Vision Flashcards
Conjunctiva
mucosal epithelium that forms a sac when eyes are shut
covers sclera
secretes mucous
lubricates surface
Disorders of the conjunctiva
conjunctivitis
pinguecula
conjunctivitis
disorder of conjunctiva
dry eye
allergies
viral and bacterial infections
Pinguecula
disorder of conjunctiva
degeneration of conjunctiva
Cornea
transparent part of the eye
powerful refractive component 2/3 eye power
Five layers
flattens in periphery to improve imager and reduce aberrations
flattest at horizontal meridian
Layers of the cornea
five: epidermis - healing stroma - collagen, transparency endothelium - maintain transparency bowman's - collagen Descemet's - basement membrane
Disorder of cornea
Keratitis
Keratitis
inflamed cornea
Sclera
white part of eye blue in young - collagen disease yellow in elderly - jaundice / lipid deposits protects and supports eyeball three layers
layers of the sclera
three:
episclera - blood vessels
stroma - irregular collagen fibres (opaque)
lamina fusca - thin pigmented connective tissue
disorders of the sclera
episcleritis
scleritis
Episcleritis
harmless form of red eye
scleritis
painful red eye which can damage sight
limbus
transition zone between cornea and sclera
aqueous humour drainage via the trabecular meshworks
Aqueous humor
transparent blood like fluid
feeds cornea and crystalline lens
secreted by ciliary processes
disorders of the limbus
glaucoma
glaucoma
blockage of the trabecular meshworks
exaggerated cupping
tonometry
measures IOP
keratometry
measure curvature of cornea
iris
vascular layer of the eye
coloured (melanin)
forms pupil which controls light entering eye
sphincter pupillae
constricts pupil
miosis
dilator pupillae
dilates pupil
mydriasis
disorders of the iris
iritis
occurs with anterior uveitis
iritis
very serious red eye
uveal tract
iris
ciliary body
choroid
retina
macula
fovea
optic disc
ciliary body
ring of tissue
vascular layer
ciliary muscle and process
ciliary muscle
focus eye (accomodation) via attachments to lens
ciliary process
secrete aqueous humour
disorders of the ciliary body
anterior uveitis
anterior uveitis
red eye
anti-glaucoma drugs
reduce aqueous humour production
choroid
posterior vascular layer
three layers:
bruch’s membrane - passes material to and from retina
vascular layer - nourish retina / blood supply
suprachoroid - melanin / absorbs stray light
disorders of the choroid
choroiditis (with posterior uveitis)
macular degeneration
choroiditis
with posterior uveitis
inflammation of choroid
threat to sight
macular degeneration
caused by dysfunction of bruch’s membrane
retina
inner neural layer
layer include:
retinal pigement epithelium - nourish photo receptors
photo receptors - rods in periphery, cones in fovea, bipolar and ganglion integrate and process photo receptor signals
cones
in fovea
object identification
high resolution
colour vision
rods
in periphery
object detection
high sensitivity
contrast, brightness, motion
disorders of the retina
retinal detachment
diabetic retinopathy
hypertensive retinopathy
macular degeneration
crystalline lens
refractive component - variable - 1/3 eye power
flatter in periphery
grows through life
made up of:
lens capsule - changes shape / accommodation
cortex - youngest lens fibres
nucleus - oldest fibres
what maintains the transparency of the crystalline lens
crystallins
regular arrangement on lens fibres
lack of organelles
antioxidants
disorders of the crystalline lens
cataract
presbyopia
cataract
transparency mechanism failure
presbyopia
lens can no longer accommodate
optic nerve head
ganglion nerve fibres take signals to brain
cupped
arteries
enter eye
veins
leave eye
blind spot
absent photo receptors
disorders of the optic nerve head
glaucoma
brain disease
pallor / swelling of optic nerve
vitreous body
transparent gel
mechanically supports lens and retina
refractive component
disorders of the vitreous body
vitreous syneresis
posterior vitreous detachment
vitreous syneresis
vitreous breakdown with age (floaters)
posterior vitreous detachment
vitreous detaches at the retina
large floaters and light flashes
Aqueous humour production
in ciliary processes
1. blood plasma leaks into stroma
2. ciliary body epithelium absorbs plasma and generates bicarbonate ions using carbonic anhydrase
3. Na/K+ pump moves Na+ out
4. bicarbonate ions drawn out by Na+
5. plasma drawn out by bicarbonate ions
REGULATED BY: sympathetic nervous system action on adenylate cyclase
IOP
10-21 mmHg
higher on a morning
3-6 mmHg variation is normal
Aqueous humour drainage
