The document summarizes the blood and nerve supply of the eye and optic nerve. It discusses the arterial supply which comes from branches of the internal and external carotid arteries. It then describes the specific branches like the central retinal artery and posterior ciliary arteries. It provides details on the venous drainage and nerve supply including the trigeminal, oculomotor, trochlear and abducent cranial nerves. In summary, it provides an overview of the arterial blood supply, venous drainage and cranial nerve innervation of the eye and optic nerve.

1. BLOOD AND NERVE SUPPLY OF
EYE AND OPTIC NERVE
Presenter – Dr. Om Patel
Moderator – Dr. Rashi Sharma

2. Arterial supply
• Internal carotid artery
• External carotid artery

3. Arterial supply
• All structures are supplied by branches of
Internal Carotid Artery
• Except eyelids and conjunctiva which receives
blood supply from the branches of both
internal and external carotid artery

4. INTERNALCAROTID
CERVICAL
PETROUS
CAVERNOUS
CEREBRAL
OPHTHALMIC

6. Post.Ciliary
(supply the
choroid and
parts of the
optic nerve)
Internal carotid a.
Supratrochlear a. &
Dorsal Nasal a.
Ant. ethmoidal a.
Post. ethmoidal a.
Ophthalmic a.
Lacrimal a.
Muscular Branches.
(Ant.ciliary arteries
are derived from it)
Central Retinal Art.
Branches of ophthalmic artery:

7. Central retinal artery
• First branch from the ophthalmic artery
• End arteries
• Divides into equal superior & inferior branches,
then another division (nasal & temporal)

8. Central retinal artery
Runs along optic nerve, then at about 1.25cm behind eyeball it pierces the
dural & arachnoid sheaths of optic nerve, enters eyeball through lamina
cribrosa

9. Central retinal artery
9
Meningeal Branches
Central Collateral
Branches
Pial Sheath
Macular Nerve
Fibres

10. Two Ciliary arteries (on each side of
the optic nerve)
• Divide into 2 long posterior ciliary
arteries and ~20 short posterior
ciliary arteries
• The short posterior ciliary arteries
directly supply the choroid and take
part in formation of Circle of Zinn
• The long posterior ciliary arteries
travel in the suprachoroidal space
anteriorly then supply the choroid
anteriorly via recurrent branches
Ciliary arteries

11. Circle Of Zinn
• Circular anastomosis
between short posterior
ciliary arteries when they
are piercing the sclera
• Gives branches to choriod,
optic nerve and pial
network
• Cilioretinal artery – helps to
maintain vision in case of
CRA occlusion

12. Anterior Ciliary arteries
– 7 arteries 2 for each rectus
muscle except LR muscle
– Takes part in formation of
Major arterial circle along
with long posterior ciliary
artery
– Supplies ciliary body and
iris

13. Eyelids
• Arterial blood supply:
– Lateral Palpebral artery
(from lacrimal artery)
– Medial Palpebral artery
( from dorsal nasal artery)
• Marginal and peripheral
palpebral arcades

14. Venous drainage:
• Medially: to
angular vein
• Laterally: to
superficial
temporal vein

15. Nerve supply:
Sensory Supply
• Lower lid:
– infra-orbital (from V2)
– Medial Aspect  infra-
trochlear nerve (V1)
• Upper lid:
– Supra-orbital nerve
– Supra-trochlear nerve
– Lacrimal nerve (v1)

16. Nerve Supply - Eyelids
• Arrangement of sensory nerves
– Submuscular plane
– Site of injection for anesthesia
• Motor Supply
– Facial Nerve – Orbicularis muscle
– Oculomotor nerve – LPS

17. Conjunctiva
• Palpebral conjunctiva marginal and peripheral arcades
(from medial and lateral palpebral artery)
• Bulbar conjunctiva  anterior and posterior conjuctival
arteries

18. Conjunctiva
• Venous drainage:
– superior and inferior ophthalmic vein
• Nerve supply:
– Long ciliary nerve (nasociliary branch of ophthalmic nerve)

19. Blood supply of the AC
Long posterior ciliary artery anastomose with anterior ciliary artery
– Major arterial arcade (ciliary stroma)
– Minor arterial arcade (At the collarete of the iris)
• They are the major blood supply to the iris and ciliary body
• Venous drainage:  minor venous circle directly into the
vortex veins (not into the corresponding major circle)

