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<b>DEPARTMENT OF ANATOMY</b>

THE EYES

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CORNEA

The cornea represents the strongest part of the refracting power of the eye, providing about 80% of
the power of the system. The index of refraction of the cornea is about 1.376. Rays pass from the cornea
into the watery fluid known as the aqueous humor which has an index of refraction of about 1.336,
so most of the refraction is at the cornea-air interface

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CORNEA

1. THE REFRACTING POWER: +45D (2/3)

2. THICK: 0.5mm-0.74/1mm
3. 11.6mm-10.6mm

1. THE REFRACTING POWER: +45D (2/3)
2. THICK: 0.5mm-0.74/1mm

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1
1

1(8ws)
1(8ws)
2
2

2 (thin scar)

3 (thick scar)

4 (very elastic)

-3500/4000cell de 2500cell adult

-Na/ATPase bump-aqueous humour supp: glucose, miner, vitC..
-Dehydration / transparent cornea

-3500/4000cell de 2500cell adult

-Na/ATPasebump-aqueous humour supp: glucose, miner, vitC..
-Dehydration / transparent cornea

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SCLERA

-thick: 1mm

-68%H<sub>2</sub>O

-thick: 1mm
-68%H2O

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CARCINOMA IN SITU

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CHOROID

1
1
2
2
3
3
4

4 55

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prod aque. humour

rad. mus. pΣ

(aque.hum. escape)

rad. mus. pΣ

(aque.hum. escape)

Zinn lig.
Zinn lig.

ACCOMMDATION

PRO. VITREOUS BODY

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RETINA

0.35mm

1.5mm

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1/3

2/3

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HYPERTENSIVE RETINOPATHY IS TRADITIONALLY DIVIDED INTO FOUR GRADES.

A, Grade 1 shows very early and minor changes in a young patient: increased tortuosity of a retinal
vessel and increased reflectiveness (silver wiring) of a retinal artery are seen at 1 o’clock in this view.
Otherwise, the fundus is completely normal.

B, Grade 2 also shows increased tortuosity and silver wiring (arrowheads). In addition, there is “nipping”
of the venules at arteriovenous crossings (arrow).

C, Grade 3 shows the same changes as grade 2 plus flame-shaped retinal hemorrhages and soft
“cotton wool” exudates.

D, In grade 4, there is swelling of the optic disc (papilledema), retinal edema is present, and hard
exudates may collect around the fovea, producing a typical “macular star.”

HYPERTENSIVE RETINOPATHY IS TRADITIONALLY DIVIDED INTO FOUR GRADES.

B, Grade 2 also shows increased tortuosity and silver wiring (arrowheads). In addition, there is “nipping”
of the venules at arteriovenous crossings (arrow).

C, Grade 3 shows the same changes as grade 2 plus flame-shaped retinal hemorrhages and soft
“cotton wool” exudates.

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AQUEOUS HUMOUR

0.25ml
0.25ml
0.05ml
0.05ml

1. maintains-regu intraocular pressure

2. nutrients, metabolic exchange for cornea-lens

3. constancy of the ocular dimensions of the eyeball

1. maintains-regu intraocular pressure

2. nutrients, metabolic exchange for cornea-lens

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GLAUCOMA

- Aqueous is formed by the nonpigmented cells of the
ciliary body by ultrafiltration of the blood, diffusion,
and active enzymatic secretion.

It flows into the posterior chamber, around the lens,
through the pupil into the anterior chamber and exits
the eye through the trabecular meshwork and the
Canal of Schlemm which leads to aqueous collector
veins which lead back to the systemic circulation.

The lower panel shows what happens in Primary Open
Angle Glaucoma, when the drainage ability of the

trabecular meshwork is impaired, aqueous cannot
drain, and intraocular pressure builds up.

- Aqueous is formed by the nonpigmented cells of the
ciliary body by ultrafiltration of the blood, diffusion,
and active enzymatic secretion.

It flows into the posterior chamber, around the lens,
through the pupil into the anterior chamber and exits

the eye through the trabecular meshwork and the

Canal of Schlemm which leads to aqueous collector
veins which lead back to the systemic circulation.

The lower panel shows what happens in Primary Open
Angle Glaucoma, when the drainage ability of the

trabecular meshwork is impaired, aqueous cannot
drain, and intraocular pressure builds up.

Pilocarpin2%

Stress-catechole

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In glaucoma, the visual field becomes constricted, leading to loss of peripheral

vision first and ultimately to blindness.

In glaucoma, the visual field becomes constricted, leading to loss of peripheral

vision first and ultimately to blindness.

