The uvea is the middle vascular layer of the eyeball and consists of the iris, ciliary body, and choroid. The iris is a thin circular structure that forms the diaphragm in front of the lens and contains the pupil. The ciliary body is a ring-shaped structure that projects posteriorly from the scleral spur and contains ciliary processes that extend into the posterior chamber. The choroid is a highly vascular membrane that lines the inner surface of the sclera and extends from the ora serrata posteriorly.
1. Introduction Gross anatomy Layers Blood supply, drainage and nerve supply
2. INTRODUCTION • Sclera forms posterior 5/6th of external tunic , connective tissue coat of eyeball. • it continues with duramater and cornea • Its whole surface covered by tenon’s capsule • Anteriorly covered by- bulbar conjunctiva • Inner surface lies in contact with choroid • With a potential suprachoroidal space in between
3. Equa THICKNESS OF SCLERA
4. • Thickness varies with individual, with age • Thinner- children, elder, F> M • Thickest posteriorly • Gradually becomes thinner when traced anteriorly • Thin at insertion of extraocular muscle
The tear film is a complex mixture of substances secreted from multiple sources on the ocular surface, including the lacrimal gland, the accessory lacrimal glands, the meibomian glands, and the goblet cells.
1. Introduction Gross anatomy Layers Blood supply, drainage and nerve supply
2. INTRODUCTION • Sclera forms posterior 5/6th of external tunic , connective tissue coat of eyeball. • it continues with duramater and cornea • Its whole surface covered by tenon’s capsule • Anteriorly covered by- bulbar conjunctiva • Inner surface lies in contact with choroid • With a potential suprachoroidal space in between
3. Equa THICKNESS OF SCLERA
4. • Thickness varies with individual, with age • Thinner- children, elder, F> M • Thickest posteriorly • Gradually becomes thinner when traced anteriorly • Thin at insertion of extraocular muscle
The tear film is a complex mixture of substances secreted from multiple sources on the ocular surface, including the lacrimal gland, the accessory lacrimal glands, the meibomian glands, and the goblet cells.
The tear film constitutes Three layers :- An outermost lipid (oily) layer An aqueous (watery) layer that makes up 90% of the tear film volume; and A mucin layer that coats the corneal surface.
3. To form smooth optical surface on cornea. To keep the surface of cornea & conjunctiva moist It serve as lubricant It transfer oxygen Provide antibacterial action Wash debris out It provides a pathway for WBC in case of injury
4. Functions of lipid layer Retards evaporation of tear film Prevents the overflow of tears
5. Function of Aqueous Layer Flushes, buffers and lubricates the corneal surface Delivers oxygen and other nutrients to the corneal surface Wash out debris Delivers antibacterial enzymes and antibodies such as lysozyme.
6. Functions of Mucin Layer Spreads tears over corneal surface. Protects the cornea against foreign substances . Makes corneal surface smooth by filling in surface irregularities
you will get information and knowledge about different dyes, their uses in the diagnosis of ocular diseases in detail.
different dyes are as follows: Fluorescein, Rose Bengal, ICG, Lissamine Green, and Trypan Blue.
The retina is the sensory membrane that lines the inner surface of the back of the eyeball. It's composed of several layers, including one that contains specialized cells called photoreceptors.
Photoreceptor cells take light focused by the cornea and lens and convert it into chemical and nervous signals which are transported to visual centers in the brain by way of the optic nerve.
In the visual cortex of the brain (which, ironically, is located in the back of the brain), these signals are converted into images and visual perceptions.
Cornea is the clear front surface of the eye. It lies directly in front of the iris and pupil, and it allows light to enter the eye.
Cornea forms the transparent and anterior 1/6th of the external fibrous coat of the globe of the eyeball.
The cornea is the eye's most powerful structure for focusing light that provides approximately 65 to 75 percent of the focusing power of the eye.
The cornea has unmyelinated nerve endings sensitive to touch, temperature and chemicals; a touch of the cornea causes an involuntary reflex to close the eyelid.
The lacrimal apparatus is the physiological system containing the orbital structures for tear production and drainage. It consists of: The lacrimal gland, which secretes the tears, and its excretory ducts, which convey the fluid to the surface of the human eye;it is a serous gland located in lacrimal fossa.
The tear film constitutes Three layers :- An outermost lipid (oily) layer An aqueous (watery) layer that makes up 90% of the tear film volume; and A mucin layer that coats the corneal surface.
