6 Cornea and Uvea Seminar 7 PDF

OPTM4102 Seminar 6: Cornea and Uvea BRI** A Dr Jason Charng [email protected]  Acknowledgement of country The University of Western Australia acknowledges that its campus is situated on Noongar...

OPTM4102 Seminar 6: Cornea and Uvea BRI** A Dr Jason Charng [email protected]  Acknowledgement of country The University of Western Australia acknowledges that its campus is situated on Noongar land, and that Noongar people remain the spiritual and cultural custodians of their land, and continue to practise their values, languages, beliefs and knowledge. Artist: Dr Richard Barry Walley OAM Objectives 1. Describe the anatomical features of the human Cornea and Uvea cornea 2. Relate corneal physiological changes to anatomy after refractive surgeries 3. Review anatomy behind pupil function. Further explore pupil anatomy via case study of pupil dysfunction. 4. Illustrate the histological features of different portions of the uvea 3 (ciliary body, choroid) Cornea 4 Cornea Cell of epithelium is made up ↑ by 3 cells - O Cornea is pain sensation highly innervated & be full of very senstive nerve tissue. to Tear film (above epithelium ( Confocal microscopy imaging of the various corneal layers using laser-scanning in vivo confocal technology. 1-3. Superficial epithelium, epithelial wing cell layer, and basal epithelium; 4. Subbasal nerve plexus; 5. Bowman's layer; 6-8. anterior stroma with A kous humour (under nerve (arrow), mid stroma with nerve trunk (arrow), and posterior stroma; 9. Endothelium; and 10. Inferior limbal palisade ridges (black arrows) with focal stromal projections (white arrows). endothelium) https://www.nature.com/articles/eye2012282 5 https://webeye.ophth.uiowa.edu/eyeforum/tutorials/Corneal-Imaging/Index.htm  Cornea epithelial cell is produced slosed off and naturally every 6-7 days. Limbal stem cells Palisades of Vogt conjuntiva xYE hypothesis https://www.sciencedirect.com/science/article/pii/S1542012415002098 6 https://www.mdpi.com/1999-4923/13/9/1483 Curvature and thickness 4 classes of Human Cornea surface currature is even steeper along vertically. danger N Spherical WTR astigmatism Oblique ATR astigmatism Is 10 or 90 steeper? Steeper along horizontally steep is wither 900 0r1800. https://www.clspectrum.com/ 7 Curvature and thickness Thin have cornea higher risk of proliferation danger.. N Why is colour scale inverted? 8 Keratoconus 9 Keratoconus Normal eye Keratoconus. thin > O - 10 Keratoconus Normal Frontal Correc surface is everely distributed. much steeper 11 CCT and IOP measure eye pressure This particular devise is designed assuming that the participant's central Cornea is 545 nm. 12 Refractive Surgery https://www.earthslab.com/anatomy/extraocular-muscles/ 13  Laser Laser is used to cut small isto usedto create The healing process of PRK a thin flap of epithelium. lens shaped tissue within the corneal stroma longerthan the other 2 reshape , is. Laser is then used to use laser to create small opening ↑ a the corneal stroma. in corneal epithelium Corneal refractive surgery. i. epithelium flap is & replaced Allow the removeal reattached by itself within mins. of the lens shape cut out from the Cornecel stroma. No flap is created Photorefractive keratectomy Laser-Assisted In Situ Small Incision Lenticule Extraction Keratomileusis PRK surface ↑ #I SMILE latest tech - * EGY LASIK flap surgery surgery Does not treat long sided vision Corneal epithelium. 1. is remove by mechanical thing. 6. use laser to reshape can be done in thin cornea Stroma cornea the corneal For thin but vision to repair tends to the refication or moderate (the higher , eye. be longer than LASIK. severe dry is required). the more shaping What eyedrops are prescribed after surgery? 14 T Antibiotic and sterial eye drop given pre-surgery are. + Antibiotic Eye protection Corneal refractive surgery Corneal wound healing after PRK surgery the injury part covers monolayer , eplithelium mitosis. limbus stem cells undergo forms by. to W Healing on of the stroma depends https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4502084/ epithelium interaction btw cells + Keratocytes - - - 15 undifferenciated. cells found in corneal stroma - Uvea 16  Which structures make up the uvea? of the middle - tunica eye Iris - body ciliary 3 portions - of urea (choroid. Uvea - Iris 18 Iris and pupil = ciliary 2Zones - pupillary No iris Tissu inner ring of the Tris => pupillary ruff 19 Iris and Pupil Iris 20 http://www.eophtha.com/posts/anatomy-of-uvea Iris and Pupil Normal pupil size range? https://www.frontiersin.org/articles/10.3389/fmed.2021.598791/full https://www.allaboutvision.com/en-gb/conditions/dilated-pupils/ 21 Iris and Pupil CONSENSUAL DIRECT 22 Iris and Pupil https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490362/ 23 Iris and Pupil Adie syndrome/Adie tonic pupil Which part of pathway affected? ANISOCORIA Is affected pupil smaller or larger? 24 https://link.springer.com/referenceworkentry/10.1007/978-3-540-69000-9_1230 Iris and Pupil Horner syndrome Which muscles? Symptoms? 25 https://www.amboss.com/ Uvea – Ciliary Body, Choroid 26 Ciliary body 27 Ciliary body Anterior uveitis Pain Redness Blurry vision Photophobia Symptoms and signs? 28 Ciliary body Anterior uveitis Symptoms and signs? 29 Choroid https://www.semanticscholar.org/paper/Developmental-Anatomy-of-the-Retinal-and-Choroidal-Anand-Apte-Hollyfield/64363afeea1c02e7621095ebb1086fdf322b08e8 30 Choroid Choroid Drawing of a histological section through the choroid close to the posterior pole. Notation: CIB—Choroid inner boundary; COB—Choroid outer boundary; CSI—Choroid-sclera interface https://clinicalgate.com/the-eye-4/ https://plos.figshare.com/articles/figure/Sample_swept-source_OCT_B-scan_ 31 Part II Ciliary Body and Choroid Choroid Increase in choroid thickness (red v blue) OCT of a healthy eye. EDI-OCT showing central serous chorioretinopathy and neurosensory The white arrows correspond to the choroid/scleral junction. retinal detachment demonstrating an increase in nasal peripapillary choroid thickness (413µm). Normal eyes = 250-350 µm https://www.reviewofoptometry.com/article/imaging-the-choroid-theres-an-app-for-that 32  1. Describe the anatomical features of the human Seminar 7 cornea Cornea and Uvea 2. Relate corneal physiological changes to anatomy after refractive surgeries 3. Review anatomy behind pupil function. Further explore pupil anatomy via case study of pupil dysfunction. 4. Illustrate the histological features of different portions of the uvea 33 (ciliary body, choroid)