BAM

KATE
PREI
N
JOA Ophthalmology
SUBJECT: DATE:
June 26, 2008
TOPIC:
VIKI
KY
MAC LECTURER:of Visual System – Dr. Guevarra
Anatomy
A TRANSGROUP:
Trans Group: Perby’s Group
ERIK
R

• Parieto occipito-temporal … (POT) – new

SHA
MIKA CORNEA
IE • clear and transparent ocular medium images
JASS
• anterior portion of the external coat of the eye • Frontal eye field – processes familiar images
• Has both protective and optical functions\ from the past
RAIN
FARS
UA • Together with the lens, it refracts light, and • Midbrain/pons – where cranial nerves are found
JOSH
helps the eye to focus, accounting for approx. • Abducens nucleus/ medial longitudinal
80% of the eye's optical power.
CO
fasciculus
•
MAR
refractive power approximately 43 dioptres
• Cranial nerve nucleus
ISAY
DY • endothelial cell count 2,500 cells/mm
CAN
G Layers
KRIN
EISA
1. Epithelium: 5 cells thick
E 2. Bowman's layer: protects the corneal ACCOMODATION
ANN
stroma, consisting of irregularly-arranged • Pupils
• Ciliary muscles
KYTH
ON collagen fibers.
• Convergence
3. Stroma (also substantia propria): a thick,
AAR
E
ALPH transparent middle layer; 90% collagen, 5%
LA SINGLE BINOCULAR VISION
KAR cells (keratocytes) and 5% • Visual perception
G mucopolysaccharides • Fusion
4. Descemet's membrane (also posterior
PEN
KC • Stereopsis
N ADI
limiting membrane): a thin acellular layer
5. Endothelium: monolayer of mesodermal EXTRAOCULAR MUSCLES
MAA
A AM
MON
cells; important in corneal dehydration • Medial rectus, lateral rectus, inferior rectus,
BUFF
superior rectus – 4 rectus muscles
Normal intraocular pressure: 10-22
•
DIE
GOL Superior oblique, inferior oblique – vertical
EZRA action
KIX RETINA • Levator palpebral superioris
Ten distinct layers. From innermost to outermost,
RIZ
EY • Origin: back of orbit at the circle/annulus of
LAIN they include: Zing (except IO – medial ring of orbit
1. Inner limiting membrane - Müller cell • Spiral of Tillaux – getting the distance from one
N
XTIA
CES footplates rectus to another
2. Nerve fiber layer • SO4, LR6, the rest 3: MR, SR, IR, IO
PS
HOO
E
3. Ganglion cell layer - Layer that contains nuclei • Lacrimal nerve – comes from the ophthalmic
division o f CN V
VINC
ESSE of ganglion cells and gives rise to optic nerve
fibers.
DEN
LLE The rectus muscles insert in sclera gradually farther
CECI 4. Inner plexiform layer from the limbus beginning with the medial rectus at
5. Inner nuclear layer
JAM
Y KC 5.5mm (range 3.0 to 6.0mm), inferior rectus 6.5mm,
PIPO 6. Outer plexiform layer - In the macular region, lateral rectus 6.9mm and superior rectus 7.7mm. The
RICH
this is known as the Fiber layer of Henle. line of insertion is called the spiral of Tillaux which is
also the line of insertion of posterior Tenon's capsule
HEIN
T 7. Outer nuclear layer
which then proceeds to the limbus as the episclera
8. External limiting membrane - Layer that
BAR
RYL fused with the underlying sclera.
SHE separates the inner segment portions of the
H
RAPL photoreceptors from their cell nuclei.
TINA
IN
9. Photoreceptor layer - Rods / Cones
ALLA 10. Retinal pigment epithelium
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TE
YVET
EYE MOVEMENTS
ARY
M
 SUBJECT: DATE:
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• Lesion at tip of nose

Optic nerve – LR6

CN III – 2 divisions upon entering orbit:
• Superior – innervates SR & levator palpebrae
superioris
• Inferior – innervates MR, IR, IO, papillary reflex
Ophthalmology
Annulus of Zing June 26, 2008
• Nasociliary nerve – supplies tip of nose and Anatomy of Visual System – Dr. Guevarra
corneal reflex Trans Group: Perby’s Group

Hutchinson’s sign ACTIONS

• Herpes zoster
The extraocular muscles are the six muscles that control the movements of the eye.

Muscle Innervation Origin Insertion

Superior branch of eye (anterior, superior
Superior rectus Annulus of Zinn
oculomotor nerve surface)
Inferior branch of eye (anterior, inferior
Inferior rectus Annulus of Zinn
oculomotor nerve surface)
eye (anterior, lateral
Lateral rectus Abducens nerve Annulus of Zinn
surface)
Inferior branch of eye (anterior, medial
Medial rectus Annulus of Zinn
oculomotor nerve surface)
eye (posterior, superior,
Superior oblique Trochlear nerve Annulus of Zinn
lateral surface)
Inferior branch of eye (posterior, inferior,
Inferior oblique Maxillary bone
oculomotor nerve lateral surface)
Muscle Primary function Secondary function Tertiary function
Superior rectus Elevation Intorsion Adduction
Inferior rectus Depression Extorsion Adduction
Lateral rectus Abduction
Medial rectus Adduction
Superior oblique Intorsion Depression Abduction
Inferior oblique Extorsion Elevation Abduction
*extorsion – excycloversion

SR IO IO SR
EXTRAOCULAR MOVEMENTS
ELEVATOR 1. Fast eye movements
• Saccades - fast eye movement that focus
OD OS the fovea on a shifting object; used to
DEPRESSOR rapidly refixate from one object to another,
comes from frontal eye field
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IR SO SO IR • Look from 1 object to another