3. To form smooth optical surface on cornea. To keep the surface of cornea & conjunctiva moist It serve as lubricant It transfer oxygen Provide antibacterial action Wash debris out It provides a pathway for WBC in case of injury
4. Functions of lipid layer Retards evaporation of tear film Prevents the overflow of tears
5. Function of Aqueous Layer Flushes, buffers and lubricates the corneal surface Delivers oxygen and other nutrients to the corneal surface Wash out debris Delivers antibacterial enzymes and antibodies such as lysozyme.
6. Functions of Mucin Layer Spreads tears over corneal surface. Protects the cornea against foreign substances . Makes corneal surface smooth by filling in surface irregularities
you will get information and knowledge about different dyes, their uses in the diagnosis of ocular diseases in detail.
different dyes are as follows: Fluorescein, Rose Bengal, ICG, Lissamine Green, and Trypan Blue.
The retina is the sensory membrane that lines the inner surface of the back of the eyeball. It's composed of several layers, including one that contains specialized cells called photoreceptors.
Photoreceptor cells take light focused by the cornea and lens and convert it into chemical and nervous signals which are transported to visual centers in the brain by way of the optic nerve.
In the visual cortex of the brain (which, ironically, is located in the back of the brain), these signals are converted into images and visual perceptions.
Cornea is the clear front surface of the eye. It lies directly in front of the iris and pupil, and it allows light to enter the eye.
Cornea forms the transparent and anterior 1/6th of the external fibrous coat of the globe of the eyeball.
The cornea is the eye's most powerful structure for focusing light that provides approximately 65 to 75 percent of the focusing power of the eye.
The cornea has unmyelinated nerve endings sensitive to touch, temperature and chemicals; a touch of the cornea causes an involuntary reflex to close the eyelid.
The lacrimal apparatus is the physiological system containing the orbital structures for tear production and drainage. It consists of: The lacrimal gland, which secretes the tears, and its excretory ducts, which convey the fluid to the surface of the human eye;it is a serous gland located in lacrimal fossa.
Slide Presentation for Anatomy of Eyeball. This slide is taken from Medicos Pdf app available in playstore. This app contains many more slides related to clinical science, basi science, nursing, dental and many more. You can download if you want many more slides.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. Anatomy and Aplied anatomy of
Uvea
Presenter : Dr. Darshan S M
Moderator : Dr. K Kanthamani
2. • Uvea is the middle vascular coat of eye ball.
• From anterior to posterior, the uvea or uveal
tract can be divided into three parts
- Iris,
- Ciliary body
- choroid.
3. • The name “uvea” has originated from Latin
word grape.
• Why a grape ?
If the stem is removed from a grape, the hole
looks like the pupil and the grape the eyeball.
4. Iris
• Iris is the anterior most part of the uveal tract.
It is a thin and circular structure which forms a
diaphragm like structure in front of the
crystalline lens.
• The word “iris” has originated from a Greek
word. In Greek mythology the iris is the name
of Greek goddess of rainbow -
5. • The diaphragm formed by iris contains a
central aperture known as pupil.
• The location of the pupil is not exactly central,
its little nasal to the center. The pupil
determines the amount of light entering the
eye.
• The normal size of pupillary aperture is
3-4mm.
6.
7. • Iris is attached to the middle of anterior
surface of ciliary body.
• The iris divides the space in front of the lens
into anterior chamber and posterior chamber.
8.
9. Topography of IRIS:
> Average diameter of the iris is 10 to 11 mm.
It is thickest at collarette, which is located
approximately 1.5 mm from the pupillary
margin and thinnest at iris root,
• Root is the part of iris which joins with the
ciliary body.
• The thickness of iris root is approximately 0.5
mm.
10. • Anterior surface of the iris is divided into a
pupillary zone and a ciliary zone by a circular
ridge, located 1.5 mm away from pupillary
margin, called collarette
• also known as iris frill.
11. Aplied anatomy
• During blunt trauma, damage to iris occurs
most commonly at the iris root, where the iris
rips away from the ciliary body
12. • Anterior surface of the iris is divided into a
pupillary zone and a ciliary zone by a circular
ridge, located 1.5 mm away from pupillary
margin, called collarette (also known as iris
frill).
14. Pupillary Zone
• Pupillary zone extends from pupillary margin
to collarette.
• Pupillary zone is relatively flat.
• Pupillary margin is marked by a dark border,
known as pupillary ruff.
• Pupillary ruff is the anterior termination of
the pigmented layer.
15. Ciliary Zone
• Ciliary zone of iris extends from collarette to
iris root.
• There are some depressions or pit arranged in
rows present in this area known as crypts.
