The Visual System Flashcards
List the bones that contribute to the formation of the orbit
Roof: Frontal Bone and Lesser Wing of Sphenoid bones
Floor: Maxilla, Zygomatic and Palantine bones
Lateral Wall: Zygomatic and Greater Wing of Sphenoid bones
Medial Wall: Maxilla, Lacrimal, Ethmoid and Body of Sphenoid
What is the structure and function of the sclera of the eye?
The sclera is the opaque and highly fibrous collagen layer of the eye. It is also known as the white of the eye - forming 5/6th of the eyeball.
The sclera maintains the shape of the eye globe, providing resistance to both internal and external forces on the eye. It also provides attachments for extraocular muscles.
Why is the sclera opaque?
The sclera is opaque as a result of the random and variable organisation of collagen fibres in the sclera.
The level of opacity varies with:
- Composition of the stroma
- Hydration
- Size and distribution of the collagen
Why is the cornea transparent?
The cornea is transparent as a result of the structure and organisation of the collagen fibrils that compose it.
Collagen fibrils of uniform diameter are evenly spaced in parallel running bundles (lamellae).
The 200-300 lamelle layered within the stroma lie at angles to each other (but remember that all fibrils within a single lamellae are parallel)
What is the structure and function of the cornea?
The cornea represents the anterior 1/6th of the eye and is the principle refracting component of the eye.
To optimise the refraction of light, the cornea is avascular and transparent.
How many layers of tissue comprise the cornea?
The five layers, from superficial to deep, are:
- Epithelium
- Bowman’s Membrane
- Stroma
- Descemet’s Membrane
- Endothelium
Note:
- The epithelium connects the tear film to the outside world
- The endothelium controls water balance of the eye. Deficiencies result in severe pathology and these endothelial cells are incapable of regeneration.
What is the anterior chamber angle?
The anterior chamber angle represents the junction between the iris and cornea
The chamber here is the site at which aqueous humour is drained from the eye.
The key structures of the **anterior chamber angle **include the cornea, trabecular meshwork, canal of Schlemm and ciliary body.
What are the three layers of the eye?
Outer layer:
- Sclera + Cornea
- Function: Strength
Middle Layer: Uvea
- Ciliary Bodies + blood vessels
Inner Layer: Retina
- Neural cells and receptors of vision
What is a ciliary body?
Ciliary bodies are circumferential tissues composed of ciliary muscle and ciliary processes (or ciliary epithelium) within the uvea layer of the eye.
Ciliary bodies, functionally:
- Form the aqueous humour
- Tether the lens (via ciliary processes)
- Accomadation (contraction altering the convexity of the lens)
What is the importance of aqueous humour?
Aqueous humour is a transparent, gelatinous fluid similar to plasma, but containing low protein concentrations. It is produced by the ciliary epithelium.
It is important for:
- Maintaining the health of the lens and cornea
- Creating intraocular pressure
It flows through the narrow cleft between the front of the lens and the back of the iris, to escape through the pupil into the anterior chamber. From here, it drains out of the eye via the trabecular meshwork of the anterior chamber angle to the venous system.
What is involved in accomodation of the eye?
Accomodation is the process by which the eye changes optical power in order to maintain a clear image or focus on an object as its distance varies.
The mechanism by which this occurs involves ciliary muscles contracting and altering the shape of the lens via zonules (ligaments connecting the lens to ciliary muscle)
What is ciliary muscle and what is important for?
Ciliary muscle is a ring of striated smooth muscle that acts a sphincter muscle around the iris in the uvea layer of the eye.
It is contained within ciliary bodies
It is innervated by the parasympathetic nervous system (involuntary muscle)
In accomodation, are the ciliary muscles contracted or relaxed for long vision? What about short vision?
For long sightedness, the ciliary muscle sphincter is relaxed - increasing tension in the zonules. This causes the lens to stretch and become thin.
For short sightedness, the cilirary muscle sphincter is contracted - removing tension in the zonules. This causes the lens to thicken.
What is presbyopia?
Presbyopia refers to the normal loss of accomodation with age.
It results from reductions in the flexibility of the lens capsule and zonules.
Treatment involves the wearing of ‘plus’ lenses - ‘reading glasses’ etc.
What is the iris? What is it’s role?
