The document provides details on the anatomy of the orbit and its contents. It discusses the seven bones that form the orbit, its four walls, base and apex. It describes the structures contained within the orbit including the eyeball, extraocular muscles, nerves and vessels. The optic canal and superior orbital fissure which pass through the apex of the orbit are also mentioned. The document summarizes the anatomy of the orbit in detail.
The external ear consists of the pinna and external auditory canal. The pinna has prominent features like the helix, antihelix and lobule. The external auditory canal is cartilaginous in the outer one-third and bony in the inner two-thirds. The tympanic membrane separates the external ear from the middle ear. It has three layers and is angled obliquely in the canal. Nerves that supply the external ear and tympanic membrane include the auriculotemporal, vagus and glossopharyngeal nerves.
The document provides an overview of the surgical anatomy of the eyelid. It discusses the key structures of the eyelid in 3 layers - skin, muscle, and fibrous layer. The skin is the thinnest in the body to allow for easy eyelid mobility. The muscle layer contains the orbicularis oculi muscle which helps protract the eyelid. The fibrous layer provides the framework and includes the tarsal plates, septum orbitale, and medial/lateral palpebral ligaments. It also describes important anatomical structures like the palpebral fissure, canthi, eyelid margins and creases. Blood supply comes from the medial and lateral palpebral arteries which form marginal arterial arc
This document describes the anatomy and structure of the lacrimal apparatus, which produces and drains tears from the eyes. It includes the main lacrimal gland located in the orbit, accessory lacrimal glands in the eyelid, and the lacrimal drainage system consisting of puncta, canaliculi, lacrimal sac, and nasolacrimal duct leading to the nose. The main lacrimal gland is a serous gland made of acini and ducts and receives blood supply from the lacrimal artery and drains to the ophthalmic vein. Tears produced drain through puncta and canaliculi into the lacrimal sac then through the nasolacrimal duct to
The document summarizes the anatomy of the orbit. It describes the bones that form the orbit, including the frontal, ethmoid, lacrimal, palatine, maxilla, zygomatic and sphenoid bones. It discusses the walls, floors, contents and dimensions of the orbit. Key structures mentioned include the medial wall formed by the frontal process of maxilla, lacrimal bone, orbital plate of ethmoid and body of sphenoid. The lateral wall is the thickest and formed by the zygomatic and sphenoid bones. The orbital surgical spaces of subperiosteal, peripheral and central are summarized.
The bony orbit is a quadrangular pyramidal cavity housing the eyeball and other structures. It is formed by 7 bones and has 4 walls - medial, lateral, roof and floor. The medial wall is formed by the frontal process of maxilla, lacrimal bone and orbital plates of ethmoid and sphenoid bones. The floor is formed by maxilla, zygoma and palatine bones. The lateral wall is formed by zygoma anteriorly and sphenoid wing posteriorly. The roof is formed mainly by frontal bone. The orbital cavity contains the eyeball, 6 extraocular muscles, lacrimal gland, blood vessels and nerves.
The external ear consists of the pinna and external auditory canal. The pinna has prominent features like the helix, antihelix and lobule. The external auditory canal is cartilaginous in the outer one-third and bony in the inner two-thirds. The tympanic membrane separates the external ear from the middle ear. It has three layers and is angled obliquely in the canal. Nerves that supply the external ear and tympanic membrane include the auriculotemporal, vagus and glossopharyngeal nerves.
The document provides an overview of the surgical anatomy of the eyelid. It discusses the key structures of the eyelid in 3 layers - skin, muscle, and fibrous layer. The skin is the thinnest in the body to allow for easy eyelid mobility. The muscle layer contains the orbicularis oculi muscle which helps protract the eyelid. The fibrous layer provides the framework and includes the tarsal plates, septum orbitale, and medial/lateral palpebral ligaments. It also describes important anatomical structures like the palpebral fissure, canthi, eyelid margins and creases. Blood supply comes from the medial and lateral palpebral arteries which form marginal arterial arc
This document describes the anatomy and structure of the lacrimal apparatus, which produces and drains tears from the eyes. It includes the main lacrimal gland located in the orbit, accessory lacrimal glands in the eyelid, and the lacrimal drainage system consisting of puncta, canaliculi, lacrimal sac, and nasolacrimal duct leading to the nose. The main lacrimal gland is a serous gland made of acini and ducts and receives blood supply from the lacrimal artery and drains to the ophthalmic vein. Tears produced drain through puncta and canaliculi into the lacrimal sac then through the nasolacrimal duct to
The document summarizes the anatomy of the orbit. It describes the bones that form the orbit, including the frontal, ethmoid, lacrimal, palatine, maxilla, zygomatic and sphenoid bones. It discusses the walls, floors, contents and dimensions of the orbit. Key structures mentioned include the medial wall formed by the frontal process of maxilla, lacrimal bone, orbital plate of ethmoid and body of sphenoid. The lateral wall is the thickest and formed by the zygomatic and sphenoid bones. The orbital surgical spaces of subperiosteal, peripheral and central are summarized.
The bony orbit is a quadrangular pyramidal cavity housing the eyeball and other structures. It is formed by 7 bones and has 4 walls - medial, lateral, roof and floor. The medial wall is formed by the frontal process of maxilla, lacrimal bone and orbital plates of ethmoid and sphenoid bones. The floor is formed by maxilla, zygoma and palatine bones. The lateral wall is formed by zygoma anteriorly and sphenoid wing posteriorly. The roof is formed mainly by frontal bone. The orbital cavity contains the eyeball, 6 extraocular muscles, lacrimal gland, blood vessels and nerves.
The document provides an overview of the anatomy of the orbit, including its walls, contents, surgical spaces, vascular and nervous supply. Some key points include:
- The orbit is a pyramid-shaped cavity formed by 7 bones and divided into 4 walls - medial, lateral, roof and floor.
- It contains the eyeball, extraocular muscles, nerves, vessels and orbital fat.
- There are 4 surgical spaces - subperiosteal, peripheral, central and subtendon.
- The orbit receives its blood supply from the ophthalmic artery and drains via the superior ophthalmic vein.
- Sensory innervation is from the ophthalmic and maxillary nerves and motor inner
This document provides an overview of the anatomy of the eyelids. It discusses the embryology, layers, muscles, glands, functions, nerve and blood supply of the eyelids. The eyelids are formed during gestation from the surface ectoderm. Each eyelid has skin, connective tissue, striated muscle layers and a tarsal plate. The document describes the anatomy and functions of the orbicularis muscle and levator palpebrae superioris muscle. It provides details on the glands, blood and nerve supply of the eyelids.
The eyelids are thin folds of skin that cover and protect the eyes. They have several important anatomical structures:
- The tarsal plates provide structure and support to the eyelids. The levator palpebrae superioris muscle elevates the upper eyelid.
- Several glands are located within the eyelid tissues, including the meibomian glands within the tarsal plates and glands of Zeis and Moll near the eyelashes.
- Blood supply comes from the superior and inferior palpebral arteries. Nerves pass through the septum orbitale to innervate the eyelid structures.
The document provides details on the anatomy of the external ear, middle ear, and their structures. The external ear includes the pinna and external auditory canal. The pinna has prominent features like the helix, antihelix, and lobule. The external auditory canal is cartilaginous outerly and bony innerly. The tympanic membrane separates the external ear from the middle ear. The middle ear contains the ossicles, muscles, and is lined by mucosa. It has boundaries like the tegmen forming the roof and the jugular bulb forming the floor. The nerves supplying these structures like the facial, vagus and trigeminal nerves are also described.
