Physiology of The Eye

By Mila Citrawati Jakarta, May 23rd 2006

Anatomy of The Eye

Rongga orbita : atas [os frontalis, os sfenoidalis], bawah [os maxilaris,os zigomatikum, os palatinum], medial [os maxilaris, os lakrimalis, os sfenoidalis], lateral [os zigomatikum, os sfenoidalis, os frontalis] Bulbus okuli N optikus Otot penggerak bola mata [m. rektus lateral/medial/superior/inferior, m.oblikus superior/inferior]

Bulbus okuli
Terdiri dari 3 tunika/lapisan : - Lap. Fibrosa [sklera, kornea] - Lap. Vaskulosa [khoroid, badan siliar, iris] - Lap. Nervosa [retina] 1. Lapisan fibrosa bfungsi : - provide mechanical support - attachment site for extrinsic eye muscles - assist in the focusing process Sclera consist of collagen, elastin, small blood vessels, nerves. Known as white of the eye

2. Vascular layer [uvea] consist of blood vessels, lymph vessels, intrinsic occulomotor muscles Functions : - provide route for blood vessels and lymph that supply tissue of the eye - regulate amount of light entering the eye - secreting and reabsorbing aqueous humor - control the shape of lens Iris : m.pupillary constrictor, m. pupillary dilatorpupil in bright 1,5-2 mm in dark 7-8 mm [control amount of light, path of light] light reflex and consensual light reflex. Contain different amount of pigmen [color of the eye]

Ciliary body function : hold lens posterior to the iris and centered on the pupil. Choroid function : suply oksigen and nutrient to rods and cones Uvea filled with aqueous humor similar to CSF, circulate from COP [space between vitreus and iris] to COA [space between iris and cornea] absorb to canal of Schlemm

3. Neural layer Consist of 2 distinct layers : - outer layer of pigment [function : absorb light, absorb damaged photoreceptors biochemical interaction to the photoreceptors] - inner layer of retina consist of photoreceptors and blood vessels

Visual sensoris

Consist of : retina, optic nerve, optic chiasm, optic tract, lateral geniculate nucleus, geniculocalcarina tract, calcarine cortex, visual cortex Optic disc : 3-4 mm medial [nasal] to fovea centralis. Site where retina nerve fibers, arteries, and veins leave the eye contain no photoreceptors

External structure

Palpebrae [superior/inferior] consist of m. riolani, m. orbicularis oculi, m. levator palpebrae [function : protect eye from light, dust, foreign body], Meibomian gland [function : prevent evaporation of lubricating fluids] Eye brows [function : protect eye from sweat, dust, sunlight] Eye lashes [function : protect eye from dust, sunlight, dirt]

Lacrimal apparatus
Secretoir : lacrimal glands and lacrimal ducts Excretoir : lacrimal punctum sup/inf, lacrimal canal, nasolacrimal duct, meatus inf. Lacrimal glands : - Os frontalis [lacrimal fosa] - Below superior fornix conjunctive - Secrete fluid since 3 weeks old neonatus - Lacrimal gland + Meibomian gland + Zeis gland oil slick 1ml/day [function : lubricating, prevent evaporation, reduce friction, remove debris, prevent infection, provide nutrient and oksigen]

Conjunctive [palpebrae and bulbi]: mucous membrane surface palpebrae and bulbi, contain a. conjunctive posterior, a. cilliar anterior, n.V, lymph vessels. Cornea: anterior part of the eye crossed by light from outside to retina. Transparent, contain lymph vessels, nerves and no blood vessels. Diameter approximately 12 mm. Consist of 5 layers [epithel, Bowman membrane, stroma, descemet, endothel]. Function as refractive surface. Aqueous humor [function: hold pressure] Iris : heavily pigmented muscles Lens : refractive media lies behind the cornea, held in place by suspensory ligaments Vitreous body [function : stabilize shape of the eye, physical support to the retina]

Development of the eye

Birth : 8-18 inch, poor coordination, night blind [less photopigment] 3-8 weeks : binocular vision 2-3 months : iris become darker, detail of facial features 3-4 months : accomodation, lens flat, binocular vision 5-7 months : visual acuity 20/200, night vision, hand-eye coordination 8-9 months : maculae becomes mature, depth perception, point with finger

1 year : visual acuity 20/100, geometric shape, facial expression 2 years : visual acuity 20/40, see small objects and detail 3 years : visual acuity 20/30 4 years : visual acuity 20/20, reading 5 years : depth perception, color 6 years : visual acuity 20/20, shades of color 8 years : eyeball adult 40 years : presbyopia +60 year : lenses become rigid, floaters [because of vitreus shrinkage], reduce tears, cataract

Refraction

Definition : bending of light rays as they travel from one transparent media to another Light : a form of energy known as electro magnetic radiation Refraction media : aqueous humor, lens, vitreous humor Refraction surface : cornea, anterior and posterior surface of the lens Correction lens : spheris (-), spheris (+), cylindris (-/+)

