
4.
Sup Ophthalmic vein
Inside the annulus of Zinn
1.
Sup and Inf div of Oculomotor N.
2.
Abducent N
3.
Nasocilliary branch
4.
Symphatetic roots of cilliary ganglion

Inferior:
Inf. Ophthalmic vein
Infraorbital and Zygomatic branch of V-2

ORBIT

ORBIT
Vascular supply
20 short posterior ciliary arteries (+10 short post cilliary
nerves)
2 long ciliary arteries (+nerves)
Anterior ciliary arteries
Pairs in the sup, med, and inf rectus
From ophthalmic artery
Single from lacrimal artery in the lat rectus

ORBIT
Vortex veins:
Drain: choroid, ciliary body, and iris
Each eye: 4-7 veins (could more)
Usually in each quadrant
Exit 14-25 mm from the limbus
Between the rectus mucles

ORBIT

ORBIT

NERVES
Cranial Nerves:
6 of 12 CN directly innervates the eye and periocular tissue

CN II CN VII

3 CN innervates the EOM

Oculomotor Nerve
Troclear Nerve
Abducent Nerve

NERVES
Ciliary Ganglion
1 cm in front of annulus of Zinn
Lat to ophthalmic artery
3 roots
Long sensory root:
10-12 mm long
From Nasociliary branch of V-1
Sensory fibres for conea, iris, and ciliary body

NERVES
Short motor root:
From inferior div of CN III
Synapse in the ganglion
Carry parasymphatetic fibres
Supply iris sphincter
Symphatetic root:
From the plexus around internal carotid artery
No synapse
Supply: dilator muscle, ocular blood vessels

NERVES

NERVES

EXTRA OCULAR MUSCLES

7 EOM:

1.
2.
3.

4.
5.
6.

7.

Medial Rectus
Lateral Rectus
Superior Rectus
Inferior Rectus
Superior Oblique
Inferior Oblique
Levator Palpebrae Superioris

EXTRA OCULAR MUSCLES

Fuction:

Med Rectus: Adduction

2. Lat Rectus: Abduction
3. Sup Rectus:
1.

1 Elevation
2 Intortion
3 Adduction

4. Inf Rectus:

1 Depression
2 Extortion
3 Adduction

EXTRA OCULAR MUSCLES

5. Sup Oblique:

1 Intortion
2 Depression
3 Abduction

6. Inferior Oblique:

1 Extortion
2 Elevation
3 abduction

7. Levator Palp Sup: elevate the sup eyelid

EXTRA OCULAR MUSCLES

Innervation:
CN III: Sup rectus, Med rectus, Inf rectus, Inf oblique, Levator
palp sup
CN IV: Sup Oblique
CN VI: Lat rectus

4 rectus muscles: annulus Zinn

Spiral of Tillaux

EXTRA OCULAR MUSCLES

EXTRA OCULAR MUSCLES

EXTRA OCULAR MUSCLES

EXTRA OCULAR MUSCLES

EXTRA OCULAR MUSCLES

EYELID

EYELID
Skin

Thinnest

Margin

Punctum
Meibomian orifices
Gray line
Eyelashes
Glands of Zeiss
Glands of Moll

Subcutaneous connective tissue

Loose
No fat

EYELID
Orbicularis oculi muscle
CN VII
Voluntary muscle
Orbital part: prestarsal, preseptal
Palpebral part
Septum:
Thin connective tissue
Act as barrier

EYELID
Levator muscle

Whitnalls ligament
Mullers mucle
Anterior part
Posterior part
50-55 mm long

Tarsus:

Dense connective tissue

No cartilage
Length: 29 mm
Thickness: 1 mm
Height: 11 mm (upper tarsus), 4 mm (lower tarsus)
Meibomian glands: 30-40(upper tarsus), 20-30(lower tarsus)

EYELID

EYELID

EYELID

EYELID

EYELID

EYELID

EYELID
Lymphatic drainage

EYELID
Conjuctiva
Palpebral
Foniceal
Bulbar

EYELID
Vascular supply:
Facial system ext carotid artery
Orbital system int carotid artery
Superficial and deep plexuses
Arterial:
Marginal arterial arcade
Peripheral arterial arcade
Venous:
Superficial/pretarsal system internal and external jugular
vein
Deep/posttarsal system - cavernous sinus

EYELID

EYELID
Accessory structures:

Caruncle
Small, fleshy, ovoid
Sebaceous gland
Fine colourless hairs
Plica semilunaris
Narrow, highly vascular
Crescent shape
Rich in goblet cells

LACRIMAL SYSTEM
Secretory apparatus
Glands:

Main: lacrimal gland

8-12 major lacrimal ducts
Orbital and Palpebral parts

Accessory:
Krause
Wolfring

Secretion:
Basal
Reflex

LACRIMAL SYSTEM
Excretory:
Puncta
Ampulla
Canaliculi
Common canaliculus
Lacrimal sac
Lacrimal duct inferior turbinate
Valves:

