Anatomy of the Eye and Ophthalmology
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Questions and Answers

What are the three geographic zones of the conjunctiva?

Bulbar conjunctiva, fornical conjunctiva, and palpebral conjunctiva.

What is chemosis in relation to the conjunctiva?

Chemosis refers to the edema (swelling) of the conjunctiva.

What is the primary function of the orbicularis oculi muscle?

The orbicularis oculi muscle is responsible for closing the eyelid.

Define subconjunctival hemorrhage and its relevance.

<p>Subconjunctival hemorrhage is bleeding beneath the conjunctiva.</p> Signup and view all the answers

How are the anterior and posterior lamellae of the eyelid differentiated?

<p>The anterior lamellae consist of skin, muscle, and eyelashes, while the posterior lamellae contain the tarsus and conjunctiva.</p> Signup and view all the answers

What is the primary function of the levator palpebrae superioris (LPS) muscle, and how is it innervated?

<p>The LPS muscle elevates the upper eyelid and is innervated by cranial nerve III.</p> Signup and view all the answers

Describe the ocular manifestations of a complete third cranial nerve palsy.

<p>A complete third cranial nerve palsy results in a completely closed eyelid and deviation of the eye outward and downward.</p> Signup and view all the answers

What is a chalazion, and what causes its formation in relation to the meibomian glands?

<p>A chalazion is a swelling resulting from the blockage of the meibomian glands, leading to inflammation and buildup within the gland.</p> Signup and view all the answers

What are the roles of the accessory lacrimal glands in the tear film composition?

<p>Accessory lacrimal glands contribute to the aqueous layer (Krause and Wolfring), lipid layer (Meibomian, Zeis, and Moll), and mucin layer (Goblet) of the tear film.</p> Signup and view all the answers

In the context of lacrimal system blockage, what is the implication of cannaliculitis and dacryocystitis?

<p>Cannaliculitis and dacryocystitis occur due to blockage of the nasolacrimal duct, leading to inflammation and swelling in the lacrimal system.</p> Signup and view all the answers

Study Notes

Anatomy of the Eye and Ophthalmological Examinations

  • The presentation is about the anatomy of the eye and ophthalmological examinations.
  • The presenter, Lily Adhiambo Nyamai, has qualifications including MBChB, MMed Ophthalmology (UoN), FCOECSA, and PHERT from the University of Toronto.
  • She also specializes in ophthalmology and glaucoma.
  • The presentation notes the importance of sight among the senses, citing Helen Keller.

Objectives

  • The objectives of the lecture included identifying and examining eye structures (embryology and anatomy).
  • Differentiating anatomy from ocular disorders.
  • Examining the external eye, globe (eyeball), orbit (CT orbit), ocular muscles, orbit retina, and choroid.
  • Studying eye embryology.

External Eye

  • Diagrams of the external eye were included, identifying key parts like the upper punctum, plica semilunaris, upper canaliculus, caruncle, medial canthus, lacrimal sac, lacrimal gland, lower punctum, lower canaliculus, limbus, iris, sclera, lateral canthus, and nasolacrimal duct.

Conjunctiva

  • The conjunctiva is described as clear, transparent, and highly vascular.
  • It has three geographic zones: bulbar conjunctiva, forniceal conjunctiva, and palpebral conjunctiva.
  • The conjunctiva is a lining that forms a fold along the eyelid and ends at the mucocutaneous junction.
  • It contains structures like the orbicularis oculi muscle, superior tarsus, Meibomian glands, sebaceous glands, Zeis glands, and cilia (lashes), palpebral commissure, superior conjunctival fornix, inferior conjunctival fornix, inferior tarsus, and accessory lacrimal glands.
  • Bleeding beneath the conjunctiva is called subconjunctival hemorrhage.
  • Edema of the conjunctiva is called chemosis.

Eyelids

  • The palpebral fissure measures 8-11 mm.
  • The lateral canthus has a sharper angle than the medial canthus, which is rounder.
  • Dimensions shown were 27-30 mm.
  • The eyelids have an upper and lower lamella, which are divided into anterior and posterior lamellae.

