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. Frontal
2. Zygomatic
3. Maxillary
4. Ethmoidal
5. Sphenoid
6. Lacrimal
7. 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. Medial Rectus
2. Lateral Rectus
3. Superior Rectus
4. Inferior Rectus
5. Superior Oblique
6. Inferior Oblique
7. Levator Palpebrae Superioris
 EXTRA OCULAR MUSCLES

Fuction:
1. Med Rectus: Adduction
2. Lat Rectus: Abduction
3. 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 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
 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 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
2. Aqueous:
 lacrimal glands
 Intermediate layer
3. Oily layer:
 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. Epithelial
2. Bowman’s layer
3. Stromal layer
4. Descemet’s membrane
5. 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:
1. 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
SCLERA
 LIMBUS

important for 2 reasons:

 its relationship to the chamber angle
 its use as a surgical landmark
Structures:
1. conjunctiva and limbal palisades
2. Tenon's capsul
3. Episclera
4. corneoscleral stroma
5. 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 line
2. Schlemm's canal and the trabecular meshwork
3. scleral spur
4. 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 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:
1. 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. the scleral spur
2. the exit points of the vortex veins
3. 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
TERIMA KASIH