This document provides an overview of the anatomy of the external ear, including the auricle (pinna), cartilage, skin, muscles, blood supply, innervation, and lymphatic drainage of the auricle. It also describes the external auditory canal in detail, including its parts, measurements, relationships, blood supply, and the tympanic membrane. Key details include that the auricle collects and directs sound into the external auditory canal, which transmits sound waves to the tympanic membrane, separating the external and middle ear.
The orbital region contains the eyeballs and associated structures. The orbits are bony cavities that contain the eyeballs, muscles, nerves, vessels and fat. Each orbit is a pyramidal cavity with openings that transmit nerves and vessels. The eyeball consists of three coats - fibrous, vascular and nervous - that contain the aqueous humor, vitreous body and lens. Muscles allow movement of the eyeball and eyelids to focus vision.
This document provides an overview of the anatomy of the eyelids. It begins with the embryological development of the eyelids, followed by a description of the layers that make up the eyelid including skin, muscle, fibrous tissue and mucous membrane. The document then discusses the anatomy and functions of specific structures like the tarsal plate, orbicularis oculi muscle, levator palpebrae superioris muscle, and glandular structures. Common congenital anomalies and clinical conditions involving the eyelids are also mentioned.
The document summarizes eyelid anatomy and physiology of the lacrimal pump. It describes the embryology, gross anatomy, structures, muscles, glands, blood supply and lymphatic drainage of the eyelids. The key structures discussed include the tarsal plates, septum orbitale, orbicularis oculi muscle, levator palpebrae superioris muscle, and meibomian glands. The document also briefly outlines the functions of the meibomian glands and arterial blood supply to the eyelids.
The document summarizes the anatomy of the orbital region. It describes the structures contained within the orbits, including the eyeballs, muscles, nerves, vessels and fat. It discusses the eyelids, lacrimal apparatus, openings into the orbital cavity, contents of the orbit, fascia of the orbit, and nerves of the orbit such as the optic nerve. The optic nerve enters the orbit through the optic canal and pierces the sclera to reach the eyeball.
The conjunctiva is the mucous membrane that lines the inner surface of the eyelids and covers the anterior surface of the sclera and cornea. It has three layers - an epithelial layer, adenoid layer, and fibrous layer. The conjunctiva receives its blood supply from the marginal arterial arcade, peripheral arterial arcade, and anterior ciliary arteries. It drains into the venous plexus of the eyelids and then into the superior and inferior ophthalmic veins. Lymphatic drainage is to the preauricular and submandibular lymph nodes. Pterygium is a wing-shaped growth of conjunctiva that extends onto the cornea, caused by exposure to sun and dust, and is
The document summarizes the anatomy of the ear in 3 parts - external, middle, and inner ear. It describes the external ear in detail including the pinna, cartilage, ligaments, muscles, blood supply, nerves, and lymphatic drainage. It then describes the anatomy of the external auditory canal. Finally, it provides an in-depth summary of the anatomy of the middle ear, including the walls, structures, blood supply and nerves of the tympanic cavity.
The document summarizes the anatomy of the ear in 3 parts - external, middle, and inner ear. It provides detailed descriptions of the structures within each part, including:
The external ear is divided into the auricle/pinna and external auditory canal. The auricle has cartilage, ligaments, muscles and blood supply. The external auditory canal has cartilage in the lateral 1/3 and bone in the medial 2/3.
The middle ear, or tympanic cavity, has 6 walls and 3 compartments. It contains the ossicles - malleus, incus and stapes. The tympanic membrane separates the external ear from the middle ear.
The inner ear contains
This document provides information on various ocular appendages and structures of the eyelids and conjunctiva. It discusses the anatomy of the eyebrows, eyelids, conjunctiva and their components. Specifically, it describes the gross anatomy, structures, vascular supply, innervation and histology of these ocular structures. Clinical considerations for some conditions are also briefly mentioned.
Anatomy of larynx & physiology, 29.08.16, dr.bakshiophthalmgmcri
This document describes the anatomy of the larynx. It discusses the cartilages that make up the skeletal framework, including the thyroid, cricoid, and arytenoid cartilages. It describes the ligaments and membranes, including the thyrohyoid membrane. It details the three compartments of the laryngeal cavity: the superior vestibule, ventricle, and subglottic space. It also discusses the vocal folds and their structure, including the epithelium, lamina propria, and vocal ligament.
Anatomy of external and middle ear by dr. faisal rahmanFaisalRahman153
This includes anatomy of external and middle ear with their clinical co relations. Embryology is also discussed here. Pinna, External auditory canal, Tympanic membrane, Middle ear Cleft, Mastoid and Auditory tube topics are included.
The document summarizes the anatomy of the orbit, including its development, walls, contents, surgical spaces, and age-related changes. Key points:
- The orbit develops around the eyeball from cranial neural crest cells that form the frontal, maxillary, and lateral nasal processes. Bones differentiate and ossify during fetal development.
- The orbit has medial, lateral, floor, and roof walls formed by several bones including the frontal, ethmoid, maxillary, zygomatic, sphenoid, and palatine. It contains the eye, extraocular muscles, nerves, vessels, lacrimal gland, and fat.
- There are subperiosteal, subtendon's
The orbit develops around the eyeball from cranial neural crest cells. The bones that make up the orbital walls differentiate during the third month in utero and undergo ossification through both endochondral and membranous processes. The shape and size of the orbit changes with age. In adults, the orbit is quadrangular in shape and bounded superiorly, medially, inferiorly and laterally by bones. It contains the eyeball and extraocular muscles, nerves, vessels and fat. The walls are thin and prone to fractures or invasion by adjacent structures like sinuses.
This document discusses secondary glaucomas, which are glaucomas caused by an underlying ocular or systemic disease. It defines several types of secondary glaucoma including phacomorphic glaucoma caused by a swollen cataract pushing on the iris, neovascular glaucoma due to retinal ischemia, and steroid-induced glaucoma from long-term steroid use. For each type, it describes the mechanism of increased intraocular pressure and recommended treatment approaches, which generally involve treating both the primary disease and controlling intraocular pressure.
This document discusses the process of determining and correcting refractive errors through objective and subjective refraction methods. It describes retinoscopy and trial frame techniques used in subjective refraction to find the optimal lens prescription. Specifically, it details how Jackson's cross cylinder and fogging techniques are used to refine the cylindrical correction and verify the accuracy of the prescription before the final step of binocular balancing for the patient.
The document provides an overview of the anatomy of the orbit, including its walls, contents, surgical spaces, vascular and nervous supply. Some key points include:
- The orbit is a pyramid-shaped cavity formed by 7 bones and divided into 4 walls - medial, lateral, roof and floor.
- It contains the eyeball, extraocular muscles, nerves, vessels and orbital fat.
- There are 4 surgical spaces - subperiosteal, peripheral, central and subtendon.
- The orbit receives its blood supply from the ophthalmic artery and drains via the superior ophthalmic vein.