trabecular overflow 80-90% meshworks
uvescleral outflow 10-15% via ciliary body surface into choroid veins
iris route - small % via iris surface
lacrimal glands
orbital
paleprabral
tear production
Tear drainage
orbicularis oculi puncta lacrimal sac lacrimal caniculi nasolacrimal duct
orbicularis oculi
tear pump
Tear layers
- outer lipid layer - delays evaporation and lubricates
- middle aqueous layer - provides o2, defends surface
- inner mucin layer - lubricates
types of tear flow
sympathetic = blood vessels supplying glands parasympathetic = myoepithelial cells
normal = sympathetic, light and pollution emotional = parasympathetic, emotional state via emotion centres reflex = parasympathetic, irritation of cornea crocodile = parasympathetic, faulty connection to lacrimal and not salivary gland
orbit bones
- frontal
- zygomatic
- maxillary
- sphenoid
- ethmoid
- palatine
- lacrimal
canals
optic
superior orbital fissure
inferior orbital fissure
sinuses
frontal
sphenoid
ethmoid air cells
maxillary
Extra ocular muscles
4 recti: superior medial lateral inferior
2 obliques:
superior
inferior
1 muscle to raise eyelid:
levator palebra superioris
meibomian gland
secretes tears to prevent dry eyes
tarsal muscles
opens eye wide with fear
strabismus
squint
amblyopia
lazy eye
disorders of eye muscles
strabismus
amblyopia
disorders of the eyelids
blepharitis
chalazion
ectropion
blepharitis
dandruff
chalazion
lump caused by infected lash or gland
ectropion
eyelid turned inside out
simplified visual pathway
- retina
- optic nerve
- optic chiasm
- optic tract
- lateral geniculate nucleus
- optic radiation
- visual cortex - V1
afferent light reflexes
light ganglion cells in retina chiasm both optic tract leave before LGN synapse at pretectal nuclei in superior colliculus both sides
efferent light reflexes
pretectal nuclei internunclial nerve both accessory oculomotor nerve nuclei parasympathetic axons sphincter pupillae
afferent - near synkinesis
looking from distance to near accomodation convergence miosis ganglion cells to V1
efferent - near synkinesis
V1 to frontal eye fields:
1. main ocular nucleus - recti muscles = convergence
OR
2. accessory oculomotor nerves - parasympathetic nerve fibres - ciliary muscle (accommodation) / sphincter pupillae (miosis)
arousal / fear dilation
sympathetic nerve fibres
superior cervical ganglion
internal carotid artery
dilator pupillae (mydriasis)
V1 damage
homonymous central hemianopia (macular fibres)
macular sparing homonymous central hemianopia (peripheral retina fibres)
V2 damage
alexia - cant read
agnosia - cant recognise objects
agraphia - cant write
visual hallucinations
bipolar cells
transmit info from photoreceptors to ganglion
retinal ganglion
transmit info retina to brain
horizontal cells
synapse with photo receptors and alter output
amacrine cells
synapse with bipolar cells and alter output
müller cells
support retinal neurons
red cones
long wavelength
green cones
medium wavelength
blue cones
short wavelength
Accomodation
- ciliary muscle contract
- tension released on lens attachments
- lens surface steepens
- lens power is raised
emmetropia
normal vision
myopia
short sighted
eye too long or cornea too powerful
focus before retina
corrected with minus lens
hyperopia
long sighted
eye too short or cornea too weak
focus after retina
correct with plus spheres
astigmatism
rugby ball shaped eye
poor near and distance vision
two focal points before and after retina
corrected with cylinders
presbyopia
old eye reduced ability to accomodate poor near vision can reduce distance vision corrected with near addition plus lens
trichromacy
dichromacy
monochromacy
normal colour vision
2/3 cones
no cones or 1 cone
prot
- anomaly
- anopia
red
- cones
- no cones
deuter
- anomaly
- anopia
green
- cones
- no cones
trit
- anomaly
- anopia
blue
- cones
- no cones
Cataract
leading cause of blindness
clouded lens ageing
congenital or injury causes
metabolic, molecular, structural, optical
Galucoma
optic nerve damage
primary open angle - white and black populations
primary angle closure - asian populations
genetic element
disc cupping large cup to disc ratio
increased IOP
Macular degeneration
leading cause of blindness in high income countries
Risks: over 50, smoking, genetic, BP, cholesterol, fat, BMI
dry form - most common no treatment
wet form - treated with injection - abnormal vessels
Caused by dysfunction of Bruch’s membrane
diabetic retinopathy
75% of diabetics
early = non-proliferative
proliferative = neovascularisation