The anterior chamber angle contains structures important for draining fluid from the eye. The angle is bound anteriorly by the cornea and posteriorly by the iris. Within the angle is the trabecular meshwork which drains fluid into Schlemm's canal and collector channels that lead to episcleral and conjunctival veins. The scleral spur attaches the trabecular meshwork preventing collapse of structures during contractions. Gonioscopy allows examination of the anterior chamber angle to assess conditions like glaucoma.

1. ANGLE
OF
ANTERIOR CHAMBER

2. ANTERIOR CHAMBER
BOUNDARY:
ANTERIORLY----POSTERIOR
SURFACE OF CORNEA
POSTERIORLY----IRIS
DIAPHRAGM AND THE PUPIL.

5. STRUCTURES IN THE ANTERIOR CHAMBER

6. DEVELOPMENT
• By 7th week---mesenchymal cells
develop trabecular meshwork.
• Iris-----from advancing bilayered
optic cup.
• At 15th week---Corneal
endothelium meets derivative of
iris to demarcate the angle.
• Angle deepening continues even
after birth.

7. SCHWALBE'S LINE
A fine scalloped anterior border which
represents termination of descemet's
membrane.
• Contains circularly arranged collagen fibers
intermixed with elastic tissue.
• Seen as glistening white line in gonioscopy.

8. • Schwalbe's line marks transition from -------
• ★Trabecular to corneal endothelium.
• ★Termination of descemet's membrane.
• ★Insertion of trabecular meshwork into corneal
stroma.

9. TRABECULAR MESHWORK
• A spongework or sieve like
structure made up of connective
tissue lined by trabeculocytes,
which have contractile &
phagocytic properties.
• Approximately 750 um in width
which covers the internal aspect of
schlemm's canal.
•
• Its main function is in drainage of
aquous humour.

12. 1.Uveal Meshwork

13. .THE TRABECULAR BANDS RUN MOSTLY IN RADIAL
FASHION WHICH INTERLACE & TAPER ANTERIORLY.
.TRABECULAR APERTURES SIZE IS 25-75 UM.
.THE TRABECULOCYTES USUALLY CONTAIN PIGMENT
GRANULES.

14. 2. The Corneoscleral Meshwork
.Consists of a series of thin,flat, perforated connective
tissue sheets arranged in a laminar pattern in the mid
portion.
.The central core consists of collagenous & elastic fibers.

15. • Each trabecular beam is covered by a monolayer of
trabecular endothelial cells, supported by basement
membrane.
• The pore size is smaller than the uveal meshwork (5-
50 um).

16. 3. JUXTACANALICULAR MESHWORK
• Also known as cribriform meshwork.
• The outermost part of TM.
• Lies adjacent to the inner wall of schlemm's canal.
• Less cellular than its trabecular counterpart &
shows a compact arrangement of fibrocytic cells.

18. SCHLEMM'S CANAL
• A narrow circular tube, some 36 mm in circumference in
the outer portion of internal scleral sulcus.
• Lined by a single layer of spindle shaped endothelial cells,
oriented parallel to its circumference.
• Conducts aquous humour flow from the trabecular region
to the episcleral venous network via the collector channels.

19. CONTINUED....
• Schlemm's canal has two
walls---
• Inner wall &
• Outer wall.

20. INNER WALL OF SCHLEMM'S CANAL
• Endothelial lining of canal consists of a complete
monolayer of flat endothelial cells that don’t rest
on a complete basement membrane.
• Lateral wall is joined by tight junctions.

21. • The most prominent features of the inner
wall of schlemm's canal are the giant
vacuoles.
• These are invaginations which are
generally globular in profile on
meridional sections.

22. • The endothelial lining is single layered with
a well developed basement membrane.
•
• These cells are longer, flatter,& smoother in
outline.
Outer wall of schlemm's canal

23. • Endothelial cells are joined by zonulae
occludentes.
• Rest on a basal lamina which is thicker &
more continuous than that on trabecular side.

24. COLLECTOR CHANNELS
• Schlemm's canal is connected to episcleral &
conjunctival veins by a complex system of
intrascleral channels.
• They arise at irregular intervals from the outer wall
of schlemm's canal.

25. • They are 25-35 in num & drain into 3
interconnecting venous plexus-----deep, mid
scleral & episcleral venous plexus.
• There are no valves present in these system.

26. EPISCLERAL & CONJUNCTIVAL VEINS
• Most aqueous vessel are directed posteriorly with
most of these drains into episcleral veins.
• A few crosses the subconjunctival tissue & drain
into conjunctival veins

27. • The Episcleral vein
• ⬇️
• Anterior cilliary & superior ophthalmic
vein
• ⬇️
• Cavernous sinus.

28. • Conjunctival vein
• ⬇️
• Palpebral & angular
vein
• ⬇️
• Superior ophthalmic
vein

29. SCLERAL SPUR
• wedge shaped circular ridge.
• Pale,translucent narrow strip of scleral tissue.
• Composed of circularly arranged collagen & elastic
fibers.

30. • Attachment
• Anteriorly : trabecular meshwork.
• Posteriorly : Sclera & anterior tendons of
longitudinal cilliary muscle.

31. • Contraction of longitudinal cilliary muscle
opens up trabecular spaces.
• Scleral spur prevents cilliary muscle from
causing schlemm's canal to collapse.

32. CILLIARY BAND
• Marks the posterior most part of angle as a dark
cilliary band
• Represents the anetrior face of cilliary body
including the insertion of cilliary muscle into the
scleral spur.
• Wide in myopes.
• Narrow in hypermetropes.

34. INNERVATION
• supraciliary nerve plexus & the cilliary plexus in
the region of the scleral spur.
• Both myelinated & non myelinated nerve fibers
have been demostrated here.
• Myelinated nerve fibers are most commonly found
towards the posterior attachment of trabecular
sheet.

35. DIAGNOSTIC MODALITIES
• Van harick test: comparing the depth of
peripheral anterior chamber to the thickness
of cornea using a narrow beam within the
limbus at a 60° angle.
• Gonioscopy.

36. • Flashlight/Pentorch test:
evaluated by focusing a beam of
light on temporal limbus, parallel
to the surface of iris.

37. • Gonioscopy: evaluation of structures by using a
special lens(goniolens) & slit lamp biomicroscope.

38. IMPORTANCE OF ANGLE OF ANTERIOR CHAMBER
• For classification of glaucoma.
• To assess traumatic glaucoma.
• To assess angle recession.
• For planning of treatment.

39. • ......Thank you.