- Sensory innervation is from the ophthalmic and maxillary nerves and motor inner
This document provides an overview of the anatomy of the eyelids. It discusses the embryology, layers, muscles, glands, functions, nerve and blood supply of the eyelids. The eyelids are formed during gestation from the surface ectoderm. Each eyelid has skin, connective tissue, striated muscle layers and a tarsal plate. The document describes the anatomy and functions of the orbicularis muscle and levator palpebrae superioris muscle. It provides details on the glands, blood and nerve supply of the eyelids.
The eyelids are thin folds of skin that cover and protect the eyes. They have several important anatomical structures:
- The tarsal plates provide structure and support to the eyelids. The levator palpebrae superioris muscle elevates the upper eyelid.
- Several glands are located within the eyelid tissues, including the meibomian glands within the tarsal plates and glands of Zeis and Moll near the eyelashes.
- Blood supply comes from the superior and inferior palpebral arteries. Nerves pass through the septum orbitale to innervate the eyelid structures.
The document provides details on the anatomy of the external ear, middle ear, and their structures. The external ear includes the pinna and external auditory canal. The pinna has prominent features like the helix, antihelix, and lobule. The external auditory canal is cartilaginous outerly and bony innerly. The tympanic membrane separates the external ear from the middle ear. The middle ear contains the ossicles, muscles, and is lined by mucosa. It has boundaries like the tegmen forming the roof and the jugular bulb forming the floor. The nerves supplying these structures like the facial, vagus and trigeminal nerves are also described.
This document provides an overview of the anatomy of the external ear, including the auricle (pinna), cartilage, skin, muscles, blood supply, innervation, and lymphatic drainage of the auricle. It also describes the external auditory canal in detail, including its parts, measurements, relationships, blood supply, and the tympanic membrane. Key details include that the auricle collects and directs sound into the external auditory canal, which transmits sound waves to the tympanic membrane, separating the external and middle ear.
The orbital region contains the eyeballs and associated structures. The orbits are bony cavities that contain the eyeballs, muscles, nerves, vessels and fat. Each orbit is a pyramidal cavity with openings that transmit nerves and vessels. The eyeball consists of three coats - fibrous, vascular and nervous - that contain the aqueous humor, vitreous body and lens. Muscles allow movement of the eyeball and eyelids to focus vision.
This document provides an overview of the anatomy of the eyelids. It begins with the embryological development of the eyelids, followed by a description of the layers that make up the eyelid including skin, muscle, fibrous tissue and mucous membrane. The document then discusses the anatomy and functions of specific structures like the tarsal plate, orbicularis oculi muscle, levator palpebrae superioris muscle, and glandular structures. Common congenital anomalies and clinical conditions involving the eyelids are also mentioned.
The document summarizes eyelid anatomy and physiology of the lacrimal pump. It describes the embryology, gross anatomy, structures, muscles, glands, blood supply and lymphatic drainage of the eyelids. The key structures discussed include the tarsal plates, septum orbitale, orbicularis oculi muscle, levator palpebrae superioris muscle, and meibomian glands. The document also briefly outlines the functions of the meibomian glands and arterial blood supply to the eyelids.
The document summarizes the anatomy of the orbital region. It describes the structures contained within the orbits, including the eyeballs, muscles, nerves, vessels and fat. It discusses the eyelids, lacrimal apparatus, openings into the orbital cavity, contents of the orbit, fascia of the orbit, and nerves of the orbit such as the optic nerve. The optic nerve enters the orbit through the optic canal and pierces the sclera to reach the eyeball.
The conjunctiva is the mucous membrane that lines the inner surface of the eyelids and covers the anterior surface of the sclera and cornea. It has three layers - an epithelial layer, adenoid layer, and fibrous layer. The conjunctiva receives its blood supply from the marginal arterial arcade, peripheral arterial arcade, and anterior ciliary arteries. It drains into the venous plexus of the eyelids and then into the superior and inferior ophthalmic veins. Lymphatic drainage is to the preauricular and submandibular lymph nodes. Pterygium is a wing-shaped growth of conjunctiva that extends onto the cornea, caused by exposure to sun and dust, and is
The document summarizes the anatomy of the ear in 3 parts - external, middle, and inner ear. It describes the external ear in detail including the pinna, cartilage, ligaments, muscles, blood supply, nerves, and lymphatic drainage. It then describes the anatomy of the external auditory canal. Finally, it provides an in-depth summary of the anatomy of the middle ear, including the walls, structures, blood supply and nerves of the tympanic cavity.
The document summarizes the anatomy of the ear in 3 parts - external, middle, and inner ear. It provides detailed descriptions of the structures within each part, including:
The external ear is divided into the auricle/pinna and external auditory canal. The auricle has cartilage, ligaments, muscles and blood supply. The external auditory canal has cartilage in the lateral 1/3 and bone in the medial 2/3.
The middle ear, or tympanic cavity, has 6 walls and 3 compartments. It contains the ossicles - malleus, incus and stapes. The tympanic membrane separates the external ear from the middle ear.
The inner ear contains
This document provides information on various ocular appendages and structures of the eyelids and conjunctiva. It discusses the anatomy of the eyebrows, eyelids, conjunctiva and their components. Specifically, it describes the gross anatomy, structures, vascular supply, innervation and histology of these ocular structures. Clinical considerations for some conditions are also briefly mentioned.
Anatomy of larynx & physiology, 29.08.16, dr.bakshiophthalmgmcri
This document describes the anatomy of the larynx. It discusses the cartilages that make up the skeletal framework, including the thyroid, cricoid, and arytenoid cartilages. It describes the ligaments and membranes, including the thyrohyoid membrane. It details the three compartments of the laryngeal cavity: the superior vestibule, ventricle, and subglottic space. It also discusses the vocal folds and their structure, including the epithelium, lamina propria, and vocal ligament.
Anatomy of external and middle ear by dr. faisal rahmanFaisalRahman153
This includes anatomy of external and middle ear with their clinical co relations. Embryology is also discussed here. Pinna, External auditory canal, Tympanic membrane, Middle ear Cleft, Mastoid and Auditory tube topics are included.
The document summarizes the anatomy of the orbit, including its development, walls, contents, surgical spaces, and age-related changes. Key points:
- The orbit develops around the eyeball from cranial neural crest cells that form the frontal, maxillary, and lateral nasal processes. Bones differentiate and ossify during fetal development.
- The orbit has medial, lateral, floor, and roof walls formed by several bones including the frontal, ethmoid, maxillary, zygomatic, sphenoid, and palatine. It contains the eye, extraocular muscles, nerves, vessels, lacrimal gland, and fat.
- There are subperiosteal, subtendon's
The orbit develops around the eyeball from cranial neural crest cells. The bones that make up the orbital walls differentiate during the third month in utero and undergo ossification through both endochondral and membranous processes. The shape and size of the orbit changes with age. In adults, the orbit is quadrangular in shape and bounded superiorly, medially, inferiorly and laterally by bones. It contains the eyeball and extraocular muscles, nerves, vessels and fat. The walls are thin and prone to fractures or invasion by adjacent structures like sinuses.
This document discusses secondary glaucomas, which are glaucomas caused by an underlying ocular or systemic disease. It defines several types of secondary glaucoma including phacomorphic glaucoma caused by a swollen cataract pushing on the iris, neovascular glaucoma due to retinal ischemia, and steroid-induced glaucoma from long-term steroid use. For each type, it describes the mechanism of increased intraocular pressure and recommended treatment approaches, which generally involve treating both the primary disease and controlling intraocular pressure.