• Crypts are found in two locations. Those
present near collarette are relatively larger
and known as Fuchs’s crypt and few are seen
in periphery of the iris
16.
17. Aplied anatomy
• In laser iridotomy, the opening is created in
areas of iris crypts, as it requires less amount
of energy in these thinnest areas of iris
thickness.
18. Microscopic structure of Iris
1. Anterior limiting layer
• Anterior limiting layer lines the iris and is the
anterior most condensations of iris stroma.
• The layer consist of mainly fibroblasts and
melanocytes.
• These cells are arranged in a meshwork
• -fibroblasts are located on the surface and
melanocyte beneath them.
19. • The colour of iris depends on the thickness of
the layer and melanocyte dispersed in anterior
limiting layer.
• The color of the iris is largely determined by
three main variables:
(1) the density and structure of the iris stroma,
(2) the pigment epithelium and
(3) the pigment content (granules) within the
melanocytes of the iris stroma
20. • Heterochromia of iris (Greek: heteros 'different'
+ chroma 'color'):
• it is of two kinds.
• In complete heterochromia, one iris is a different
color from the other.
• In partial heterochromia or sectoral
heterochromia, part of one iris is a different color
from its remainder.
22. 2. Iris stroma
• Iris stroma forms the main bulk of iris tissue
and contains sphincter pupillae, dilator
pupillae muscles, vessels and nerves
• Cells in iris stroma:
• Pigmented cells = melanocytes + clump cells
• Non-pigmented cells = fibroblasts +
lymphocytes + macrophages + mast cells
23.
24. Aplied anatomy
• Pigment dispersion syndrome
• It is a bilateral condition characterized by the
liberation of pigment granules from the iris
pigment epithelium.
• It Is caused by the mechanical rubbing of the
posterior pigment layer of the iris against lens
zonules as a result of excessive posterior
bowing of the mid-peripheral portion of the iris.
• sometimes pigment epithelium itself may be
abnormally susceptible to pigment shedding.
25.
26. Muscles in iris stroma:
• The sphincter pupillae muscle is a circular muscle,
• 0.75 to 1 mm wide, composed of smooth-muscle cells.
• The muscle is 0.1 to 1.7 mm in thickness and is
considerably thicker than the dilator papillae.
• It encircles the pupil and is located in the pupillary zone
of the stroma.
• The sphincter muscle is firmly adherent to the
surrounding stroma of iris.
• Sphincter muscle is composed of spindle-shaped cells
that are oriented parallel to the pupillary margin so
contraction of the sphincter causes the pupil to constrict
(a process known as miosis).
• The muscle is innervated by the parasympathetic system.
27. Aplied anatomy
• the sphincter pupillae retains its function even
if severed radially because of its unique
distribution of fibres.
28. • the dilator pupillae muscle extends from the iris
root to a point in the stroma below the
midpoint of the sphincter.
• A dense band of connective tissue separates the
sphincter and dilator muscles from each other.
• Because of the radial arrangement of the fibres
of the muscle, contraction of the dilator pupillae
muscle pulls the pupillary
portion toward the root, thereby enlarging
the the size of pupil ( a process ka mydriasis).
• The dilator pupillae muscle is sympathetically
innervated.
29. Blood vessels in iris stroma:
• The iris arteries are branches of major circle of the
iris, located in the ciliary body near the iris root.
• The iris vessels usually follow a radial course from the
iris root to the pupil margin.
• These vessels are surrounded by a dense network of
collagenous fibrils which is embedded in to the
collagen network of the stroma.
• Such arrangement of collagen network prevents the
iris vessels from
kinking and compression during the extensive iris
movement during constriction and dilatation of
pupil.
• Iris veins have very thin walls consisting of
endothelium surrounded by a thin layer of collagen
30. Ciliary body
• Ciliary body is the middle part of the uveal tract . It is a
ring shaped structure which projects posteriorly from
the scleral spur.
• It is brown in colour due to melanin pigment.
• Anteriorly it is confluent with the periphery of the iris
(iris root) and anterior part of the ciliary body bounds a
part of the anterior chamber angle.
• Posteriorly ciliary body has a crenated periphery,
known as ora serrata, where it is continuous with the
choroid and retina.
• Ciliary body has a width of approximately 5.9 mm on
the nasal side and 6.7 mm on the temporal side.
31. Parts of ciliary body
• Ciliary body, in cross section, is a triangular
structure .
• Outer side of the triangle (O) is attached with the
sclera with suprachoroidal space in between.
