20.3 Vision Flashcards
(115 cards)
What is the retina?
The retina is a layer structure composed of an epithelium and neurons that transduce light into an electrical stimulus and process it, before transmitting it via the optic nerve
Perceptive opening for retinal processing
-
The eye is a clinician’s window into the brain
- not least of all because the retina is an extension of the CNS but the arrangement of blood vessels and the optic nerve sheath can provide information on the intraoccular and intracranial pressures as indicators of disease.
- Similarly, the pupillary light reflex can be used to assess the function of the brainstem and optic nerves.
- This is because the retina has the sole responsibility of transducing the light into an electrical impulse which is then conducted via the optic nerves to higher brain centres.
- However, retinal function is not limited to transduction.
- The retina is comprised of complex circuits that process information from the 127 million photoreceptors and compress it into just 1 million optic nerve fibers.
What are the three main histological parts of the anterior eye?
- Cornea
- Scelera
- Conjunctiva

Outline the layers of the cornea
EBSDE
-
Epithelium
- 5-7 cells thick
- High turnover
- Prevents bacterial entry
-
Bowman’s membrane
- Dense, thin connective sheet
- Forms the junction between the epithelium and the stroma
-
Stroma
- Regularly arranged, parallel type 1 collagen fibres are organised into fibrils
- Fibrils form lamellae which are equally spaced, making the cornea clear
- Mucopolysaccharides to embed the fibrils
-
Descemet’s membrane
- Separates the stroma from the underlying endothelium
-
Endothelium
- Singe layer of cells
- Deepest surface is covered in aqueous humour

Outline the function of the scelera
- Attachment for extraocular muscles
- Anterior 1/3 = joins choroidal tissue to form the lamina cribrosa
-
Posterior 2/3s = continous with the dura mater
- Scelera - ESLEL
- Endothelium
- Stroma
- Lamina fusca
- Episcelera
- Lamina cribosa
- Scelera - ESLEL

Outline the histological layers of the scelera
ESLEL
-
Episclera
- Loose fibrous elastic tissue
-
Stroma
- Irregular type 1 collagen fibres
-
Lamina fusca
- High count of pigmented cells
- Dense capillary plexus
- Endothelium
-
Lamina cribrosa
- Fenestrated region of the scelera which the optic nerve exits from
- Collagen lattice that maybe compressed
- Supports the toptic nerve as it exits the eyeball
- Forms a boundary to oligodendrocytes
- Myelination would decrease the transparency of the retina

What does the conjunctiva cover? What is its structure?
- Covers the anterior eye scelera, inner eyelids but not the cornea
- Structure
- Non-keratinised, stratified squamous
-
Interspaced goblet cells
- Secrete gel forming mucins
- Contains:
- Blood vessels
- Lymphoid tissue
- Fibrous tissue
What value of intraoccular pressure would be indicative of raised intraoccular pressure and what are the potential consequences?
- Normal IOP = 16.5 mmHg
- Raised IOP e.g. in glaucoma results in compression of the collagen lattice
- At around 21 mmHg, the optic nerve head is compressed
- Results in conduction block and can cause permanent damage and blindness
What are the two main layers of the retina?
-
Inner sensory retina
- Layers of nerve cells that span from the deep pigmented epithelium to the vitreous humour anteriorly
-
Outer retinal epithelium
- Simple cuboidal epithelial cells with melanin granules
- Dark pigments
- prevent the reflection of light within the posterior chamber of the eye

Histology of the inner sensory retina
-
Deep (pigmented epithelium)
-
Layer of photoreceptor outer segments
- The outer segment of the photoreceptor contains the light sensitive elements
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Outer nuclear layer
- The outer nuclear layer contains the cell bodies of the photoreceptors
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Outer plexiform layer
- The outer plexiform layer contains the synaptic connections between the photoreceptors, bipolar cells and horizontal cells
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Inner nuclear layer
- The inner nuclear layer contains the cell bodies of bipolar cells, horizontal cells and amacrine cells
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Inner plexiform layer
- The inner plexiform layer contains the synaptic connections between the bipolar cells, ganglion cells and amacrine cells
-
Ganglion cell layer
- The ganglion cell layer contains the cell bodies of the ganglion cells
-
Layer of photoreceptor outer segments
- Superficial (vitreous humour)

- Describe the segments of photoreceptors
- Inner segment
- Mitochondria
- Golgi body
- RER & SER
- Outer segment
- Stacks of membranous discs with photo pigment

- Describe the rods and cones in terms of:
- Outer segment shape
- Termination shape
- What they synapse onto
- Their photo pigment
-
Rods
- Outer segment shape -cylindrical
- Termination structure - rod spherule
- Small knob
- Synapse onto - bipolar and horizontal cells
- Photo pigment - rhodopsin
- Night vision
- Low resolution
-
Cone
- Outer segment shape - conical
- Termination structure - cone pedicle
- Thicker
- Synapse onto - bipolar and horizontal cells
- Photo pigment - photopsin
- High resolution detail
- Discriminates primary colours