This document discusses the process of determining and correcting refractive errors through objective and subjective refraction methods. It describes retinoscopy and trial frame techniques used in subjective refraction to find the optimal lens prescription. Specifically, it details how Jackson's cross cylinder and fogging techniques are used to refine the cylindrical correction and verify the accuracy of the prescription before the final step of binocular balancing for the patient.
This document discusses optic disc edema (papilledema), which is swelling of the optic disc due to increased intracranial pressure. It defines papilledema and differentiates it from pseudopapilledema. Symptoms, signs, investigations and treatment are described. Papilledema is caused by increased intracranial pressure disrupting axoplasmic flow in the optic nerve. Signs include blurred disc margins, retinal folds, and fullness of the optic cup. Treatment involves addressing the underlying cause to reduce pressure and prevent vision loss.
This document discusses orbital cellulitis and its causes, signs, symptoms, investigations, differential diagnosis, treatment and complications. Some key points:
- Orbital cellulitis is an infection of the soft tissues of the eyelids and orbit. It is usually caused by Staphylococcus aureus or Streptococcus bacteria spreading from nearby infections.
- Symptoms include eyelid swelling, pain, redness and fever. Proptosis and vision issues may occur if the infection spreads to the orbit.
- Diagnosis involves examination, blood tests and imaging like CT scans. Broad-spectrum antibiotics are the primary treatment. Surgery may be needed to drain abscesses. Complications can include vision loss, ca
This document discusses optic neuritis, including its anatomy, classification, clinical presentation, diagnostic evaluation, and treatment. Some key points:
- Optic neuritis is inflammation of the optic nerve that can occur in any part of its course from the eye to the brain.
- It is classified ophthalmoscopically into retrobulbar neuritis, papillitis, and neuroretinitis depending on the location of nerve involvement.
- Common causes include multiple sclerosis, infections, and autoimmune disorders.
- Clinical features include acute unilateral vision loss, eye pain on movement, and color vision changes.
- MRI of the brain and orbits with contrast is useful to evaluate for other
Optic nerve atrophy refers to degeneration of the optic nerve fibers leading to loss of vision. It can be primary, resulting from conditions like glaucoma, or secondary to disorders that first affect the retina or optic nerve like papilledema. Primary atrophy presents with a pale white disc with clear margins, while secondary atrophy shows a dense white disc with blurred margins and proliferation of fibrous tissue on the disc and vessels. Symptoms include progressive vision loss depending on degree of nerve fiber loss, and examination finds reduced acuity and visual field defects reflecting the extent of optic nerve damage. Treatment targets the underlying cause when possible.
This document discusses various types of cataracts, their causes, symptoms and management. It describes how cataracts can be primary/age-related or secondary due to other ocular diseases, systemic conditions like diabetes or medications. Trauma is also a common cause of unilateral cataract in young individuals. The document provides details on clinical findings, mechanisms and treatment of different cataract subtypes.
This document discusses corneal transplantation, including definitions, types (penetrating keratoplasty and lamellar keratoplasty), indications, donor evaluation and storage, contraindications, surgical techniques, and postoperative care and complications. It provides details on penetrating keratoplasty, including that it is the most common type and its main indications are diseases involving all corneal layers. It also summarizes anterior and posterior lamellar keratoplasty.
1) Hypermetropia, also known as farsightedness, is a refractive error where parallel rays of light from infinity focus behind the retina when accommodation is at rest.
2) There are different types of hypermetropia including axial, curvatural, and pathological. The most common form is simple hypermetropia which can be hereditary.
3) Treatment options for hypermetropia include spectacle correction with convex lenses, contact lenses, and refractive surgery depending on the amount of refractive error and presence of symptoms.
Astigmatism is a refractive condition where the eye's refractive power varies in different meridians, causing blurred vision. It occurs when the cornea or lens is irregularly curved or positioned. Common causes are corneal abnormalities, lenticular conditions, or retinal placement issues. Symptoms include blurred distance and near vision. Diagnosis involves visual acuity tests, autorefraction, keratometry, and retinoscopy. Treatment options are spectacle lenses, toric contact lenses, and refractive surgery such as PRK or LASIK.
This document discusses various types of blepharitis, their signs and symptoms, and treatment approaches. It covers common forms of blepharitis like seborrheic blepharitis and ulcerative blepharitis. Complications from untreated blepharitis like trichiasis and madarosis are also mentioned. Treatment typically involves gentle removal of scales, warm compresses, antibiotic and steroid eye ointments, and occasionally oral antibiotics.
Anterior ischemic optic neuropathy (AION) refers to infarction of the anterior part of the optic nerve and is caused by occlusion of short posterior ciliary arteries, resulting in sudden vision loss. There are two types: arteritic AION (A-AION) caused by giant cell arteritis and non-arteritic AION (NA-AION) which may be associated with conditions like diabetes or hypertension. A-AION is treated as a medical emergency with high-dose steroids to prevent bilateral blindness, while there is no established treatment for NA-AION.
CORNEAL DEGENERATION AND DYSTROPHIES.pptxdratulkranand
This document discusses various types of corneal dystrophies including:
1. Epithelial basement membrane dystrophy which presents as dot-like opacities and can cause recurrent erosion.
2. Fuchs' endothelial dystrophy which typically affects females over 50 and is characterized by guttata and progressive edema.
3. Granular dystrophy which presents as milky deposits in the anterior stroma.
4. Keratoconus which presents as a conical protrusion of the cornea causing irregular astigmatism.
5. Posterior polymorphous dystrophy which has variable lesions at the level of Descemet's membrane.
It provides descriptions, classifications, inheritance patterns
This document discusses various topics related to ophthalmic drugs including:
- 4 routes of drug administration including topical, periocular injection, intraocular injection, and systemic administration.
- Classes of drugs used for treating eye infections like penicillins, cephalosporins, aminoglycosides, fluoroquinolones, macrolides and others.
- Anti-fungal drugs like amphotericin B, natamycin, azoles.
- Classes of drugs used for lowering intraocular pressure in glaucoma like cholinergic drugs, adrenergic agonists, beta blockers, prostaglandin analogues, carbonic anhydrase inhibitors, and hyperosm
This document discusses cataract surgery techniques and complications. It provides information on preoperative medications, different types of cataract surgery procedures including ICCE, ECCE, phacoemulsification, and SICS. It discusses types of intraocular lenses, surgical steps for different procedures, advantages and disadvantages of techniques, and potential postoperative complications.
This document discusses various types and causes of cataracts. It provides details on cataracts caused by diabetes, radiation, trauma, genetics and other medical conditions. Examination steps for evaluating a patient for cataract surgery are outlined, including testing visual acuity, slit lamp examination, dilation, and assessing the lens, anterior chamber, retina and other structures. Considerations for cataract surgery like intraocular lens implantation and managing comorbidities are also mentioned.
This document provides information about cataracts, including their classification, causes, symptoms, and progression. It discusses the following key points:
1. Cataracts are opacities of the lens or its capsule that can be developmental or acquired. Acquired opacities typically progress until the entire lens is involved.
2. Cataracts are caused by degeneration and opacification of lens fibers due to abnormalities in lens proteins and fiber organization.
3. Cataracts can be classified by anatomic location (e.g. cortical, nuclear), etiology (e.g. senile, traumatic), and maturity (immature, mature, hypermature).
