By Abdullah A.

Wahbi

The ccessory structure contain: 1- Eye li s or Palpebrae 2- Eye lashes 3- Eye brows 4- Conjunctiva 5- Lachrymal pparatus 6- Extrinsic eye muscles

An eyelid is a thin fol of skin that covers and protects an eye. ith the exception of the prepuce and the labia minora, it has the thinnest skin of the whole body. These are skin tissues consisting of subcutaneous connective tissue, Orbicularis Oculi muscle, tarsal plate and tarsal glands (Meibomian gand) secreting oily substance for lubrication and innermost mucosal conjunctiva tissue .

Hair follicles growing at the end of the eye lids, protecting the eyeballs from foreign bodies, perspiration and direct sun rays. Pairs of ciliary sebaceous glands and ciliary sweat glands open into the eyelash follicles.

The eyebrow is an area of thick, delicate hairs above the eye that follows the shape of the lower margin of the brow ridges of some mammals. Their main function is to prevent sweat or water, and other debris, from falling down into the eye socket .

The conjunctiva is a clear mucous membraneconsisting of cells and underlying basement membrane that covers the sclera (white part of the eye) and lines the inside of the eyelids. It is composed of rare stratified columnar epithelium The conjunctiva helps lubricate the eye by producing mucus and tears, although a smaller volume of tears than the lacrimal gland. It also contributes to immune surveillance and helps to prevent the entrance of microbes into the eye.

Lacrimal Apparatus: group of structures producing and draining the lacrimal fluid (tears) , It consists of:

Lacrimal gland Lacrimal Ducts Lacrimal Puncta Lacrimal canaliculi The Lacrimal sac The nasolacrimal duct Lacrimal fluid is made up of water, salts, mucus and Lysozyme, an enzyme that breaks down bacterial wall, lactoferrin, IgA, tear specific pre-albumin, some major serum proteins (IgM, IgG, transferrin and serum albumin) .

Extra ocular muscles spread around the eyeballs allowing flexible movement of the eye into different directions. There are six extrinsic muscles: Medial Rectus External Rectus Superior Rectus Inferior Rectus Superior Oblique Inferior Oblique

The Eyeball of diameter about 1 inch is divided into three parts: Fibrous Tunic, Vascular Tunic and Nervous Tunic

Consist of :
Epithelium Bowmans Layrer Stroma Descements Membrane Endothelium The Sclera

 The epithelium is the cornea's outermost region , It is comprised of 5-7 layers of epithelial cells To block the passage of foreign material, such as dust, water, and bacteria, into the eye and other layers of the cornea To provide a smooth surface that absorbs oxygen and cell nutrients from tears, then distributes these nutrients to the rest of the cornea To prevent the flow of the fluid and electrolytes from the tears to the stroma, keeping the stroma dehydrated

 The basement membrane of the epithelium It is a condensation of the superficial stroma, composed of strong layered protein fibers called collagen Once injured, Bowman's layer cannot be replaced and forms a scar as it heals

 Comprises about 90% of the cornea's thickness It consists primarily of water (78%) and collagen (16 %) Collagen gives the cornea its strength, elasticity, and form Not contain any blood vessels. Essential in producing the cornea's light-conducting transparency

 A thin but strong sheet of tissue that serves as a protective barrier against infection and injuries Descemet's membrane is regenerated readily after injury.

 The endothelium is the extremely

thin, innermost layer of the cornea Endothelial cells are essential in keeping the cornea clear The endothelium's primary task is to pump this excess fluid out of the stroma and to allow the diffusion of nutrients to the cornea

 The white of the eye, spreading around the eyeball except for the cornea The anterior part is covered by conjunctiva The internal surface is attached to the choroid The canal of Schlemm is an endothelial canal located near the internal surface of the Sclera and at the cornea-sclera junction. Through this canal the aqueous humor filters from the anterior chamber in to the ciliary veins

Consist of:
Choroid Ciliary Body Ciliary Processes Ciliary Muscles Iris

 The layer located underneath the Sclera , It is dark brown tissue , highly vascularized Providing nutrients and Oxygen to the Retina The choroidal pigment cells prevent the passage of light across the sclera into the retina

 Thickest portion of the

Vascular Tunic , directly continuous with the choroid behind and the iris in front It is a highly vascularized region, made up of Ciliary processe & Ciliary muscles

