Anatomy of Eyeball

- lies in the Bony Orbit which

contains and protects
- the eyeballs and their
- muscles
- nerves
- Vessels
- most of lacrimal
apparatus
- lined with periosteum which
form fascial sheath of
the eyeball
(Tenon’s capsule). 1
 Fascial sheath of eyeball
Tenon’s capsule
thin, cup-like sheath surrounds the eyeball except the
cornea part
It separates eyeball from fat and other contents in the
orbit.
perforated posteriorly by ciliary nerves & vessels and fuses
with dural sheath of the optic nerve.

2
The eyeball is
about 2.5 cm long.
surrounded by peri-orbital fat

It has 3 concentric coats

External or Fibrous coat

Middle or Vascular coat

Internal or Retinal coat

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1. The External or fibrous coat consist of :
- cornea - transparent anterior 1/6

- sclera - white, opaque posterior 5/6

The inner surface of eyelids & front of eyeball is covered
by a thin mucous membrane is conjunctiva, which
is transparent over eyeball so the sclera is visible.
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 2. Middle or Vascular coat - uvea),
(1) choroid – is heavily pigmented layer
(2) ciliary body surrounds the lens and
Ciliary process – folds on internal surface of ciliary body; secrete
aqueous humour of anterior and posterior chambers
(3) Iris –circular pigmented structure
controls the aperture of the pupil
contain Sphincter pupillae and Dilator pupillae
choroid

Iris

lens

ciliary body
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 3. Internal or Retinal coat
• It is composed of 2 layers:
(1) Outer pigment layer - thin and delicate membrane
(2) Inner neural layer – photo-receptors & neurones

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 Macula lutea
-Oval, yellowish area
-at the centre of posterior part of retina
- most distinct vision
- central depression (fovea centralis) composed
entirely of cones.

Retina by
ophthalmoscopy

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 Optic disc
-3 mm medial to macula, where optic nerve
leaves the retina.
- blind spot
no rods and cones and is insensitive to light
- pierced by central retinal artery
( anatomical end artery)
Optic disc

Macula
lutea Retina by
ophthalmoscopy 8
9
Refractive media of eye -
Light waves pass through

1. Cornea,
2.Aqueous humour,
3. Lens,
4. Vistrous humour
1. Cornea
– transparent, avascular
sensitive to touch,no lymphatic
drainage,is nourished by
diffusion fr. aqueous humor &
capillaries at its edge
- it bends the light to the
greatest degree of
refraction - most  powerful  
focusing  structure  of  the  eye 10
2. Aqueous humor in AC & PC
- is clear watery solution produced by the ciliary
processes of the ciliary body in the PC
- provides nutrients to cornea and lens.
- circulate through the pupil into the AC, it
drains through at trabecular meshwork at the
iridocorneal angle into scleral venous sinus
- removed by the limbal plexus
Anterior chamber of the eye - space between the
cornea anteriorly & the iris/pupil posteriorly
Posterior chamber of the eye - space b/t iris/pupil
anteriorly & lens and ciliary body post eriorly
Int ra-ocular
pressure (IOP) is a
balance between
production & out
flow of aqueous
humor. 11
Production and removal of aqueous humor

Epithelial cells covering the ciliary

body secrete the aqueous into the
posterior chamber (1), from which it
flows past the lens and through the
pupil into the anterior chamber of
that cavity (2). The fluid then drains
into the iridocorneal angle and is
removed at the scleral venous sinus
(3), which is continuous with veins in
the sclera.

Aqueous humor maintain an optimal

microenvironment within the anterior
cavity of the eye.

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3. Lens
- posterior to the iris & anterior to
the vitreous humor
– transparent biconvex structure
enclosed in a lens capsule
anchored by zonular fibers -
suspensory ligament to the
encircling ciliary processes.
- Ciliary muscle in ciliary body
change the shape of lens.
(Accommodation Reflex)

4. Vitreous humor/chamber – is a
watery fluid enclosed in
meshes of gelly like vitreous
body, a transp arent jelly-
like substance in posterior
four fifths of eyeball
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4. Vitreous humor/chamber/ Vitreous Body
– is a watery fluid enclosed in meshes of gelly like vitreous
body, a transparent jelly-like substance in posterior
four fifths of eyeball

- fills the eyeball behind the lens and is a transparent gel.

- hyaloid canal runs through
from the optic disc
- contribute slightly to the
magnifying power of the eye
-supports the the lens
- Assists in holding the neural Vitreous humor

part of retina against pigment

part of the retina.
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15
 Optic disc
blind spot

Lens
Anterior chamber
Aqueous humor
Macula lutea
fovea centralis.

