Eye | Aesthesiology | Anjani Mishra

 Written by Anjani Mishra

Eye

The eye or organ of vision in the broader sense of the term, comprises the eye-ball or globe of the eye, the optic nerve and certain accessory organs associated there with. The accessory organs are the orbital fasciae, muscles of eye-ball, the eyelids, conjunctiva and the lacrimal apparatus.

The eye is special organ of the sense of sight. It is situated in the orbital cavity. It is smaller in diameter than the orbital cavity and the intervening space is occupied by the fatty tissue. The bony walls of the orbit and the fatty tissue help to protect the eye from injury.

Structurally the two eyes are the same, some of their activities are coordinated, so that they function as a pair. They are supplied by the optic nerve.


Structure

There are three layers of tissue which constitute the wall of the eye. They are;

1.      The outer fibrous layer: sclera and cornea

2.      The middle vascular layer: choroid, ciliary body & iris

3.      The inner nervous tissue layer: retina

The other structures includes;

4.      The lens

5.      The aqueous humor

6.      The vitreous body

The accessory structures include;

1.      The orbital fascia

2.      The muscles of eye-ball

3.      The eyelids

4.      The conjunctiva

5.      The lacrimal apparatus

1.      The outer fibrous layer

The sclera and cornea

The sclera: the sclera of the eye is composed of fibrous tissue which consists of mainly collagenous fiber with some elastic fiber. It is opaque and forms the outer layer of tissue of the posterior and lateral aspects of the eye-ball and is continuous anteriorly with the transparent cornea. It is a firm membrane and maintain the shape and form of the eye. It gives attachment to the extrinsic muscles of the eye.

The cornea: the cornea forms the anterior fifth of the fibrous tunic. It is transparent, colourless and non-vascular except at its periphery but posseses a well developed plexus of nerve. The light rays pass through the cornea to reach the retina. It is convex anteriorly and involved in the refraction or bending of light rays to focus them on the retina.

2.      The middle vascular layer:

The choroid, ciliary body & iris

The choroid: the choroid is a thin membrane which lies between the sclera and retina. It is very rich in blood vessels and is a deep chocolate brown in colour. Posteriorly the choroid is perforated by the optic nerve and anteriorly it is continuous with the ciliary body.

The ciliary body: the ciliary body is a continuation of the choroid anteriorly, consisting of non-striated muscle fibers (ciliary muscle) and epithelial cells. It gives attachment to a fine ligament called suspensory ligament, which at its other end is attached to the capsule of the lens. The contraction and relaxation of the ciliary muscle changes the thickness of the lens which bends the light rays entering the eye to focus them on the retina.

The epithelial cells secrete aqueous fluid into the anterior segment of the eye, that is the space in front of the lens between iris and cornea. It may also be associated with the secretion of the vitreous body which occupies the space behind the lens.

The iris: the iris is a muscular diaphragm of the eye, which extends anteriorly from the ciliary body covering the anterior one-sixth of the eye. It lies behind cornea and in front of the lens. It divides the anterior segment of the eye into anterior and posterior chambers which contain aqueous fluid. It is a circular body composed of pigment cells and two layers of muscle fibers, one circular and the other radiating. In the center, there is an aperture called pupil. The pupil varies in size depending upon the intensity of light present. In the bright light the circular muscle fibers contract and constrict the pupil. In dim light the radiating muscle fibers contract and dilate the pupil. The iris is the coloured part of the eye and its colour depends on the number of pigment cells present.

3.      The inner nervous tissue layer:

retina

The retina: the retina is the innermost layer layer of the wall of the eye. It is an external delicate membrane and specially adapted to be stimulated by light rays. It is composed of several layers of nerve cells and nerve fibers lying on a pigmented layer of epithelial cells which attached it to the choroid. It is described as the photosensitive part of the eye. The light sensitive cells in the retina are the rods and cones. Light rays cause chemicals changes in these cells and they emit nerve impulses which pass to the optic nerve. 

Accessory structures

The orbital fascia: the orbital fascia surrounds the contents of the orbit. It consists of three layers; the outer, middle and the deepest. The outer layer arises at the periphery of the optic foramen and extends forward to the eye lids; it sends septa between the eye muscles. This fascia is just under the periorbital and is thin.

The middle/second layer of fascia originates in the vicinity of the optic foramen and the orbital fissure. It also consists of two layers; the outer and inner layer.

The deepest/third layer of fascia is called Tendon’s capsule. This layer may be traced from the limbus area over the bulb and closely covers the retractor bulbi muscle to the optic foramen.

The muscles of eye ball: the eyes of domestic animals move within their orbits, and this movement results from the action of the extraocular muscles. All domestic animals, with the exception of the avian species, have the same extraocular muscles. However, the sizes of the muscles, the exact points of attachment and the exact innervation may show some slight difference.

There are seven extrinsic bulbi muscles; 4 rectus, 2 oblique and 1 retractor.

1.      Rectus dorsalis, ventralis, medialis and lateralis

2.      Oblique dorsalis and ventralis

3.      Retractor bulbi


Fig: Muscles of eye-ball (extrinsic)


                                          Fig: Muscles of eye-ball (extrinsic)

The eye lids: these are two fibrous sheets, attached to the periphery of the orbital margin which cover the anterior portion of the eye-ball when it is closed. The slit between them is known as palpebral fissure. They protect the eye, prevent drying of the cornea by distributing lacrimal secretions and contain glands that assist in lubricating the cornea and specially the margin of the lids. The outer surface of the lids is covered with stiff hairs termed cilia or eye lashes. The eye lids are composed of skin, subcutaneous areolar tissue, fibers from orbicularis oculi muscle and conjunctiva.


The conjunctiva: the membrane lining the eye lid and covering the eye-ball is known as conjunctiva. It is a thin transparent membrane which covers the front portion of sclera and cornea and is reflected to the inner surface of palpebral at the palpebral fissure. The portion lining the eye lid is called palpebral conjunctiva and the portion covering the eye-ball is known as bulbar conjunctiva. The line of reflection is known as fornix conjunctiva. When the eye lids are in apposition, the conjunctiva encloses a capillary space between the lids and eye-ball and is known as conjunctival sac. It protects the delicate cornea and the front of the eye.



Fig: Lacrimal apparatus

The lacrimal apparatus: the lacrimal apparatus comprises following structures;

Lacrimal and accessory gland

Lacrimal duct or excretory duct

Caruncula lacrimalis

Punctum lacrimalis

Lacrimal canals

Lacrimal sac

Naso-lacrimal duct

Lacrimal gland: The gland is situated below supraorbital process and inside of the upper lateral margin of the orbital cavity. The gland is lobulated and tubulo-acinar in structure. The secretion is conveyed through excretory duct (about 12 in number) to the superior conjunctival fornix. There is a triangular space at the medial angle of the eye known as lacus lacrimalis.

Caruncula lacrimalis: is a small rounded body situated in the lacus and helps in the flow of tears in proper direction.

Puncta lacrimalis: are minute orifices of the lacrimal canal at the lacrimal papilla, situated on the margin of each lid and close to the lacus lacrimalis.

Lacrimal canals: are two in number; superior and inferior. They connect lacus lacrimalis to the lacrimal sac.

Lacrimal sac: The sac is lodged in a fossa at the front end of the medial wall or the orbit.

Nasolacrimal duct: starts from the sac, passes through the nasolacrimal canal and opens on the external wall of the nostril.



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