 Secrete the aqueous Humor Aqueous Humor drained into the posterior chamber Then through the pupil into the anterior chamber of the eye Then drained into the Sclera through the canal of Schlemm , to the blood . Aqueous humor nourishes and oxygenates the cornea and lens which are non-vascularized. It is responsible for exerting the intraocular pressure in the eyeball. Keeps the retina smoothly applied to the choroid and maintains a rigid shape of the eyeball. If the Intraocular pressure increases to exceed the normal pressure of 16 mmHg, glaucoma results, which degenerates the retina and causes blindness , The Humor is completely replaced every 90 minutes

 Smooth muscles that affect the shape of the lens (dilation or contraction). Contain three type of muscle , meridional, oblique and circular Stimulated by the parasympathetic nerves, The ciliary muscles contract affecting the shape of the lens during accommodation.

 The colored slightly bulged portion of the eyeball, positioned between the cornea and the lens, The Sphincter papillae: Made up of circular and radial smooth muscle fibers that regulate the amount of light passing through the Pupil into the posterior cavity In bright light and in response to stimulation by parasympathetic nerve fibers, these muscles contract reducing the pupil size. Dilatator papillae: Myoepithelial cells in which myofilaments appear in their basal muscular processes, hen these radial muscles dilate upon stimulation by the Sympathetic nerve fibers during dim light, the pupil dilates.

Consist of :
Retinal Pigment Epithelium The Ganglion Cell Layer The Bipolar Cell Layer Photoreceptor Layer

 They are involved in the turnover of rod and cone photoreceptor cells This layer acts as an antireflection device as the cytoplasm of the pigment cells contains melanin The epithelium forms an important blood- retinal barrier between the retina and the vascular system of the choroid

The final common pathway for the nervous impulse as their dendrites are synaptically connected to the Bipolar cells and their axons reaching the CNS.

 There are two main types of bipolar cells : Cone bipolar cells that
communicate with cone cells Rod bipolar cells receiving photoreceptive inputs from rods exclusively

 That transduces light rays into receptor potentials due to the presence of 120x 106 rod neurons and 6x106 cone neurons The rods are responsible for the discrimination between white and black, identification of shapes and movement, dominating the peripheral retina The cones are responsible for color vision and high visual acuity in bright light

Image is formed due to a combination of events accomplished mainly by the lens and cornea, with the fruitful collaboration of other organelles. The process requires:
1) Refraction of light rays by the cornea and lens 2) Accommodation of the lens 3) Constriction of the pupil

75% of the focus is done by the cornea and the fine tuning of the image is accomplished by the lens. The refracted image is projected in an inverted manner on the retina

The lens is convex on both sides which intensifies the focusing power. The lens curvature is flexible and dependent on the lighting conditions. The shape of the lens is controlled by the ciliary muscles and the tension applied on the zonular fibers. To focus on distant objects, the zonular fibers pull the lens into a flattened, oval shape. hen the object is near, the lens is more spherical due to its natural elasticity. Accommodation of the lens also includes moving the lens backwards towards the back of the eye. ith age, the lens hardens and fails to respond to the directions of the ciliary muscles.

Constricting the pupil is narrowing the hole through which light passes into the inner eyeball. This occurs as the sphincter muscles of the iris contract.

 Myopia Hypermetropia Astigmatism

Is a refractive defect of the eye in which collimated light produces image focus in front of the retina when accommodation is relaxed. In simpler terms, myopia is a condition of the eye where the light that comes in does not directly focus on the retina which is in the back of the eye. Because of this, the image that one sees is out of focus when looking at a distant object but comes into focus when looking at a close object.

Is a defect of vision caused by an imperfection in the eye (often when the eyeball is too short or the lens cannot become round enough), causing difficulty focusing on near objects, and in extreme cases causing a sufferer to be unable to focus on objects at any distance. As an object moves toward the eye, the eye must increase its optical power to keep the image in focus on the retina. If the power of the cornea and lens is insufficient, as in hyperopia, the image will appear blurred.

Astigmatism is an optical defect in which vision is blurred due to the inability of the optics of the eye to focus a point object into a sharp focused image on the retina. This may be due to an irregular or toric curvature of the cornea or lens. There are two types of astigmatism: regular and irregular. Irregular astigmatism is often caused by a corneal scar or scattering in the crystalline lens and cannot be corrected by standard spectacle lenses, but can be corrected by contact lenses. Regular astigmatism arising from either the cornea or crystalline lens can be corrected by a toric lens.

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