Vitreous humor
Retinal coat
pigment layer
Inner neural layer Posterior chamber
Aqueous humor

Refractive Media of light 16

 Fibrous coat
Sclera
cornea

Lens
Anterior chamber
Aqueous humor

•Vascular coat
Vitreous humor •iris
Retinal coat •ciliary body
pigment layer •choroid ,
Inner neural layer

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Acessory Structures of the eye

Eyebrow - help to shade and protect eyes

Eyelids - --

Conjunctiva is lined by mucosa & lubricate

the eyelids and covers

Lacrimal apparatus consists of the lacrimal

gland , lacrimal canaliculi, lacrimal sac
and nasolacrimal duct
- moistens and lubricates the surface of
the eye and eyelids
-Tears contain an enzyme- lysozyme,

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Tears drain from the eye
through lacrimal puncta of
the lacrimal canaliculi,
located at medial angle

Upper & lower canaliculi

join to form the common
canaliculus that opens
into the lacrimal sac

The sac is continuous

with the nasolacrimal
duct that opens into the
nasal cavity.
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20
 Applied Anatomy

1. Fracture of orbit or ‘blowout’ fracture

• fracture in thin medial and inferior wall involve with ethmoid,
sphenoide and maxillary sinus.
• orbital fracture often result in intraorbital bleeding, which exerts
pressure on the eye ball, causing exophthalmos.
• Any trauma to eye may affect adjacent structures.
• Bleeding into the maxillary sinus and Displacement of maxillary
teeth
• Fracture of nasal bone result in haemorrhage, air way
obstruction and infection which can spread to cavernous sinus
through Oph. vein. 21
Periorbital Ecchymosis - Blows to periorbital region - - can
cause swelling and haemorrhage into eye lid and
extravasation of blood into periorbital skin
(Ecchymosis), common in boxers and basket ball
players.
Orbital tumor
• Malignant tumor in sphenoidal and posterior
ethmoidal sinus may erode thin bony wall and
compress optic nerve and contents
• Tumor in orbit produce exophthalmoses.
• Spread from tumor in middle cranial fossa – through
superior orbital fissure, tumor in temperoral and
infratemporal fossa through inferior orbital fissure
• Approach for operation of eye ball through lateral
side because 2.5cm of eyeball is exposed on lateral
side. 22
Ophthalmoscope = fundoscope
View the fundus of eyeball
Optic disc - pale,oval disc on the medial side of fundus
- optic nerve enters the eyeball; contains nerve fibers, no
photoreceptors, in sensitive to light.
- retinal arteries and veins rediate from its center-pulsation
Blind sport or macula lutea or yellow area – lies lateral to optic
disc, is a special photo receptor cones, and is specialized for
acuity of vision. The center is fovea centralis – the areas of
most acute vision.
macula lutea Optic disc

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 Papilledema – edema of the
retina, swelling of optic disc
resulting from increased
intracranial pressure and
increased CSF pressure in
the extension of the
subarachnoid space around
the optic nerve.

Funduscopic findings of papilledema

- engorged and tortuous retinal veins,
- hyperemic and swollen optic disk, - by disk elevation
- retinal hemorrhages around the disk.
- loss of the optic cup,
- obscuration of the fine vessels on the optic nerve surface
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Retina Detachment
The pigment cell layer of retina develops from the outer layer of
optic cup and the neural photoreceptor layer develops from the inner
layer of cup, are not firmly joined to one another
Retina detachment between these two layer.
Complained of fleshes of light going on and off.

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Applied anatomy
Glaucoma – drainage of the
aqueous decrease –
increased pressure in AC
& PC of eye
Blockage of central retina
artery - blindness
Inflammation of the palpebral
glands - style
(hordeolum) painful, red,
suppurative swelling on
eye lids.
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Applied anatomy
Inflammation of the palpebral glands - stye (hordeolum)
painful, red, suppurative swelling on eye lids.
Tarsal chalazian – inflammation of the tarsal gland due to
obstruction
Hyperemia of conjunctiva – bloodshot eyes is caused by
local irritation from dust, smoke, etc.
Conjuctivitis – pink eye – contagious infection of eye
Subconjuntiva haemorrhage – bright or dark red patches
deep to and in the bulbar conjunctiva

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Presbyopia
Lenses become harder & more flattened in old age,
it reduce the focusing power of the lenses.
Cataracts
Loss of transparency (cloudiness ) of the lens
Intra-ocular lens implant
Extracapsular cataract extraction
Intracapsular lens extraction

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Hemorrhage into Anterior Chamber - (hyphema)
-d/t blunt trauma to the eyeball
-anterior chamber is tinged red

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Coloboma of Iris
Absence of a section of iris in
which the choroid (retinal) fissure
fails to close properly, from penet
rating or non-penetrating injuri es
to the eyeball , or a surgical i ri
dectom y.

