DYANA T. WATANIA
Anatomi dan Fisiologi Mata
ORBIT
Pear shapedVolume: ± 30 ccHeight: ± 35 mmWidth: ± 45 mmDepth: ± 40 – 45 mmInfluenced by: race and sex
ORBIT
7 bones:1. Frontal2. Zygomatic3. Maxillary4. Ethmoidal5. Sphenoid6. Lacrimal7. 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 foramen2. Supraorbital foramen3. Anterior ethmoidal foramen4. Posterior ethmoidal foramen5. Zygomatic foramen
Duct: nasolacrimal ductCanal: infraorbital canal
ORBIT
Fissures: Superior:
Outside the annulus of Zinn1. Lacrimal N.2. Frontal N.3. Troclear N.4. Sup Ophthalmic vein
Inside the annulus of Zinn1. Sup and Inf div of Oculomotor N.2. Abducent N3. Nasocilliary branch4. 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. Medial Rectus2. Lateral Rectus3. Superior Rectus4. Inferior Rectus5. Superior Oblique6. Inferior Oblique7. Levator Palpebrae Superioris
EXTRA OCULAR MUSCLES
Fuction:1. Med Rectus: Adduction2. Lat Rectus: Abduction3. Sup Rectus:
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 ZinnSpiral 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 Whitnall’s ligament Muller’s 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 plexusesArterial:
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 apparatusGlands:
Main: lacrimal gland 8-12 major lacrimal ducts Orbital and Palpebral parts
Accessory: Krause Wolfring
Secretion: Basal Reflex
LACRIMAL SYSTEM
Excretory:PunctaAmpullaCanaliculiCommon canaliculusLacrimal sacLacrimal duct → inferior turbinateValves:
Rosenmuller Hasner
LACRIMAL SYSTEM
LACRIMAL SYSTEM
LACRIMAL SYSTEM
LACRIMAL SYSTEM
Inervation:Afferent: V-1Efferent: 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
2. Aqueous: lacrimal glands Intermediate layer
3. Oily layer: meibomian glands Reduces evaporation Stabilize
LACRIMAL SYSTEM
GLOBE
NOT a true sphereAP diameter: 23-25 mm3 compartments:
Anterior chamber Posterior chamber Vitreous cavity
GLOBE
CORNEA
5 layers:1. Epithelial2. Bowman’s layer3. Stromal layer4. Descemet’s membrane5. Endothelium
CORNEA
CORNEA
CORNEA
About 43 DThickness:
Central: 0.5 mm Peripheral: 0.7 mm
AsphericAverage diameter: 12 mmRadius: 7.4 -8.4 mmOptically clearAvascular
SCLERA
3 layers:1. Episclera2. Stroma3. 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
SCLERA
LIMBUS
important for 2 reasons: its relationship to the chamber angle its use as a surgical landmark
Structures:1. conjunctiva and limbal palisades2. Tenon's capsul3. Episclera4. corneoscleral stroma5. aqueous outflow apparatus
LIMBUS
surgical limbus : 2 equal zones: 1. an anterior bluish gray zone
overlying clear cornea and extending from Bowman's layer to Schwalbe‘s 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. Schwalbe's line2. Schlemm's canal and the trabecular meshwork3. scleral spur4. anterior border of the ciliary body (where its
longitudinal fibers insert into the scleral spur)5. iris
ANTERIOR CHAMBER
ANTERIOR CHAMBER
deeper in aphakia, pseudophakia, and myopiashallower in hyperopia
TRABECULAR MESHWORK
a circular spongework of connective tissue lined by trabeculocytes
Divided into 3 layers:1. uveal portion2. corneoscleral meshwork3. juxtacanalicular tissue, which is directly
adjacent to Schlemm's canal
TRABECULAR MESHWORK
TRABECULAR MESHWORK
UVEAL TRACT
Consists of:1. iris2. ciliary body (located in the anterior uvea)3. choroid (located in the posterior uvea)firmly attached to the sclera at only 3 sites:
1. the scleral spur2. the exit points of the vortex veins3. 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 plana2. Pars plicata Cilliary muscle:1. Longitudianal2. Radial3. Circular
UVEAL TRACT
UVEAL TRACT
Choroid: Posterior portion Perfusion: long and short posterior ciliary arteries 3 layers of vessels:1. Choriocapilaries - inner2. Small vessels - middle3. Large vessels – outer Drain: vortex vein
LENS
CapsuleEpitheliumFibresZonule 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 lamina2. rod and cone inner and outer segments3. external limiting membrane4. outer nuclear layer (nuclei of the
photoreceptors)5. outer plexiform layer
RETINA
6. inner nuclear layer7. inner plexiform layer8. ganglion cell layer9. 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 Mlgel-like structure99% waterConsists of:
fine collagen fibrils (chiefly type II) cells
VITREOUS
VITREOUS
TERIMA KASIH