4. Senile
Dr. Atul Kumar Anand discusses primary congenital glaucoma, which occurs due to a developmental defect in the trabecular meshwork and anterior chamber angle. It affects about 1 in 10,000 births and is usually diagnosed within the first year of life. The main symptoms are photophobia, epiphora, and blepharospasm. Examination reveals corneal edema, enlargement, and increased intraocular pressure. The primary treatment is surgical, through procedures like goniotomy or trabeculotomy to relieve pressure and allow drainage of fluid from the eye. Follow-up is required over an indefinite period to monitor intraocular pressure and optic nerve changes.
This document discusses aphakia, which is the absence of the crystalline lens from the eye. It defines aphakia, describes the causes including congenital absence and surgical removal of the lens. It outlines the changes that occur in the eye with aphakia such as high hypermetropia. Methods for correcting aphakia are discussed including spectacles, contact lenses, and intraocular lens implantation. Pseudophakia is defined as the condition when aphakia is corrected with an intraocular lens.
This document discusses uveitis, an inflammatory condition of the uveal tract of the eye. It defines uveitis and outlines its various classifications based on location, course, pathology, and cause. Anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis are described. The document also covers clinical features, complications, investigations, and management of uveitis.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central19various
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
3. Quadrangular pyramid or pear shaped
space b/w anterior cranial fossa above &
maxillary sinus below.
Formed by portion of Seven bones (viz: 1.
frontal, 2. maxilla, 3. zygomatic, 4.
sphenoid, 5. palatine, 6. ethmoid, 7.
lacrimal
Nasal bone not involved in orbit formation
4.
5. Has four walls, base & apex
Roof: by 2 bones, triangular shape, orbital
plate of frontal & lesser wing of
sphenoid.(lacrimal gland in superotemporal part, so its
tumor push globe inferonasally)
Lateral wall: by 2 bones, greater wing of
sphenoid & zygomatic Thickest wall,
Floor: by 3 bones, zygomatic maxillary &
palatine, quite thin wall, frequently invoved in
blow out fracture.
6. Medial wall: by 4 bones frontal process of maxilla,
lacrimal ethmoid & sphenoid Thinnest wall {so
infection of ethmoidal sinus spread easily to orbit
causes orbital cellulitis, specially in child as orbital
plate of ethmoid [lamina papyracea ] is absent in child}
has lacrimal fossa formed by lacrimal bone & frontal
process of maxilla
Base of orbit: anterior open end of orbit,
bounded by thick orbital margin
7. Apex of orbit:
posterior end of
orbit , all four
orbital wall
converge here,
has two orifices
optic canal &
superior orbital
fissure
8. Volume of orbit: 30cc, about 1/5th occupied
by eyeball( 6.5cc)
Other content of orbit include part of optic
nerve, EOM, lacrimal gland, lacrimal sac
ophthalmic artery, 3rd, 4th,6th, ophthalmic &
maxillary division of 5th cranial nerves
sympathetic nerve, orbital fat & fascia
Depth of orbit 40mm
Inter orbital distance 25mm
9. Lies b/w roof & lateral wall of orbit in gap
b/w lesser & greater wing of sphenoid.
Comma shaped, 22mm long,longest
connection b/w orbit & middle cranial fossa
Two parts: narrow lateral portion & wider
medial portion, at the junction of two is
spina recti lateralis –LR originates here
10.
11. Structure passing above common tendinous
ring: lacrimal nerve. Frontal nerve, trochlear
nerve, superior ophthalmic vein & recurrent
laryngeal nervve
Structure passing within tendinous ring:
superior division of 3rd nerve, inferior division
of 3rd nerve, nasociliary nerve, 6th cranial
nerve, sympathetic root of ciliary ganglion,
inferior ophthalmic vein.
12. Formed by lesser wing & body of sphenoid
Vertically oval
Length 6mm, diameter 4mm
Transmits :1. Optic nerve & its meningeal
covering(dura, arachnoid, & piamater)
2. Ophthalmic artery
13. From surgical point of view 4 spaces which
are relatively self contained, within each of
which inflammatory process are contained for
a considerable time, if necessary, be opened
separately.
Subperiosteal space: potential space b/w
bone of orbital wall & periorbita(periosteum)
Peripheral/Extraconal space: b/w
periorbita & EOM.(peribulbar anaesthesia injection is
given in this space) tumor present here cause eccentric
proptosis.
17. Position: UL covers
1/6th of cornea, LL just
touches limbus.
Canthus: The two lids
meet each other at
medial & lateral angles.
Palpebral aperture
elliptical space b/w
lids, vertical 10-
11mm in centre,
horizontal 28-30mm
18. 2mm broad, divided by
punctum in two parts,
Medial Lacrimal portion is
rounded & devoid of
lashes or gland, lateral
ciliary portion consists of
a rounded anterior border,
a sharp posterior
border(placed against
globe) & an intermarginal
stripe(b/w the two
borders)
19. The Grey line(junction of skin &
conjunctiva) divides intermarginal stripe
into anterior part bearing eyelashes –
about100-150 in UL & half in LL and
posterior part on which openings of
meibomian glands are in vertically parallel
row, has surgical importance (splitting of lid
done at this level)
20.
21. Following layers from Anterior to Posterior
Skin: thinnest in the body, fine & elastic
Subcutaneous areolar tissue: very
loose, no fat, so easily distended by edema
Layers of striated muscle: contains
orbicularis oculi forms an oval sheet across
eyelid, it closes eyelids. In UL also contains
Levator Palpebrae Superioris(LPS), it arises
from apex of orbit & inserted by three parts
22. On skin of lid, anterior surface of tarsal plate &
conjunctiva of superior fornix. It raises UL.
Submascular areolar tissue: loose
connective tissue nerves & vessels lie in this
layer
Fibrous layer: framework of lid, two parts,
central tarsal plate & peripheral orbital septum
Tarsal plate: one for each lid, give shape &
firmness to lid, upper & lower tarsal plate join
23. With each other at medial & lateral canthi &
attached to orbital margin by medial & lateral
palpebral ligaments.
Orbital septum: thin connective tissue attached
centrally to tarsal plate & peripherally to
periosteum of orbital margin.
Layers of non- striated muscle: contains
Muller muscle, in UL arises from LPS fibres & in
LL from prolongation of inferior
24. rectus, & inserted on peripheral margin of tarsal
plate.
Conjunctiva: lines the lid & this part of
conjunctiva KA palpebral conjunctiva.
25.
26. Meibomian gland: modified sebaceous
gland, present in tarsal plate(KA Tarsal gland),
vertically parallel, in UL 30-40 & LL 20-30, duct
opens at lid margin, secretion constitute lipid
layer of tear film.
Gland of Zeis: modified sebaceous gland,
duct opens into follicles of eyelashes.
Gland of Moll: modified sweat gland(the only
sweat gland of lid), at hair follicle, open into hair
follicle or into duct of Zeis gland.
27. Both lid by marginal arterial arcade, UL
also by superior arterial arcade.
Veins: two plexus, post tarsal into ophthalmic
vein, pre tarsal into subcutaneous vein.
Lymphatics: lateral half of lids drain into
preauricular lymph nodes & medial half of lids
into submandibular lymph nodes.