Rosenmuller
Hasner

LACRIMAL SYSTEM

LACRIMAL SYSTEM

LACRIMAL SYSTEM

LACRIMAL SYSTEM
Inervation:
Afferent: V-1
Efferent: sup. salvary nucleus intermediolat of
N.VII greater superf. Petrosal nerve
sphenopalatine ganglion zygomaticotemporal
nerve lacrimal nerve

LACRIMAL SYSTEM
Tear film:
1.
Mucinuous layer:

goblet cell
Even distribution
Stabilize

Aqueous:

2.

lacrimal glands
Intermediate layer

Oily layer:

3.

meibomian glands
Reduces evaporation
Stabilize

LACRIMAL SYSTEM

GLOBE
NOT a true sphere

AP diameter: 23-25 mm
3 compartments:
Anterior chamber
Posterior chamber
Vitreous cavity

GLOBE

CORNEA
5 layers:

1.
2.
3.

4.
5.

Epithelial
Bowmans layer
Stromal layer
Descemets membrane
Endothelium

CORNEA

CORNEA

CORNEA
About 43 D

Thickness:
Central: 0.5 mm
Peripheral: 0.7 mm
Aspheric
Average diameter: 12 mm
Radius: 7.4 -8.4 mm
Optically clear
Avascular

SCLERA
3 layers:

Episclera
2. Stroma
3. Lamina fusca
Thinnest: 0.3 mm behind the insertion of rectus
muscles
Thickest: 1.0 mm around the optic nerve head
White
Strong, act as skeleton
1.

SCLERA

LIMBUS
important for 2 reasons:
its relationship to the chamber angle
its use as a surgical landmark
Structures:
1.
2.
3.
4.
5.

conjunctiva and limbal palisades

Tenon's capsul
Episclera
corneoscleral stroma
aqueous outflow apparatus

LIMBUS
surgical limbus : 2 equal zones:

an anterior bluish gray zone

1.

overlying clear cornea and extending from Bowman's layer to

Schwalbes line

2. a posterior white zone

overlying the trabecular meshwork and extending from

Schwalbe's line to the scleral spur, or iris root

LIMBUS

ANTERIOR CHAMBER
Bordered:
anteriorly by the cornea
posteriorly by the iris diaphragm and the pupil
AC angle:
1.

2.
3.
4.
5.

Schwalbe's line
Schlemm's canal and the trabecular meshwork
scleral spur
anterior border of the ciliary body (where its
longitudinal fibers insert into the scleral spur)
iris

ANTERIOR CHAMBER

ANTERIOR CHAMBER
deeper in aphakia, pseudophakia, and myopia

shallower in hyperopia

TRABECULAR MESHWORK
a circular spongework of connective tissue lined by

trabeculocytes
Divided into 3 layers:
1. uveal portion
2. corneoscleral meshwork
3. juxtacanalicular tissue, which is directly adjacent to
Schlemm's canal

TRABECULAR MESHWORK

TRABECULAR MESHWORK

UVEAL TRACT
Consists of:

iris
2. ciliary body (located in the anterior uvea)
3. choroid (located in the posterior uvea)
firmly attached to the sclera at only 3 sites:
1.

1.
2.
3.

the scleral spur

the exit points of the vortex veins
the optic nerve

UVEAL TRACT
Iris
Stroma
Vessels and nerves
Posterior pigmented layer
Dilator muscle
Sphicnter muscle
Variety in colour

UVEAL TRACT

UVEAL TRACT
Ciliary body
Ciliary epithelium and stroma
2 parts:
1.
Pars plana
2.
Pars plicata
Cilliary muscle:
1.
Longitudianal
2.
Radial
3.
Circular

UVEAL TRACT

UVEAL TRACT
Choroid:
Posterior portion
Perfusion: long and short posterior ciliary arteries
3 layers of vessels:
1.
Choriocapilaries - inner
2.
Small vessels - middle
3.
Large vessels outer
Drain: vortex vein

LENS
Capsule

Epithelium
Fibres
Zonule of Zinn / suspensory ligament

LENS

RETINA
a thin, transparent structure that develops from the

inner and outer layers of the optic cup

In cross section, from outer to inner retina, its layers
are:
1. RPE and its basal lamina
2. rod and cone inner and outer segments
3. external limiting membrane
4. outer nuclear layer (nuclei of the photoreceptors)
5. outer plexiform layer

RETINA
6. inner nuclear layer

7. inner plexiform layer

8. ganglion cell layer
9. nerve fiber layer (axons of the ganglion cells)

10. internal limiting membrane

RETINA

RETINA

RETINA
Macula
Clinical retina specialists tend toregard the macula as the area
within the temporal vascular arcades
Histologically, it is the region with more than 1 layer of
ganglion cell nuclei
macula lutea ("yellow spot")
Two major pigments: zeaxanthin and lutein

RETINA

VITREOUS
Occupies four fifths of the volume of the globe

Volume : close to 4.0 Ml

gel-like structure
99% water

Consists of:
fine collagen fibrils (chiefly type II)
cells

VITREOUS

VITREOUS