• Anterior side of the triangle (A) forms part of the
anterior & posterior chamber. In its middle, the iris
is attached.
• The inner side of the triangle (I) is divided into two
parts. The anterior part (2 mm) with finger like
processes is known as pars plicata (corona ciliaris)
and posterior smooth (4 mm) is known as pars
plana (orbicularis ciliaris).
32.
33. Pars plicata:
• The pars plicata is the portion of ciliary body
which contains the ciliary processes.
• Ciliary processes are the finger like projections ,
which extend into the posterior chamber.
• The regions between ciliary processes are called
valleys of Kuhnt.
• They are approximately 70 to 80 in numbers.
• A ciliary process measures approximately 2
mm in length, 0.5 mm in width, and 1 mm in
height.
34. Pars plana
• Pars plana is the flat or
smooth part of the ciliary body.
• It terminates at the ora serrata, which is the
transitional zone between ciliary body and
choroid.
• Histologically, the pars plana consists of a double
layer of epithelial cells: the inner, nonpigmented
epithelium, which is continuous with
neurosensory retina
• and the outer, pigmented epithelium, which is
continuous with the retinal pigment epithelium
(RPE) .
35. Aplied anatomy
• The pars plana is a relatively avascular zone,
which is important surgically in the pars plana
approach to the vitreous space.
• The pars plana provides surgical access to the
vitreous and retina
36. Ora serrata: the transition zone
• The ora serrata can be termed as the anterior
border of the neurosensory retina
• Aplied anatomy
Topographically, ora serrata corresponds to the
insertion of the medial and lateral rectus
muscles.
37. Lens and ciliary body:
• The zonules course from ciliary body to the
lens.
• Some of these zonular fibers insert into the
internal limiting membrane of the pars plana
region and travel forward through the valleys
(valleys of Kuhnt) between the ciliary
processes
38. Layers of ciliary body:
• From inside to outside (from sclerad to vitread), ciliary
body consists of following four layers.
• 1. Ciliary epithelium:
• 1A . Non pigmented epithelium of ciliary body NPE of
ciliary body extends from iris root to ora serrata.
• It begins as a continuation of posterior pigmented
epithelium of iris near iris root.
• At ora serrata, the NPE continues as sensory retina.
• It gives origin to parts of the suspensory lens ligament.
39. • 1 B. Pigmented epithelium of ciliary body:
• The cells of the pigmented epithelium are 8 to 10
micro meter wide and contain large pigment
granules.
• These pigment granules are three to four times
larger than those of the choroid and retina.
• These cells are rich in organelles and are very
active metabolically .
•
The cells of pigment epithelium secretes basement
membrane which continues posteriorly with
the retinal pigment epithelium (RPE).
40. Aplied anatomy
• Ciliary epithelium : metabolic activity
• The cells of both the ciliary epithelium have a
greater number of mitochondria and thus
they have a higher degree of metabolic
activity, with a significant role in the active
secretion of aqueous humor.
41. 2. Ciliary stroma:
• Ciliary stroma contains blood vessels, nerves
and ciliary muscle.
• Ciliary stroma continues anteriorly with iris
stroma and continues posteriorly with
choroidal stroma after thinning out at pars
plana
42. • Blood vessels in ciliary stroma: Major arterial circle
of iris
• Major arterial circle of iris, formed by the
anastomosis of long posterior ciliary arteries and
anterior ciliary arteries , is located in ciliary stroma
near iris root just in front of circular portion of
ciliary muscle.
• Ciliary stroma also consists of numerous capillaries
which are fenestrated and large in size.
• The capillaries are more in numbers in ciliary
processes, making them the most vascular organ of
the eye
43. Muscle in ciliary stroma: ciliary muscle
• Ciliary muscle is a nonstriated or smooth
muscle primarily situated in the anterior two
thirds of the ciliary body stroma. The muscle
has three parts –
> Outer longitudinal (Brücke's muscle)
> Middle oblique portion (also called reticular
or radial)
> inner circular portion (Müller's muscle)
44. • Contraction of the ciliary muscle, especially of
the longitudinal and circular fibers, pulls the
ciliary body forward during accommodation.
• This forward movement of ciliary body
relieves the tension in the suspensory lens
ligament (zonules), making the elastic lens
more convex and there by helps the eye in
accommodation by increasing the refractive
power of the lens
45. • Ciliary muscle is innervated by the autonomic
nervous system, parasympathetic
postganglionic fibres derived from the
oculomotor nerve.
• The nerve fibres reaches the muscle via short
ciliary nerve.