Outline the types of cones and their wavelengths
- S
- 445 nm
- Blue
- M
- 535 nm
- Green
- L
- 575 nm
- Red
What are the different types of retinal cells? What are their functions?
-
Muller glial cells
-
Present in all layers
- Nuclei in the inner nuclear layer
-
Cytoplasm spans the length of the lamina
- Cytoplasmic processes fill the gaps betwen other retinal cells
-
Regulate neuronal exictability
- Monitoring:
- Extracellular K+
- Uptake of neurotransmittter at synapses
- Monitoring:
-
Present in all layers
-
Horizontal cell
- Branch to the photoreceptors and bipolar cells in the outer plexiform layer
- Present in the outer edge of the inner nuclear layer
-
Bipolar cells
- Rod specific cells
-
Cone specific cells
- Cone bipolar cell have 2 subtypes
-
Midget
- Single cone photoreceptor to a single ganglion cell
-
Parasol
- Connect several cone photoreceptors to a single ganglion cell (convergence)
-
Midget
- Each subtype can have ON/OFF cells
- Cone bipolar cell have 2 subtypes
-
Ganglion cell
- 3 main types that feed into the lateral geniculate pathways:
- Midget = parvocellular
- Parasol = magnocellular
- Bistratified = koniocelular
- Each have ON/OFF that can be found in separate sublamina
- On = sublamina A of the inner plexus layer
- Off = sublamina B of the inner plexus layer
- 3 main types that feed into the lateral geniculate pathways:
- Outline the difference between midget cells and parasol cells in terms of:
- Soma size
- Dendritic field size
- Concentration
- Colour
- Summation
- Longetivity
- Projections
- Receptive field size
- Conduction velocity
- Pathway to the lateral geniculate nucleus

What is the fovea?
- Area of highest visual colour acuity and is at the centre of the gaze
- There is a 1:1 relationship between photoreceptors and ganglion cells
- Area containing the highest density of cone photoreceptors
- Present within the macula of the retina
- The other cell layers are pushed aside to reduce the blur from light scattering by other cells

What is the optic disc?
- Where axons of the ganglion cells converge and emerge from the back of the eye
- AKA blind spots
- No photoreceptors are present and is nasal to the fovea
- Light never falls on the blindspots of both eyes simultaneously

Describe the photoreceptor distirbution across the retina
-
Fovea
- Contains predominanty red/green cone (LMS)
- 575 nm = red
- 545 nm = green
- 445 nm = blue
- Few
- No rods present
- Contains predominanty red/green cone (LMS)
- Peripheral retina
- Some cones are present - but not in high densities like the fovea
- More rods in these areas

What is the role of pigmented eptihelium?
- Choroid = vascular layer between the retina and scelera
- Prevent reflection of light posteriorly
-
Transport nutrients
- from the choroidal blood vessels to the sensory retina layers
-
Removal of waste metabolic products
- from the sensory layer
-
Active phagocytosis and recycling
- of photoreceptor disks shed from cones and rods
-
Synthesis of basal lamina of Bruch’s membrane
- Bruch’s membrane = inner most layer of choroid layer that attach the pigmented retina
-
Formation of rhodopsin
- converting the bleached pigment into retinal and returning it to the rods via intersitial retinoid binding protein (IRBP)

What is retinal detachment?
- Separation of the fovea from the optic disc
- Caused by:
- Trauma
- Vascular disease
- Metabolic disorders
- Risk factors
- Myopia
- If detached for long enough, the sensory retina can become necrotic and this can lead to blindness
- Treatment
-
Retinal layers can be surgically reattached
- Cryotherapy
-
Retinal layers can be surgically reattached

Outline the equation for optical refractive power of the eye (P) and the contributions of different eye components
-
P = µ/f
-
µ = refractive index of media of the eye
- 1.33 (approximately that of water)
- f = focal length of the eye
- 0.022 m
- P = 60 dioptres
-
µ = refractive index of media of the eye
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Cornea
- 42 dioptres
- Non adjustable
- 42 dioptres
-
Lens
-
18 doptres
-
Adjustable - accommodation via ciliary muscles
- Contraction of annnular ciliary muscles which reduces tension in radial zonular fibres, allowing lens to relax to a more convex state
- Contract to thicken lens
-
Parasympathetic of M3 muscarinic receptors
- Gq
- Allows focus on close by objects
-
Adjustable - accommodation via ciliary muscles
-
18 doptres
- Air/cornea interface (42 dioptres) causes more refraction than lens/aqueous humour interface (18 dioptres)

Define 1 dioptre
The power of a lens to focus parallel light at a focal point 1 m away

How does the eye accommodate to near vision?
- Increase in power
- Ciliary muscles contract
- Pulling border of choroid towards lens
- Reduces tension in radial zonular fibres
- Suspensory ligaments relax
- Lens becomes thicker and rounder

How does the eye accommodate to distance vision?
- Decrease in power
- Ciliary muscles relax and border of choroid moves away from lens
- Suspensory ligaments pull against lens
- Lens become flatter, focusing on distant objects




