Emetrop : parallel light that comes to the resting eye will be refracted right at the maculae lutea / retina Ametrop : parallel light that comes to the resting eye isnt refracted right at the retina Myop : refraction disorder which without accomodation light that comes parallel will be focused in front of the retina. Myop axial and myop refractive. Mild [0-3D], moderate [3-6D] severe [>6D]. Complication ; retina ablation, strabismus, maculae bleeding. Cocrreted by spheric (-) lens Hypermetrop : focused behind the retina. Hypermetrop axial and hypermetrop refractive. Corrected by spheric (+) lens

Astigmat : refraction disorder caused by different degree of refraction at different meredian. Astigmat reguler [with the rule and against the rule] and astigmat irreguler. Corrected by cylindric lens Presbyop : reduced accomodation capability at late age. Corrected by spheric (+) lens Aphakia : condition of no lens [cataract op, congenital, dislocation of the lens]. Corrected by spheric (+) lens Visual acuity : 0 [no visual image], 1/~ [visual of light only in 1 m], 1/300 [visual of hand movement in 1 m], 1/60 [visual of finger in 1m], 6/6 6/10 [emetrop]

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Refractive disorder examination : Subjective Snellen chart and lenses Objective Ophthalmoscope, retinoscope, refractometer, ceratometer Jaeger test Near response : accomodation, convergance of visual axis, miosis

Close object viewed lens thickening light refraction better focusing in retina Distant object viewed lens flattening light refraction better focusing in retina

Light and photoreception

Retina consist of pigment, rod and cone cells, horizontal cells, bipolar cells, amacrine cells, ganglion cells Human eyes are sensitive to light with 400-700 nm wavelength [visible light]. ROY G BIV [red, orange, yellow, green, blue, indigo, violet] Photon : single energy packet of visible light. Reflected photon by surface seen as color, absorbed photon by surface seen as black Photoreceptors detect photon. Rods respond to any photon, more sensitive. Cones respond to red, green, blue photon, less sensitive

Comparison of photoreceptors

Rod: Photopigment: 1 rodhopsin Acuity + threshold: low Type of vision : black & white Most concentrated location: peripheral Wavelength peak sensitivity : 505 nm Estimated total number : 20 million

Cone : 3 [blue, green, red sensitive pigment] High Color

Central [fovea centralis]

Blue 445 nm, Green 535, red 570 nm 7 million

Maculae has highest density of photoreceptors. Fovea centralis contain only cones, therefore has the sharpest vision Look directly to target means focusing the image right on the fovea [color vision] In the dark photoreceptors release neurotransmitter across synaps at inner segment continuously Light activate opsin from cis form to trans form [has the ability as enzyme]activate 2nd enzyme [transducin and G protein] Transducin activate PDEcGMP breakdown Sodium channel closed membrane hyperpolarizedNT release reduced membrane potential decreasesignal of light struck the retina

Color Vision

Blue cones 16%, green cones 10%, red cones 74%. The other colors are combination of two type cones Anomaly shows color weakness, anopia shows color blind Protanomaly, deuteranomaly, tritanomaly, normal color vision grouped as trichromat Dichromat has only two type of cone function well Monochromat has only one type of cone function well [can only see black, white, shade of grey] Color blind is inhereted. Linked to X chromosom, resesive.

Eye movement

M. rectus lateralis abduction N.VI M. rectus medialis adduction N.III M. rectus superior elevation N.III M. rectus inferior depression N.III M. oblique superior oblique depression N.IV M. oblique inferior oblique elevation N.III Disorder of occulomotor muscles can cause strabismus

Visual Fields and Binocular Vision

Visual field of each eye is the portion of the external world visible out of that eye. Binocular vision central parts of visual fields of the 2 eyes that coincide. Impulses set up in the 2 retinas by light rays from an object are fuse at the cortical level into a single image Perimetry is an examination of visual field using device. Another simple examination is direct confrontation Many pathologic conditions show narrow visual fields

Humans uses single binocular vision in viewing an object. Both eyes focus on the same object. The light rays that enter the eyes are focused onto corresponding points of the two retinas. In viewing near objects requires the eyes to rotate medially in order for the light rays to hit the same point of the two retinas [convergance]

Neural Pathways

Axons of ganglion cells pass caudally in optic nerve and optic tract to end in the lateral geniculate body. Fibers from each nasal hemiretina decussate in the optic chiasm. Geniculocarcarine tract : fibers from nasal half of one retina and temporal half of the other Visual cortex : Brodmanns area 17

Dark adaptation : decline of visual threshold. If a person spends a considerable length of time in brightly lighted surrounding and then moves to dimly lighted environment, the retinas slowly become more sensitive to light as the individual becomes accustomed to the dark [20minutes]. It took times because most of the rodhopsin has been broken down in the bright light and the cones are inactive in the dim light. With the time, rodhopsin molecules reform. This caused the sensitivity of the retina increase and visual threshold decrease vision

Light adaptation : if one passes suddenly from a dim to a brightly lighted environment, the light seems intensely and even uncomfortably bright until the eyes adapt to the increased illumination and the visual threshold rises [5 minutes] The presence of bright light causes the breakdown of the visual pigments of the rods and the cones into retinal and opsin. The retinal is converted to vit A. Prolonged exposure to bright light decrease the consentration of visual pigments in rods and cones. The result is a reduced sensitivity of the eye to light

Wait !!!!!! Its not over yet ! Theres Physiology of the eye part two !