• The parasympathetic stimulation activates the
muscle for contraction, whereas sympthetic
innervation likely has an inhibitory effect.
46. Supraciliary lamina:
• supraciliary lamina is the outermost layer of
ciliary body which lies adjacent to the sclera.
• Because of the lamellar arrangement of
connective tissue in this area, supra ciliary
lamina acts as a potential space.
• Thus it also helps aqueous humor to exit by
the unconventional pathway .
48. Ciliary process :
• Ciliary processes are finger like projections seen
in pars plicata of ciliary body.
• Ciliary processes are approximately 70 to 80 in
numbers in each eye and extend into the
posterior chamber, and the regions between
these ciliary processes are called valleys of Kuhnt.
• Zonules of lens (suspensory ligaments of lens) are
inserted in these valleys.
• The ciliary processes are white whereas the
valleys of Kuhnt are dark in colour.
49. • Ciliary processes increase the surface area of
pars plicata, which is approximately 6 square
centimetre, approximately five times the
surface area of corneal endothelium
50. Blood supply of ciliary process:
• Long posterior ciliary artery, a branch of
ophthalmic artery, pierce the globe near the
optic nerve and run up to ciliary body to form
major arterial circle.
• Several branches from major arterial circle
supply ciliary processes.
• These are mainly pre capillary arterioles and
they divide in to network of capillary plexuses
in each of the ciliary processes.
• These vessels drain in to choroidal and
intrascleral veins
51. Aplied anatomy
• The pre capillary arterioles supplying the
ciliary processes have sphincters which may
be responsible for the auto regulation of
blood supply to the tissue.
52. Choroid
• Choroid is a thin but highly vascular
membrane lining the inner surface of sclera.
• It extends from anteriorly ora serrata to the
optic nerve posteriorly.
• Choroid becomes continuous with pia and
arachnoid at the optic nerve.
• Choroid is normally 100-220 µm thick ;
thickness is highest at macula 500- 1000 µm.
54. • Choroid can be divided into the following
layers histologically
• 1. Suprachoroid lamina (lamina fusca):
• 2. Choroidal stroma:
• 3. Layer of Choriocapillaris (Choriocapillaries
are thickest and most abundant in submacular
area )
55. Aplied anatomy
• choroidal circulation:
• Choroidal circulation constitutes 85% of the
blood circulation of the eye.
• Choroidal blood flow is higher than that in
tissues like retina and brain.
• Choroidal blood-flow ranges from 800 to 2000
mL/min/100 g of tissue.
• In embryonic life, choroid serves as an
additional site for the erythropoiesis.
56. 4. Bruch's membrane:
• Bruch's membrane is the innermost layer of
choroid
• Bruch's membrane is composed of 5 layers
and from internal to external,
• these are
57.
58. Aplied anatomy
• Outer blood–retinal barrier
The outer blood–retina barrier (BRB) is
composed of three structural entities,
> the fenestrated endothelium of the
choriocapillaris,
> Bruch's membrane and
> the retinal pigment epithelium (RPE).
59. Blood supply of uveal tract:
• The blood supply of the uveal tract is mainly
from three arteries namely short posterior
ciliary arteries, long posterior ciliary arteries
and anterior ciliary arteries.
The posterior ciliary arteries are branches of
the ophthalmic artery.
60. SHORT POSTERIOR CILIARY ARTERIES
• 15 to 20 short posterior ciliary arteries arise →
form 10 to 20 branches → enter the sclera in a
ring around the optic nerve → anastomose with
other branches from the short posterior ciliary
arteries to form the circle of Zinn (Zinn-Haller)
which encircles the optic nerve at the level of the
choroid → they run in suprachoroidal space
between sclera and choroid, branch and
• supply the choroid.
61. LONG POSTERIOR CILIARY ARTERIES
• two long posterior ciliary arteries enter the
sclera: one lateral and one medial to the ring
of short ciliary arteries → run between the
sclera and the choroid to the anterior globe →
enter the ciliary body and branch superiorly
and inferiorly → anastomose with each other
and with the anterior ciliary arteries to form a
circular blood vessel,
• the major arterial circle of the iris
62. ANTERIOR CILIARY ARTERIES :
• 7 anterior ciliary arteries are derived from
muscular branches of ophthalmic artery
• two each from arteries of superior rectus,
medial rectus, inferior rectus and only one
from lateral rectus muscle → reaches
episclera, form plexus and give branches →
pierce sclera near the limbus to enter the eye
→ anastomoses with long posterior ciliary
arteies to form major arterial circle of iris