21. Macula Region
Supplied by Superior & Inferior temporal branches of central retinal artery
**In 20% population Cilioretinal Artery supplies macula.(in case of CRA occlusion it helps to retain vision)
• Outer-plexiform layer
• CRA + partially by choriocapillaries
• Inner nuclear layer, Inner Plexiform Layer,
Ganglion cell layer, Nerve Fibre Layer,
Internal Limiting Membrane
• Supplied by Central Retinal Artery
• RPE, Rodes and Cones ,External Limiting
Membrane, Outer Nuclear Layer
• Supplied by choriocapillaries
Retina

22. Venous Drainage Of Eye
• No valves
• Tortuous & freely anastomose with one
another

23. Venous Channels
• Superior ophthalmic vein
• Inferior ophthalmic vein
• Middle ophthalmic vein
• Medial ophthalmic vein
• Angular Vein
• Cavernous Sinus

24. Venous drainage of eye

25. Superior ophthalmic vein
• Formed by union of supraorbital & angular veins
• Communicates with Central Retinal Vein, receives
Inferior Ophthalmic Vein & 2 vorticose veins from the
upper part of the eyeball
• Leaves the orbit through superior orbital fissure to
join the cavernous sinus

26. Inferior Ophthalmic Vein
• Arises from venous plexus in orbital floor
• Communicates with pterygoid venous plexus
• Receives muscular branches & 2 inferior vorticose vein
• Joins superior ophthalmic vein or drains directly into the
cavernous sinus

27. Angular Vein
• Formed by supratrochlear and supraorbital veins
• Runs down the side of nose about 8 mm from the
medial canthus
• Important landmark for lacrimal sac surgery
• Continues as facial vein

28. Blood supply of Optic Nerve:
A. Intraocular part/ optic nerve head
• Cilioretinal artery
• Peripapillary choroidal vessels
• Vessels from zinn and heller
Surface nerve
fiber layer and
Prelaminar part
• Short Posterior Ciliary Arteries
Lamina cribrosa
region
• Central retinal artery
• Pial vessels
Retrolaminar

29. Periaxial System Axial System
Derived From branches of ICA Derived from branches of Central Retinal Artery
Ophthalmic Artery Cental Retinal Artery
Long posterior ciliary artery Central collateral branches
Short posterior ciliary artery Intraneural branch
Lacrimal Artery
Central Retinal Artery
B. Intraorbital part :

30. • The anterior portion of the nerve derives its blood supply from the posterior
ciliary arteries (PCA) and the choroid (C)
• The posterior optic nerve derives its blood supply from penetrating pial arteries
(Col br) and branches of the central retinal artery (CRA)

31. C .Intracanalicular part :
Periaxial system of vessels
D . Intracranial part :
Pial system of vessels

32. Venous drainage :
Optic nerve
head
• Central
retinal vein
Orbital part
• Peripheral
pial plexus
• Central
retinal vein
Intracranial
part
• Pial plexus
which ends
in anterior
cerebral &
basal vein

33. NERVE SUPPLY
• Sensory N/S – *Trigeminal nerve
(Mixed nerve) V
*Ophthalmic (V1) &
Maxillary(V2)
divison play main role of
eye sensation
• Motor N/S -- *Cranial nerve 3rd ,4th,6th
for ocular movements
*Cranial nerve 7th for
eyelid closure
• Sympathetic N/s --* Nasociliary branch of
ophthalmic nerve
• Parasympathetic N/S:-- * Occulomotor (3rd)

34. TRIGEMINAL NERVE
OPHTHALMIC MAXILLARY MANDIBULAR

35. •SUPRA-ORBITAL
•SUPRA-TROCHLEAR
•Ant.Ethmoidal –----- Supplies Ethmoidal Sinus
•Post.Ethmoidal ------ Supplies Sphenoidal Sinus
•Infratrochlear -------- Medial Eyelid
•Long Ciliary Nerves---Pierces Sclera & Supply
Cornea, Iris, Ciliary Body
•Sympathetic Fibres---Dilate Pupil
Supply
Forehead + Scalp +
Conjunctiva +
upper & central
eyelid
Supplies to
lateral eyelid +
lacrimal gland
+ conjunctiva
OPHTHALMIC
Frontal Nerve
Lacrimal Nerve
Nasociliary Nerve

36. The nerves of the orbit that enter through the superior orbital fissure
and supply the ocular muscles :
• Oculomotor (CN III)
• Trochlear (CN IV)
• Abducent (CN VI)

37. Thank You