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Corneal abrasion and laceration
Caused by dirt or sand or by sharp objectives to cornea.
Corneal ulcers and Transplants
Scarred or opaque cornea
Hyphemia
Haemorrhage into the anterior chamber

Pupillary Light Reflex

- rapid constriction of pupil in response to light .
- involving CN II (afferent) & CN III (efferent limb),
Uveitis
- inflammation of the vascular layer of eyeball (uvea),

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Extrinsic muscles of the eyeball consist of :-
1. Levator palpebrae superioris

2. The rectus muscles

- Superior rectus
- Inferior rectus
- Lateral rectus
- Medial rectus

3. The Oblique muscles

- Superior oblique
- Inferior oblique

N/S – LR6 , SO4 , the Rest 6

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1. Levator palpebrae superioris muscle
Origin - Roof of orbit, anterior to optic canal
Insertion
• It fans out into a wide aponeurosis and inserts into
skin of upper eyelid.
• Inferior part of aponeurosis contains smooth muscle
which is inserted into tarsal plate. Levator
Action – Palpebrae
superioris
Elevation of upper eyelid.
Eyelid
• Nerve Supply
• Superior fibres by 3rd CN
• Smooth muscle fibres by sympathetic fibers
Injury to 3rd CN
Tarsal
Paralysis of this muscle causes plate
drooping of eyelid or Ptosis. Ptosis may also
be due to Horner’s syndrome (stellate
ganglion) 33
2. Origin of the Rectus muscles
These 4 rectus muscles arise from
common tendinous ring or tendon which surrounds
optic canal and bridges the superior orbital
fissure.
Common tendinous
ring

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 Insertion
Each muscle runs anteriorly in the
position implied by its name, pierces fascial
sheath of the eyeball and inserted into sclera
about 6 mm behind sclero-corneal junction,
( that is, in front the coronal equator line of the
eyeball)

MR

LR 35
 levator  palpebrae  superioris

superior  rectus
superior  oblique
(trochlea)

medial  rectus lateral  rectus

(abducent)

inferior  rectus

inferior  oblique

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37
 3. Oblique Muscles
A. Superior Oblique Muscle
Origin- From body of sphenoid bone, supero-medial
to common tendinous ring.
Insertion -It passes anteriorly and ends in a rounded
tendon which loops around trochlear at upper
medial angle of orbit.
- The tendon turns postero-laterally and inserted into
the sclera behind the coronal equator at the
supero-lateral part of eyeball
B. Inferior Oblique
Origin -from maxilla in floor of orbit near the antero
medial angle
Insertion -It passes postero-laterally and inserts into
the sclera of infero-lateral part of eyeball
behind the coronal equator line. 38
39
 Eyeball muscles never act alone.
They work in unison. Any particular movement
is acted by 2 muscles working in unison.
Thereby each eyeball muscle has 3
types of movements. They move on the
following axes:
1. Horizontal axis - elevation & depression
(SR,IO) (IR, ,SO)
2. Vertical axis – adduction & abduction
(MR,SR,IR) (LR, SO,IO)
3. Antero-posterior axis
Intorsion (medial rotation)(SR,SO)
Extorsion (lateral rotation)(IR,IO).
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SR
IO
-E,AD,MR
-E,AB,LR

IR SO
-D,AD,LR -D,AB,MR

MR LR
-ADD -ABD

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42
Nerve Supply of Muscles

• LR 6 SO 4 &
remainder 3

lateral rectus -
-abducent nerve
superior oblique -
-trochlear nerve.
rest of the eyeball
muscles
- oculomotor nerve.

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Orbital Vessels Arteries (br.of ICA)
1.Ophthalmic artery
a.Central A.of Retina
b.Ciliary arteries
c.Lacrimal artery
d.Muscular brs.
e.Other brs.

Ophthalmic artery
44
 Veins

1. Superior ophthalmic vein

• Anastomoses with facial vein at medial angle of eye
• This is important because infection from face can
reach the carvenous sinus by this route.
2. Inferior
ophthalmic vein
- Connects with
pterygoid plexus
, ends into
cavernous sinus.
3. Central vein of
retina
- Usually enters
cavernous sinus 45
46
 Nerve Supply
1. Optic nerve- 2nd CN of sight

2. 3rd,4th and 6th CN- motor nerves of eye

to extrinsic muscles

3. Ophthalmic division ( V1) of 5th CN-

general sensory nerves of eye

4. Parasympathetic supply to intrinsic

muscles – for accomodation & light reflex

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APPLIED ANATOMY
1. Lesion of the 6th CN
– paralysis of lateral
rectus à results in medial
squint & diplopia.
2. Lesion of the 4th CN
– paralysis of superior
oblique à results in
diplopia; eye cannot look
downwards beyond the
nose; patient has
difficulty in walking down-
stairs.
3. Lesion of the 3rd CN
– paralysis of SR, IR, MR
& IO à results in ptosis,
lateral squint & diplopia.
_ Pupil on the affected is
dilated with loss of
accommodation reflex & 48
light reflex.