The iris is a thin, circular structure of the eye, responsible for controlling the diameter of the pupil - thus the amount of light reaching the retina.
It is made up of two muscles:
- Sphincter pupillae: constricts pupil & innervated by parasympathetic NS.
- Dilator pupillae: dilates pupil & innervated by sympathetic NS
What is the choroid?
Where is the choroid?
What is its primary role?
Choroid is a term incompassing three layers of blood vessels that sit immediately below the retina
The most important blood vessel layer is the **choriocapillaris **which is directly below the retina.
These blood vessels are important in supplying nutrients to the retina - particularly the neurons of the outer retina where alternative supplies are not present.
What is special about the fovea?
The fovea is a specialised area of the eye for high visual acuity.
Particularly, it is:
- Avascular (recieves nutrients from choroid)
- High density of cone cells
- No rod cells
- Reduced number of neuron layers preceding it.
How is the optic nerve region of the eye specialised for it’s function?
Involve the relevance of the lamina cribosa
The optic nerve is formed by axons of ganglion cells as they exit the retina to transmit visual information to higher cortical areas.
The lamina cribosa is the structure at which the ganglion cell axons form the optic nerve and exit the eye. It is a band of dense connective tissue arranged in a sieve pattern. It occupies a region in the eye where there is a deficiency in the continuency of the retina.
From what vessels of the head and neck is the blood supply to the eye derived from?
Internal carotid artery - > Opthalamic artery.
The opthalamic artery gives rise to the central retinal artery; as well as long posterior ciliary arteries, short posterior ciliary arteries and anterior ciliary arteries.
Which arteries provide arterial supply to the retina?
The central retinal artery supplies the inner retina - it transmits in the optic nerve through the lamina cribosa to be on the internal surface of the retina.
The posterior ciliary arteries supply the outer retina (including the photoreceptors). Long PCA’s supplies can extend around the choroid and supply the peripheral retina, while short PCA’s supply the central retina.
Anterior ciliary arteries do not supply the retina - it supplies the anterior structures of the eye and extraocular muscles.
List the important structures of the eyelid
- Skin
- Glands
- Eyelashes
- Conjuctivae
- Muscles
- Orbicularis oculi
- Levator palpebrae superiosis
- Lacrimal Apparatus
- Lacrimal gland and ducts
- Nasolacrimal sac and duct
What are the two muscles of the eyelid?
How are these two muscles controlled and what innervations are responsible for this?
**Levator palpebrae superiosis **elevates the upper lid. It is innervated by CN III. Anatomically, it is rectangular shaped muscle on the upper eyelid.
**Obicularis Oculi **depressed the upper lid. It is innervated by CN VII. Anatomically, it is a spherical muscle surrounding the orbit of the eye.
Both are straited muscles
These muscles never work simultaneously. One is always relaxed while the other is contracting.
What is the macula of the eye?
The macula is an oval-shaped, pigmented yellow spot near the centre of the retina.
In the centre of the macula lies the fovea
What is visual acuity?
What is the test and formula utilised to determine an individual’s visual acuity?
Visual acuity refers to the ability to resolve fine detail.
Testing is conducted by the recognition of letters on a Snellen or LogMAR chart.
VA= D’ (test distance) / D (where each letter subtends the 5 min arc)
What is the normal visual acuity of a person?
When is somebody legally blind?
Put these two visual acuities in perspective by comparing their ability to see an object.
6/6 is the normal visual acuity
A person is legally blind at a visual acuity of 6/60
This implies that a normal person can see an object from 60m away; whereas a legally blind person could only see it from 6m away.
What optical factors affect visual acuity?
Visual acuity is affected by the following optical factors:
- Pupil size
-
Clarity of optical media
- Cataracts, corneal opacities, scarring etc.
-
Refractive errors
- Myopia (eye too long or short)
- Presbyopia
- Hypermetropia
- Astigmatism
Compare the best visual acuities capable during the day and night; and what areas of the retina are responsible for such acuity?
At phototopic light levels (day), the best VA= 6/6.
This is achieved via the fovea which is specialised for high resolution acuity. It has a dense population of cones and low density of neural transduction cells. There is demonstratable VA loss 5 degrees from the fovea.
At scotopic light levels (night), the best VA= 6/60.
This is achieved via rod densities located 5-15 degrees off centre (thus, better night vision is obtained by looking off centre of the visual fields).