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LENS

1
1

About 9mm in diameter and 4 mm thick, the crystalline lens provides perhaps 20% of the refracting
power of the eye. Hecht likens it to a tiny transparent onion with some 22,000 fine layers. The index
ranges from about 1.406 at the center to about 1.386 in outer layers, making it a gradient index lens.
It is pliable, and changes shape to accomplish accommodation for close focusing

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LENS

-65%H2O, 35%protein, K+, ascorbic a., glutathione

- Oxygen de, H2O, Na, Ca incre, Protein de / UV B= CATARACT

-65%H<sub>2</sub>O, 35%protein, K+, ascorbic a., glutathione

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ACCOMMODATION

When the eye is relaxed and the interior lens is the least rounded, the lens has its maximum focal length
for distant viewing . As the muscle tension around the ring of muscle is increased and the supporting
fibers are thereby loosened, the interior lens rounds out to its minimum focal length.

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ACCOMMODATION

To model the accommodation of the eye, the scale model eye was used with the cornea through the front
surface of the lens held constant at the model values. The matrix for that part of the eye was calculated
and then the thickness d and back surface power P were varied.

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ACCOMMODATION

When the ciliary muscles contract, they loosen the ciliary fibers which are attached to the envelope
of the crystalline lens. Because the lens is pliable, it relaxes into a more curves shape, increasing it's
refractive power to accommodate for closer viewing. The iris serves as the aperture stop for the eye,
closing to about 2mm in diameter in bright light and opening to a maximum of about 8mm in dim light.

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CATARACT

This slide shows a nuclear cataract; the lens seen within the pupil has a yellow-orange colour to it,
rather than being clear as in younger life. Nuclear cataracts dull the light path into the eye, affect
colour vision and acuity. They are most common in older eyes.

cataracts occur for many reasons, the most common being diabetes, intraocular inflammation, topical or
systemic steroid use, and trauma.

This slide shows a posterior subcapsular cataract. There is a plaque of whitish appearing material that
covers the back surface of the lens. A posterior subcapsular cataract scatters the light, producing glare,
especially at night with oncoming lights. It also significantly affects visual acuity. Posterior subcapsular
cataracts occur for many reasons, the most common being diabetes, intraocular inflammation, topical or
systemic steroid use, and trauma.

This slide shows complete opacity of the anterior cortex, a condition that used to be called a "ripe" or
"mature" lens. This will completely obscure the vision, allowing only light to pass into the eye.

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VITREOUS BODY

-99%H

O, gel-like, (hyalocytes)Na-hyaluronate- glycosaminoglycan frame

-Absent at birth, 4-5

y and incre.

-

Hyaloid canal – disappear 6ws bef birth

-99%H

O, gel-like, (hyalocytes)Na-hyaluronate- glycosaminoglycan frame

-Absent at birth, 4-5

y and incre.

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Nearsightedness or myopia, occurs when light entering the eye focuses in front of the retina instead of
directly on it. This is caused by a cornea that is steeper, or an eye that is longer, than a normal eye.
Nearsighted people typically see well up close, but have difficulty seeing far away.

Nearsighted people typically see well up close, but have difficulty seeing far away.

Farsightedness or hyperopia, occurs when light entering the eye focuses behind the retina, instead of
directly on it. This is caused by a cornea that is flatter, or an eye that is shorter, than a normal eye.
Farsighted people usually have trouble seeing up close, but may also have difficulty seeing far away
as well.

Farsighted people usually have trouble seeing up close, but may also have difficulty seeing far away
as well.

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LASIK

LASIK (laser in situ keratomilieusis) is a laser vision correction technique that uses an excimer laser
to reshape the cornea without disturbing adjacent cell layers.

1. The eye is numbed using anesthetic drops.
2. An eyelid holder is used to prevent blinking.
3. A small suction ring is placed on the cornea.
4. Using a microkeratome, a flap is created.

5. Using an excimer laser, a predetermined amount of corneal tissue is removed to re-sculpt the cornea.
6. The flap is placed back into position where it naturally re-adheres.

LASIK (laser in situ keratomilieusis) is a laser vision correction technique that uses an excimer laser
to reshape the cornea without disturbing adjacent cell layers.

1. The eye is numbed using anesthetic drops.
2. An eyelid holder is used to prevent blinking.
3. A small suction ring is placed on the cornea.
4. Using a microkeratome, a flap is created.

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2mm

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CONJUNCTIVA

-to regenerate epithe-cornea

-immune system

-mucin

-to regenerate epithe-cornea

-immune system

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The outer layer of the tear film is the oily layer which serves to decrease evaporative loss.

The middle layer is the aqueous layer which provides the bulk of the tear film.

The inner layer is the mucin layer which allows the aqueous layer to adhere to the hydrophobic
surface of the cornea and conjunctiva.

Abnormalities of any of the three layers can produce either a dry eye or one which overflows with
tears (epiphora).

The outer layer of the tear film is the oily layer which serves to decrease evaporative loss.

The middle layer is the aqueous layer which provides the bulk of the tear film.

The inner layer is the mucin layer which allows the aqueous layer to adhere to the hydrophobic
surface of the cornea and conjunctiva.

Abnormalities of any of the three layers can produce either a dry eye or one which overflows with
tears (epiphora).