28. Motor nerves: orbicularis by zygomatic
branch of facial,(in facial palsy lagophthalmos–
exposure keratitis) LPS by oculomotor & Muller
muscle by sympathetic fibre( in 3rd nerve palsy
ptosis due to LPS, complete ptosis, as in UL
Muller arise from LPS){ in Horner syndrome due
to sympathetic lesion ptosis due to Muller
muscle, so partial ptosis}
29.
30. A translucent
mucous
membrane which
lines posterior
surface of the
eyelids and
anterior aspects of
the sclera.
‘Conjoin’ means to
join (it joins the
eyeball to the
eyelid)
31. 1. Palpebral Conj : it lines the eyelid,
firmely adherent
(sulcus subtarsalis: shallow groove common
location for extraocular FB)
2. Bulbar Conj : loosely adherent to
anterior sclera, moved easily, 3mm ridge
around cornea KA limbal conjunctiva,
where its epithelium becomes continuous
with that of corneal epithelium.
32. 3. Conjunctival Fornix : joins the bulbar
conjunctiva with palpebral conjunctiva.
(divided into superior, inferior, medial &
lateral fornices.)
33. Three layers :
Epithelium : stratified sq. non keratinized
Adenoid layer : also KA lymphoid layer
Fibrous layer
34. Two types
Mucin secretory glands : are goblet
cells (crypts of Henle in palpebral conj. &
glands of Manz in limbal conj.) secret
mucin : a component of tear
Accessory lacrimal gland : glands of
Krause & glands of Wolfring.
35. Pinkish crescentric
fold of conj. in
medial canthus,
lateral free border
concave, vestigeal
str. in human,
represents
nictitating memb. of
lower animal
36. Small ovoid pinkish
mass in inner
canthus, just medial
to plica semilunaris,
piece of modified
skin, so contains
sweat & sebaceous
gland & hair follicles
37. Arteries : peripheral arterial arcade of the
eyelid
marginal arcade of the eyelid
anterior ciliary arteries
Veins : drain into the venous plexus of the
eyelid
38. Arranged in two layers : superficial &
deep
From lateral side drain into
Preauricular lymph node
From medial side drain into
submandibular lymph node
39. Circumcorneal zone by branch from
long ciliary nerve
Rest of conjunctiva by branches from
lacrimal, infratrochlear, supratrochlear,
supraorbital & frontal nerves
44. Whole outer surface covered by Tenon’s
capsule, in anterior part it is also covered
by bulbar conjunctiva.
Inner surface lies in contact with choroid
with a potential suprachoroidal space in
between. It is pierced by anterior Ciliary
arteries & episcleral vein anteriorly and
vortex vein, posterior ciliary nerve &
vessels and optic nerve posteriorly.
45. Thee layers:
Episcleral tissue: thin vascularised layer.
Sclera proper: an avascular structure.
Lamina fusca: innermost layer.
Nerve supply: by branches from long
ciliary nervs which pierce it 2-4mm from
limbus & form a plexus.
46. Refractive power about +45D (about 3/4th
of total refractive power{+60D} of eye)
Refractive index 1.376 (1.38)
Thickness: central 0.5-0.6mm , peripheral
1.2mm
Diameter horizontal 11.7, vertical 10.6
Avascular & devoid of lymphatics.
47.
48. Five layers:
Epithelium: stratified sq. non keratinized, 5-6
layer, excellent property to regenerate(from
epithelial stem cell present as Palisade of Vogt at limbus)
Bowman’s layer: condensed superficial
stroma, does not regenerate, once damaged
leaves opacity
Stroma: thickest layer(90% thickness)
consists of collagen fibrils(lamellae)
49. Descemet’s membrane: strong layer, very
resistant to chemical agent, trauma, &
infection, can regenerae to some extent.
Endothelium: single layer, hexagonal cells,
density at birth 2500- 3000
cells/mm2,(specular microscopy) with age
No. decreases, 1500-2000 cells/mm2 in adult,
does not regenerate but adjacent cell slide to
fill in a damaged area, have Na+K+ATPase
pump, imp. role in transparency of cornea.
50. By long ciliary nerve which is branch
of ophthalmic division of the 5th cranial
nerve.
Nerve fibres are unmyelinated.(forms
three plexus).
Due to dense nerve supply cornea is
extremely sensitive.
51. Tear film for maintaining corneal epithelial
cell healthy.
Relative Dehydrated State: maintained
by barrier effect of hydrophobic epithelium,
endothelium, endothelial pump & osmotic
gradient of tear & aqueous(as hypertonic). epithelium
& endothelium maintain steady fluid content of
cornea(trauma to either of these layers produce corneal
edema, in acute glaucoma raised IOP open endothelial
pump pushing aqueous into cornea causing edema----
compromising transparency.
52. Avascularity
Unmyelinated nerve fibres
Uniform refractive index of all layers
Uniform spacing of collagen fibrils in
stroma(lattice arrangement of corneal
lamella) collagen fibrils are separated by a distance
which is less than wavelength of light(400-700nm) so
any irregularly refracted rays of light are eliminated by
destructive interference. If increase in separation or
loss of this arrangement cornea becomes opaque.
53.
54. From anterior to posterior
three parts:
Iris
Ciliary body
Choroid
55. Anterior most part of
uveal tissue
Diameter – 21mm
Central aperture 3-4mm in
diameter KA pupil,
regulate amount of light
reaching retina
At periphery attached to
anterior surface of ciliary
body, where iris is
thinnest
Divides space b/w cornea
& lens into anterior &
posterior chamber
56. Divided by collarette
(thickest part, 2mm from
pupil) into inner pupillary
zone & outer ciliary zone.
Crypts are depressions
where superficial layer of
iris missing, present in
ciliary zone, arranged in
two rows:- peripheral
present near iris root &
central present near
collarette, allows easy
transfer of fluid b/w iris &
anterior chamber
57. From anterior to posterior:
Anterior limiting layer: (previously KA endothelial
layer) consists of melanocytes & fibroblast, so color of
iris depends on this layer, deficient in crypts
Iris Stroma: consists of loose connective tissue, in it
embedded:- sphincter pupillae, dilator pupillae muscle
vessels, nerves, pigment cells
Sphincter pupillae: circular 1mm broad smooth
muscle, form a ring all around pupillary margin, derived
from neuroectoderm, supplied by 3rd cranial
nerve(parasympathetic), constrict the pupil
58.
59. Dilator pupillae: thin
layer of plain muscle fibre,
extend from pupil to iris,
supplied by cervical
sympathetic nerve, dilates
the pupil.
Anterior epithelial
layer: anterior
continuation of pigment
epithelium of retina &
ciliary body
60. Posterior pigmented epithelial layer: anterior
continuation of non pigmented epithelium of ciliary body.
Nerve supply:
Iris richly supplied by sensory nerve fibres from
trigeminal nerve
Sphincter pupillae by 3rd CN(parasympathetic)
Dilator pupillae by cervical sympathetic chain
61.
62. Forward continuation of
choroid at ora serrata,
begins 1mm behind limbus,
in cut section triangular in
shape, two parts: -Anterior
part( 2mm) have finger like
ciliary process(KA Pars
Plicata ) each process
2mm long & 70-80 in NO.