• Fast phase, nystagmus

2. Slow eye movements
• Smooth pursuit – focus fovea on a moving
object
• Vestibule – fast Doll’s head maneuver
• Slow phase, nystagmus
Frontal Eye Fields
• activated during the initiation of eye
movements, such as voluntary saccades and
pursuit eye movements.
Saccade is a fast movement of an eye, head or other
part of an animal's body or device. It can also be a fast
shift in frequency of an emitted signal or other quick
change.
Eye saccades are quick, simultaneous movements of
both eyes in the same direction. Initiated by the frontal
MIDBRAIN
CN VII- Nasolabial Fold (central); forehead and chin
(peripheral)
CN III- Posterior Communicating Artery
CN IV- Located between midbrain and pons
Herring’s Law
• states that “muscles of the left and right eye
perform with equal contraction”
• law of 2 eyes
Sherrington’s Law (Law of Reciprocal
Innervation)
• law of 1 eye
• Ex: if left eye looks to the right, the left medial
rectus contracts and the left lateral rectus
relaxes.
SUBJECT: DATE:
TOPIC:
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TRANSGROUP:
lobe of the brain (Brodmann area 8), saccades serve as
a mechanism for fixation, rapid eye movement and the
fast phase of optokinetic nystagmus.
Smooth Pursuit movement is the ability of the eyes
to smoothly follow a moving object. It is one of two
ways that visual animals can voluntarily shift gaze, the
other being saccadic eye movements. Pursuit differs
from the vestibulo-ocular reflex, which only occurs
during movements of the head and serves to stabilize
gaze on a stationary object. Most people find pursuit
extremely difficult, if not impossible, to initiate without
a moving visual signal.
Ophthalmology
June 26, 2008
Anatomy of Visual System – Dr. Guevarra
Trans Group: Perby’s Group
PONS
Axial section of the pons at the level of the facial
colliculus (PPRF not labeled, but region is visible, near
abducens nucleus)
Paramedian Pontine Reticular Formation (PPRF)
• part of the pontine reticular formation, a brain region
without clearly defined borders in the center of the
pons.
• located anterior and lateral to the medial longitudinal
fasciculus (MLF)
Horizontal eye movements
• generated from the horizontal gaze centre in
the PPRF
• From here the output is to the ipsilateral sixth
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nerve nucleus to abduct the ipsilateral eye
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• To adduct the contralateral eye, fibres from the

PPRF also cross the pons and pass up the
medial longitudinal fasciculus (MLF) to the
contralateral medial rectus nucleus in the third
nerve complex, which also receives
independent descending input from the
vergence control centres.natomical pathway of
medial longitudinal bundle.
• Stimulation of the PPRF on one side therefore
causes a conjugate movement of the eyes to
the same side. Loss of normal horizontal eye
movements occurs when the PPRF is disrupted

Horizontal Gaze Oculomotor nerve

Abducens nucleus → PPRF → MLF → Oculomotor • Icontrols most of the eye's movements,
nucleus → Medial rectus muscle constriction of the pupil, and maintains an
open eyelid
CRANIAL NERVE III
• arises from the anterior aspect of
mesencephalon (midbrain)

CAVERNOUS SINUS (lateral sellar compartment)

• a large collection of thin-walled veins creating
Ophthalmology
a cavity bordered by the sphenoid bone, lateral
June 26, 2008
to the sella turcia, and the temporal bone of
Anatomy the
of Visual
skull. System – Dr. Guevarra
• receives
Trans Group: Perby’sthe ophthalmic
Group vein through the
superior orbital fissure and is connected to the
basilar plexus of veins posteriorly.
• The internal carotid artery, and cranial nerve • internal carotid artery (and sympathetic
III, IV, V, and VI all pass through this blood filled plexus). See also cavernous part of internal
space carotid artery.
• Infection from the face may reach the • abducens nerve (CN VI)
cavernous sinus through its many anastomotic
connections, with severe consequences.
• The cavernous sinus drains by two channels,
the superior and inferior petrosal sinuses.

Each cavernous sinus (one for each hemisphere)

contains the following:

vertically, from superior to inferior

• oculomotor nerve (CN III)
• trochlear nerve (CN IV)
• ophthalmic nerve, the V1 branch of the
trigeminal nerve (CN V)
• maxillary nerve, the V2 branch of CN V
 Dorello’s Canal – Trauma in Mastoid.Test for
horizontally Cranial nerve V, VI, VII, VIII.
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 Increase Intracranial Pressure may cause

diplopia.
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How is the eye protected?

• Orbit 1. Frontal bone
• Lids 2. Nasal bone
• Conjunctiva 3. Lacrimal bone
• Sclera 4. Maxillary bone
5. Zygomatic bone
• Tears
6. Temporal bone
7. Parietal bone
Bones of the Orbit 8. Greater wing of sphenoid bone
1. Roof - Frontal bone (anterior cranial fossa is superior to 9. Zygomatic process of temporal bone
roof) 10. Lesser wing of sphenoid bone
2. Floor - Maxillary bone (maxillary sinus is inferior to 11. Ethmoid bone
floor) 12. Palatine Bone
3. Medial wall - Maxillary, Lacrimal, Ethmoid, Frontal and
Sphenoid bones (nasal cavity is medial to medial wall of
orbit)
4. Lateral wall - Zygomatic bone and sphenoid bone Classmates,

Hindi pa nasend ni doc yung ppt lec nya. Pero we tried

our best to complete our notes. Pag meron nang copy
ng ppt, pakita na lang namin sa inyo kung gusto nyo pa
LEFT FRONTAL VIEW OF SKULL ipa-fotox. 

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