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L 1212

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250

250 <sub>25</sub><sub>25</sub>0<sub>0</sub>

7mm

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7mm

7mm 5.5mm5.5mm

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L 1212

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1 1111
11

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REFERENCES

1. TEXTBOOKS

1. Legent F., Perlemuter L., Vandenbrouck Cl.

1. Legent F., Perlemuter L., Vandenbrouck Cl. Cahiers D’anatomie O.R.L., 4Cahiers D’anatomie O.R.L., 4thth<sub> ed, 2 Vol</sub><sub> ed, 2 Vol</sub><sub>. Paris: Masson,</sub><sub>. Paris: Masson,</sub>

1986, pp.71-115.

2. Williams PL, Warwick R et al.

2. Williams PL, Warwick R et al. Gray’s Anatomy, 37Gray’s Anatomy, 37thth ed<sub> ed</sub>. NewYork : Churchill Livingstone, 1989, <sub>. NewYork : Churchill Livingstone, 1989, </sub>

pp. 401-22, 499-16.

2. Pick TP & Howden R.

2. Pick TP & Howden R. Gray’s Anatomy, The Classic Collector’s edGray’s Anatomy, The Classic Collector’s ed. NewYork : Gramercy, 1977.. NewYork : Gramercy, 1977.
3. Imran T. Khawaja, Barbara A. Phillips.

3. Imran T. Khawaja, Barbara A. Phillips. Obstructive Sleep Apnea : Diagnosis & TreatmentObstructive Sleep Apnea : Diagnosis & Treatment. Hospital . Hospital
Medicine 34(3):33-36, 39-41, 1998.

Medicine 34(3):33-36, 39-41, 1998.

4. Jerald S. Altman, Robert D.H et al.

4. Jerald S. Altman, Robert D.H et al. Effect of UPPP and genial & hyoid advancement on swallowing Effect of UPPP and genial & hyoid advancement on swallowing
In patients with OSAS

In patients with OSAS. The annual meeting of the American Academy of Otolaryngology- Head & . The annual meeting of the American Academy of Otolaryngology- Head &
Neck surgery. Sanfrancisco, CA, Sept, 7-10, 1997

Neck surgery. Sanfrancisco, CA, Sept, 7-10, 1997

5. Sabiston.

5. Sabiston. Textbook of Surgery, 15Textbook of Surgery, 15thth ed<sub> ed</sub>. Philadelphia : W.B. Saunder Company, 1997.<sub>. Philadelphia : W.B. Saunder Company, 1997.</sub>

6. Oxford Textbook of Surgery on CD-ROM, ver 1.0Oxford Textbook of Surgery on CD-ROM, ver 1.0. Oxford University Press, 1995. . Oxford University Press, 1995.
1. Legent F., Perlemuter L., Vandenbrouck Cl.

1. Legent F., Perlemuter L., Vandenbrouck Cl. Cahiers D’anatomie O.R.L., 4Cahiers D’anatomie O.R.L., 4thth ed, 2 Vol<sub> ed, 2 Vol</sub>. Paris: Masson,<sub>. Paris: Masson,</sub>

1986, pp.71-115.

2. Williams PL, Warwick R et al.

2. Williams PL, Warwick R et al. Gray’s Anatomy, 37Gray’s Anatomy, 37thth<sub> ed</sub><sub> ed</sub><sub>. NewYork : Churchill Livingstone, 1989, </sub><sub>. NewYork : Churchill Livingstone, 1989, </sub>

pp. 401-22, 499-16.

2. Pick TP & Howden R.

3. Imran T. Khawaja, Barbara A. Phillips. Obstructive Sleep Apnea : Diagnosis & TreatmentObstructive Sleep Apnea : Diagnosis & Treatment. Hospital . Hospital
Medicine 34(3):33-36, 39-41, 1998.

Medicine 34(3):33-36, 39-41, 1998.

4. Jerald S. Altman, Robert D.H et al.

4. Jerald S. Altman, Robert D.H et al. Effect of UPPP and genial & hyoid advancement on swallowing Effect of UPPP and genial & hyoid advancement on swallowing
In patients with OSAS

Neck surgery. Sanfrancisco, CA, Sept, 7-10, 1997

5. Sabiston.

5. Sabiston. Textbook of Surgery, 15Textbook of Surgery, 15thth ed<sub> ed</sub>. Philadelphia : W.B. Saunder Company, 1997.<sub>. Philadelphia : W.B. Saunder Company, 1997.</sub>

6. Oxford Textbook of Surgery on CD-ROM, ver 1.0Oxford Textbook of Surgery on CD-ROM, ver 1.0. Oxford University Press, 1995. . Oxford University Press, 1995.

2. WEBSITES

1. />2. />2. />3. />3. />4. />4. />5.
5.
6.

6. Anatomy of the Human Body Henry GrayAnatomy of the Human Body Henry Gray />1.

1. />2. />2. />3. />3. />4. />4. />5.
5.
6.

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