These are site of aqueous
production. Posterior
smooth part (4mm) KA
Pars Plana
64. Microscopic structure :- from without inwards(5 layers)
Supraciliary lamina
Stroma
Layers of pigmented epithelium
Layers of non-pigmented epithelium
Internal limiting membrane
Stroma of ciliary body contain ciliary muscle(smooth
muscle),which has 3 parts, outermost– longitudinal, middle–
oblique(radial), & inner-- circular, action –
Accommodation(helps in near vision), this is mainly done by
circular & radial part of muscle
Resting tone of ciliary muscle is +1D
Richly supplied with sensory nerve fibres fom trigeminal nerve
ciliary muscle supplied with motor fibre by 3rd CN
65.
66. Posterior most part of uveal
tissue, extremely vascular,
pigmented
Extends from optic disc to
ora serrata
Inner smooth brown surface
lies in contact with RPE of
retina
Outer rough surface lies in
contact with sclera with a
potential space in between
the two KA supra- choroidal
space
67. From without inwards
following layers
Suprachoroidal lamina or
lamina fusca: supra-
choroida space b/w this &
sclera, contains long &
short posterior ciliary
arteries & nerves
Stroma: loose connective
tissue, contains layersof
large vessels, layer of
medium vessels, & layer of
choriocapillaris
68. Basal lamina/Bruch’s membrane: firmly
adherent to RPE
Choroid is supplied with sensory nerve
fibres from trigeminal nerve (so sensory
supply of whole uvea by trigeminal nerve)
69. Uveal tract is supplied by:- ciliary arteries, which are divided
into three groups– short posterior, long posterior & anterior
Short posterior ciliary arteries – supply choroid
Long posterior ciliary & anterior ciliary arteries -- supply iris &
ciliary body
Short posterior ciliary arteries: arise as two trunks
from ophthalmic artery; each trunk divides into 10-20
branches which pierce sclera in a ring around optic nerve &
supply choroid in a segmental manner.
Long posterior ciliary arteries: two in NO.(nasal &
temporal), derived from ophthalmic artery, pierce sclera
obliquely on medial(nasal) & lateral(temporal) side of optic
nerve & run forward in supra choroidal space to
70. reach ciliary muscle, without giving any branch. At anterior
end of ciliary muscle these anastomose with each other &
with anterior ciliary arteries & gives branches which supply
ciliary body.
Anterior ciliary arteries: derived from muscular
branches of ophthalmic artery. 7 in NO. 2 each from arteries
of SR, IR & MR and one from that of LR muscle. These
arteries pass anteriorly in episclera, give branches to sclera,
limbus & conjunctiva and ultimately pierce sclera near
limbus to enter ciliary muscle where they anastomose with
two long posterior ciliary arteries to form circulus arteriosus
major(major arterial circle),near root of iris
71. Several branches arise from circulus arteriosus major &
supply ciliary processes(one branch for each process).
Similarly, many branches from this major arterial circle run
radially through iris towards pupillary margin, where they
anastomose with each other to form circulus arteriosus
minor(minor arterial circle)
Major arterial circle: site-- on ciliary body & root of iris,
made of long posteror ciliary arteries & anterior ciliary
arteries.
Minor arterial circle: present at collarette of iris.
Venous drainage: series of small veins which
drain blood from iris, ciliary body & choroid join to form
vortex vein
72. Vortex vein are 4 in NO.-
superotemporal, inferotemporal,
superonasal & inferonasal. They pierce
sclera behind equator & drain into superior &
inferior ophthalmic veins which ultimately
drain into cavernous sinus.
73. Coloboma means absence of tissue
Congenital coloboma of iris, ciliary body & choroid may be
seen in association or independently.
May be typical or atypical
Typical coloboma: seen in inferonasal quadrant, occurs
due to defective closure of embryonic fissure.
Atypical coloboma: found in other position
Complete coloboma: extends from pupil to optic nerve,
with sector shaped gap involving retina, choroid, ciliary
body, iris & indentation of lens where zonular fibres
missing
74.
75.
76. Extends from optic disc to
ora serrata
Purplish red background
colour due to RPE &
vascular choroid
Neurosensory retina is
transparent
Divided into two region :
posterior pole and
peripheral retina by
imaginary line called
retinal equator.
77. Retinal equator: an imaginary line, considered to lie in
line with exit of 4 vortex vein.
Ora serrata: serrated peripheral margin where retina
ends, here retina firmly attached both to vitreous &
choroid.
Retina posterior to equator is posterior pole (& anterior to
equator upto ora serrata is peripheral retina which is best
examined by indirect ophthalmoscope)
Posterior pole have two distinct area: Optic disc &
Macula lutea.
78. Optic disc(ONH):
pink coloured, 1.5mm
diameter, only layer
peresnt- nerve fiber layer
which pass through
lamina cribrosa to run into
optic nerve. A depression
seen in disc KA
physiological cup, normal
C:D ratio=0.3, (increase in
glaucoma)
79. On Optic Disc--No photoreceptors,--if light falls—no
visual Impression excited, so KA BLIND SPOT.
Disc Diameter(1.5mm)– unit of measurement in retina.
Central retinal artery & vein emerge through centre of
Cup
Macula Lutea: also KA yellow spot, small,
circular area, comparatively deeper red due to pigment
xanthophyll, 5.5mm in diameter, situated about
3mm(2DD) temporal to optic disc & a little below the
horizontal meridian,
Fovea centralis: depression in centre of macula,
1.5mm(1DD) in diameter, 6-8 layers of ganglion
cells(outside macula only one layer)
80.
81. Foveola: central depression in fovea, 0.35mm in
diameter, only cones, no rod present, THINNEST part of
retina, one cone connected to one ganglion cell( in rest of
retina one ganglion cell connected to 100 cones),so
vision most acute at foveola
Site of maximum vision- foveola> Fovea> Macula.
Foveal Avascular Zone(FAZ): no retinal blood
vessels at fovea itself & for a short distance around the
centre known as FAZ.
Thickness of retina: not uniform, 100 micron at ora
serrata, 350 micron at macula(THICKEST), 90micron at
foveola(THINNEST)
84. RPE: outermost layer, extends from ONH to ora serrata,
single layers of cells firmly adherent to Bruch’s
membrane of choroid but loosely to rods & cones, many
function, also macrophagic function, forms part of outer
Blood Brain Barrier
Layers of rods & cones: name derived from shape of
cell--- rods– long & cylindrical, cones – conical, Rods
contain photosensitive pigment Rhodopsin, helps in
peripheral vision & dim light vision(Scotopic vision),
about 120 milions rods & 6.5 millions cones in retna,
cones help in central vision(photopic vision) & color
vision
85. ONL: consists of nuclei of rods & cones
OPL: involved layer in CME
RNFL: consists of axons of ganglion cells which
pass through lamina cribrosa to form optic nerve,
layer damage in glaucoma.
ILM: innermost layer that separates retina from
vitreous.
86. Outer 4 layers of retina(RPE, layers of rods &cones, ELM &
ONL) get nutrition from choroidal vessels
Inner 6 layer supplied by central retinal artery, a branch of
ophthalmic artery.
Central retinal artery: emerges from centre of cup of optic
disc ÷s into 4 branches namely: supero-nasal,
supero-temporal, infero-nasal, infero-temporal. These are
end arteries(do not anastomose with each other)
Retinal veins follow pattern of retinal arteries Central
retinal vein drains into cavernous sinus directly or through
superior ophthalmic vein.
87.