Eyelid Muscles

  • The levator palpebrae superioris (LPS) elevates the upper eyelid, innervated by CN III.
  • The orbicularis oculi muscle is responsible for closing the eyelids, innervated by CN VII.
  • The presentation covers what happens to the eyelid in cases of CN III palsy.

Lacrimal System

  • The lacrimal system is composed of the main lacrimal gland (responsible for reflex tearing), accessory lacrimal glands (Meibomian glands for lipid layer), Krause glands and Wolfring glands (for aqueous layer), Zeis and Moll glands (lipid layer), and goblet cells (mucin layer).
  • Tear drainage occurs via the pump (orbicularis occuli).

Chambers of the Eye

  • The presentation describes the chambers of the eye - anterior, posterior, and vitreous chambers
  • The chambers of the eye play a crucial role in maintaining the rigidity and structure of the globe.

Vitreous Chamber

  • The vitreous chamber is the largest chamber in the eye filled with vitreous humour.

Posterior Vitreous Detachment

  • The presentation describes the condition of posterior vitreous detachment.

Floaters

  • These are visualized as spots or specks in one’s vision.

Aqueous Flow, Trabecular Meshwork and Angle Closure Glaucoma.

  • Aqueous flow is discussed.
  • The anterior chamber has boundaries of the cornea, the iris, the pupil, and the anterior chamber angle.
  • Angle-closure glaucoma involves a blockage of the trabecular meshwork.

Iris and Ciliary Body

  • The iris gives the eye its colour, and is continuous with the ciliary body.
  • The ciliary body controls the pupil size.
  • The ciliary body is a muscular structure that circles the eye.
  • It is attached to the zonules and contracts the zonules, making the lens more spherical for focusing on near objects.

The Lens

  • The lens has three layers: capsule, nucleus, and cortex.

Retinal Examination

  • The retina receives light and converts it to signals for the brain.
  • The retina has five layers: epithelium, Bowman’s layer, stroma, Descemet’s membrane, and endothelium; the stroma is the largest layer.
  • The presentation discusses instruments to view the retina (direct ophthalmoscope, slit lamp, and fundus camera) and diseases like central retinal vein occlusions.

Macula and Optical Coherence Tomography (OCT)

  • Macula edema is highlighted as a condition requiring regular retinal examinations for those with diabetes.
  • OCT is used for evaluating the macula.

Optic Nerve Head (Optic Disk)

  • The optic disc, including the optic cup and cilioretinal vessels, is a part of the retina.

Choroid

  • The choroid, a part of the eye, is described.

Retina – Retinal Pigment Epithelium

  • Light entering the eye activates photochemical reactions in rods and cones, which activates the bipolar cells.

Visual Pathway and Testing

  • The presentation discusses the visual pathway, involving the optic nerve, optic chiasm, optic tract, lateral geniculate body, optic radiation, and visual cortex.
  • Ways to test the pathway, including videos on the subject matter are shared.

Pupillary Testing

  • Instruction on pupillary testing is included.

Retinal Detachment

  • The presentation describes retinal detachment.

Extraocular Muscles, Nerve Supply to Extraocular Muscles (and Video)

  • The slide shows the extraocular muscles.
  • The components of the extraocular muscles, and their nerve supply are detailed, including diagrams and videos.

Orbit

  • The presentation mentions the bones that form the orbit (frontal, sphenoid, maxilla, zygomatic, ethmoid, and lacrimal bones), including their margins.

Embryology of the Eye

  • The presentation briefly covers the embryology of the eye, highlighting key stages such as weeks 1, 2, 3 of development.
  • Specific mentions were made of gastrulation, notochord formation, and organogenesis, covering day 22 optic sulci, and optic pits among others.

Summary (Recap)

  • The presentation provides a summary of the discussed topics, encompassing the eyelids, conjunctiva, lacrimal system, precorneal tear film, chambers of the eye, aqueous flow, and the globe, including the cornea, sclera, iris and ciliary body, and lens.

Visual Acuity – Home Work

  • Links to videos regarding visual acuity are given.

  • A further summary section is included, with key takeaways and important structures discussed.

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Description

This quiz covers the anatomy of the eye and the essentials of ophthalmological examinations. Participants will learn to identify eye structures, differentiate between normal anatomy and ocular disorders, and explore embryology. Ideal for students and professionals in the field of ophthalmology.

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