88. Transparent,Biconvex
crystalline structure
placed b/w iris &
vitreous KA patellar
fossa
Diameter 8.8-9.2mm
Antero-posterior
thickness changes
with accommodation
Has two surfaces:
anterior surface less
89. Convex( radius of curvature 10mm) than
posterior(radius of curvature 6mm), these two
surfaces meet at equator. Anterior surfaces
shortens with accommodation.
Lens grows throughout life(unique organ), weight
at birth 65mg & by 80 yrs 258mg
35% refractive power eye(power +18 to 20D)
refractive index 1.42(nucleus has high RI than
cortex) accommodative power of lens varies with
age(at birth 14-16D,7-8D at 25yrs,1-2D at 50yrs
of age)
90. Composed of 64% water, 35% protein & 1%
lipid carbohydrate & trace element(protein
concentration in lens is highest amongst
body tissue), main type of protein are
alpha[31%] beta[55%] & gamma[2%]
crystallins{so called crystalline lens} and
insoluble albuminoids[12%]
91.
92. Lens capsule: thin, transparent, elastic, anterior
capsule is 3 times thicker than posterior. Thickest at pre-
equator region & thinnest at posterior pole
Anterior epithelium: single layer cuboidal cells
linnig anterior capsule, cells are of two types, in central zone
not actively dividing, in pre-equatorial germinative zone that
give rise to lens fibre. Lens fibre elongates undergo
differentiation, loss of cell organelles & nucleus. As new lens
fibre form, older one pushed towards depth of lens, so
youngest fibres are most superficially located (no
correspondig posterior epithelium)
93. Nucleus: central part consists of densely compacted,
oldest fibre, depending upon period of development
different zone of lens nucleus:
Embryonic nucleus: innermost part of nucleus, upto 6-
12 weeks of embryonic life. Primary lens fibre.
Fetal nucleus: around embryonic nucleus, upto 3-8
months of fetal life, fibres meet around sutures, anterior
Y shaped, posterior inverted Y shaped, secondary lens
fibres.
Infantile nucleus: last month of IU life till puberty.
Adult nucleus: after puberty to rest of life.
Cortex: peripheral part b/w capsule & nucleus.
94. Suspensory ligament: that suspend
lens from ciliary body, attached to ciliary
process of pars plicata & pars plana’
Holds lens in position & have role in
Accommodation--- ciliary muscle
contracts---- zonules relax--- lens more
convex(increase in lens power)--- near
object better viewed (accommodation)
95. Maintained by regular arrangement of lens fibres which
are devoid organelles & nucleus.
Avascularity
Devoid of nerve supply
Pump mechanism of lens fibre membrane that regulate
electrolyte & water balance, maintaining Relative
Dehydration.
Loss of transparency--- opacity--- cataract
98. Main lacrimal gland: 95% of aqueous component of
tear, two parts
Orbital parts: large superior part, lies in anteolateral
part of roof of orbit in orbital plate of frontal bone(fossa for
lacrimal gland)
Palpebral part: small inferior part, lies in fornix &
palpebral conjunctiva
Lacimal gland is tubulorecemose gland
Duct of lacrimal gland: 10-12 ducts open in lateral part of
superior fornix, 1-2 duct in lateral part of inferior fornix
99. Main lacrimal gland is supplied by lacrimal artery, a branch
of ophthalmic artery
Lymphatics: to conjunctival lymphatics—preauricular lymph
nodes
Nerve supply: sensory supply from lacrimal nerve, a branch
of ophthalmic division of 5th nerve
Accessory lacrimal gland: 5% of aqueous
component of tear, gland of Krause in palpebral conjunctiva–
about 42 in upper fornix, 6-8 in lower fornix, gland of
Wolfring—superior &inferior tarsus
100. Puncta: one small
opening each on upper &
lower lid on papila
lacrimalis, prominent in old
age, normally puncta dip
into lacus
lacrimalis(collection of tear
in medial canthus)
Canaliculi: join puncta to
lacrimal sac, two parts:
vertical(2mm) &
horizontal(8mm), horizontal
part converge towards
inner canthus to open in
sac
101. Two canaliculi may open
separately or may join to form
common canaliculus which
opens in lacrimal sac, common
canaliculus– guarded by valve
of Rosenmuller– prevents
reflux of tear from sac to
canaliculi
Lacrimal sac:10-15mm long,
lies in lcrimal fosaa(formed by
lacrimal bone & frontal process
of maxilla) b/w anterior &
posterior lacrimal crest in
medial wall of orbit.
102. Sac has 3 parts: Fundus(portion above opening of
canaliculi), Body(middle part),& Neck(lower small part
continuous with NLD)
In front of sac Medial Palpebral ligament(MPL), Angular vein
crosses MPL 8mm from medial canthus
Nasolacrimal Duct(NLD): 24mm long, extends from
neck of sac to Inferior meatus of nose Direction:-
backwards, laterally & downwards, externally its location
represented by a line joining inner canthus to ala of nose,
opening(lies 3cm from external nare) guarded by valve
of Hasner which prevents reflux from nose
103.
104.
105. Plays an important
role in aqueous
drainage
Clinically angle
structures seen by
Gonioscope/Goniol
ens
106. From anterior to posterior
Schwalbe’s Line(SL): corresponds to
peripheral termination of Descemet’s membrane
of cornea.
Trabecular Meshwork(TM): - 2 parts
Parts adjacent to schwalbe’s line – whitish, non-
functional
Functional part – pigmented, lies adjacent to
schlemm’s canal
107. Scleral Spur(SS): part that is attached to
longitudinal part ciliary muscle
Ciliary Body Band(CBB): dull brown
Root of Iris(ROI):
108. it includes:-
Trabecular meshwork: sieve like structre,
consists of three portion:--Uveal meshwork,
Corneoscleral meshwork & juxtacanalicular
meshwork
Schlemm’s canal:
Collector channels:
Aqueous vein:
Episcleral vein:
109.
110. Grade Angle width
in degree
Structures
visible on
gonioscope
Configration Chances of
closure
0 0 None of angle
structure
Closed angle Closed
I 10 SL only Very narrow High
II 20 SL, TM Narrow Possible
III 20-35 SL, TM, SS Open angle Nil
IV 35-45 SL, TM, SS,
CBB
Wide open NIl
111.
112.
113.
114. 6 in NO.
4 recti & 2 obliques
SR
IR
MR
LR
SO
IO
115. All EOM (Except IO)
originate from a common
tendinous ring(annulus of
zinn) attached at orbital
apex .
All recti inserted into sclera
anterior to equator by flat
tendons at different
distances from limbus as
under
MR – 5.5mm (closet to limbus)
IR – 6.5mm
LR – 7mm
SR – 7.7mm (farthest from
limbus)
116. SO: arises from orbital apex run forward & turns
around a pulley(KA trochlea present at anterior
part of superomedial angle of orbit) & inserted in
upper & outer part of sclera behind equator.
IO: arises anteriorly from lower & inner orbital
wall near lacrimal fossa, passes laterally &
backward to be inserted into lower & outer part
of sclera behind equator.
Nerve Supply: SO4, LR6 & RO3
117. Muscle Primary action Secondary action Tertiary action
MR Adduction
LR Abduction
SR Elevation Intorsion Adduction
IR Depression Extorsion Adduction
SO Intorsion Depression Abduction
IO Extorsion Elevation Abduction