PHYSIOLOGY OF THE EYE

Dr.Budu, Ph.D, Sp.M (K)

Department of Ophtlmology, Faculty of Medicine,

Hasanuddin University, Makassar
2011

Anatomy

Eye ball organs

1.
2.
3.
4.
5.
6.
7.
8.
9.

Eyelid
Tears
Kornea
Humor aquous
Uvea (iris, ciliary body, choroid)
Lens
Vitreous
Retina and visual cortex
Motor physiology of the eye

Palpebra = Eye lid

Function : to prevent trauma

to prevent excessive light
to distribute eye tears
to open-close the eye

There are 2 important muscles in eye lids :

1. M. Levator palpebra
- Elevation/contraction of eyelid .. Open the eye (N.III)

2. M. Orbicularis oculi
- Blink .. Pars palpebralis
- Close the eye ..pars orbitalis
- Tightly close the eye .. Pars tarsalis
The 3 functions contraction of the m. orbicularis oculi (N.VII)

Tears
Function of the tears :
1.

Releasing media of cell desquamation

2.

Oxygen supplay to cornea

3.

Antimicroba

4.

Palpebra-cornea lubrication material

5.

To prevent dryness of external surface of the eye.

Tears are produced by 2 systems :

1. Lacrimal gland /mayor : reflex secretion.

2. Lacrimal gland/accesorius : Krause and Wolfring . basic secretion.

Mechanisms of tears excretion

Sebagian besar air mata mengalir melalui pompa aktif

m. orbikularis okuli
Pompa air mata Rosengren-Doane, kontraksi otot
orbikularis menghasilkan daya penggerak. Kontraksi
tekanan positif pada sakus air mata ke dalam
hidung. Kelopak mata terbuka dan bergerak ke lateral
tekanan negatif di sakus dan ditahan oleh valve of
Hasner. Kelopak mata terbuka sempurna, pungtum
terbuka tekanan negatif kanalikuli.

Mechanisms of tears excretion

Tears layers

Tear film component

Tears consists of 3 layers :

1. Lipid layer (superficial layer), produced by Meibom gland
To prevent excess of tears dryness.
To fix the hydrophobic barrier
To fix tears meniscus.
2. Aquous layer (medium layer), produced by Krause and
Wolfring glands.
Oxygen supplier
Antimicroba
Corneal surface media
Release corneal surface unwanted materials
To adjust the function of corneal surface cell.
3. Mucin layer , produced by goblet cell
To alter hydrophobic to hydrophylic function
For eyelid lubrication

Tears function test (Schirmer Test)

Evaluation:
- Normal
Wetting of Whatman paper :10-30 mm
- Borderline dry eye
Wetting Whatman paper : 5-20 mm
- Dry eye
Wetting Whatman paper : 5

Cornea

Corneal layers

Cornea
The main corneal functions :
- Refraction media
- Barrier of eye ball contents
Corneal endothelial function :
1. Barrier of aquous humor to difuss into stroma.
2. Active metabolic pump of water from stroma.
Corneal metabolisms process :
1. Glucose and glycogen metabolisms
2. Oxygen metabolisms
3. Amino acid metabolisms.

Metabolic pump in cornea

Uveal tract dan Aquous humor

I. Iris and pupil
M. Spinter pupil, contraction . Myosis of pupil
M. delatator pupil, contraction . Mydriasis/delatation of
pupil

Pupil function: to arrange light into the eye .

Myosis

Mydriasis

Pupillary light reflex in general:

Light enters the eye

the pupil constricts

Direct pupillary reflex:

Light goes in one eye

the ipsilateral pupil constricts

Miosis

Consensual (indirect) pupillary reflex:

Light goes in one eye

the contralateral pupil constricts

Miosis

Nerves involved:
Optic nerve (N.II) is the sensory nerve
Oculomotor nerve (N III) is the motor nerve
specifically, the pre-ganglionic fibers
from the Edinger-Westphal nucleus
travel in the oculomotor nerve to
innervate the ciliary ganglion neurons
that activate the constrictor muscle
of the pupil

The wiring
ciliary
ganglion

ciliary
ganglion

RETINA

CN 3

CN 2

CHIASM

PRETECTAL
NUCLEUS

EDINGER
WESTPHAL
NUCLEUS

PRETECTAL
NUCLEUS

EDINGER
WESTPHAL
NUCLEUS

Neural pathways for direct reflex

light goes in one eye

then through optic nerve

to optic tract ipsilaterally
to ipsilateral pretectal nucleus
then to ipsilateral EdingerWestphal nucleus and
through ipsilateral oculomotor
nerve (CN3)
to ciliary ganglion, then
short post-ganglionic ciliary
nerves activate the constrictor

ciliary
ganglion

ciliary
ganglion

RETINA

CN 3

CN 2

CHIASM

PRETECTAL
NUCLEUS

EDINGER
WESTPHAL
NUCLEUS

PRETECTAL
NUCLEUS

EDINGER
WESTPHAL
NUCLEUS

Neural pathways for consensual reflex

Note: there are 2 places
where information can
cross

ciliary
ganglion

RETINA

At the optic chiasm

From the pretectal
nucleus to the EdingerWestphal nucleus
The following slides show the 2
routes separately, but light travels
both routes simultaneously.

ciliary
ganglion

CN 3

CN 2

CHIASM

PRETECTAL
NUCLEUS

EDINGER
WESTPHAL
NUCLEUS

PRETECTAL
NUCLEUS

EDINGER
WESTPHAL
NUCLEUS

1. Neural pathway for consensual reflex,

crossing at chiasm
light goes through optic

nerve
crosses at chiasm to
contralateral optic tract
continues to pretectal nucleus
and Edinger-Westphal
nucleus contralateral to light
stimulus
then out through the
oculomotor nerve
contralateral to light
stimulus
to ciliary ganglion, from
which ciliary nerves
activate the constrictor

ciliary
ganglion

ciliary
ganglion

RETINA

CN 3

CN 2

CHIASM

PRETECTAL
NUCLEUS

EDINGER
WESTPHAL
NUCLEUS

PRETECTAL
NUCLEUS

EDINGER
WESTPHAL
NUCLEUS

2. Neural pathway for consensual reflex,

10

crossing from pretectal nucleus

light goes through one optic

nerve
to optic tract ipsilaterally
to ipsilateral pretectal
nucleus
pretectal cells send axons
across midline in posterior
commissure
to Edinger-Westphal
nucleus then out through
the oculomotor nerve, both
contralateral to light
stimulus
to ciliary ganglion, and
pupillary constrictor

ciliary
ganglion

ciliary
ganglion

RETINA

CN 3

CN 2

CHIASM

PRETECTAL
NUCLEUS

EDINGER
WESTPHAL
NUCLEUS

PRETECTAL
NUCLEUS

EDINGER
WESTPHAL
NUCLEUS

II. Ciliary body

Functions :
Involving in accommodation system.
Production of aquous humor.
Involving in aquous drainage system

Ciliary body

Accommodation :
The ability of lens to convex.
Accommodation process (Hemholtz theory :
During ciliary muscle constraction --- Zinnii zonnula relaxation--lens became convex. Decrease of lens diameter.

Aquous Humor :
Produced by non-pigmented epithelial of ciliary body
Trough some physiological mechanisms : diffusion, ultrafiltation,
Active carbonic anhydrase, active secretion.
Secreted to posterior chamber trough pupil to anterior chamber .
Excretion of aquous humor via 2 routes :
trabecular meshwork-Schlemn canal and uveoskleral.

Humor aquous function :

1. Refraction media
2. Integrity of eye ball structure.
3. Nutrition of anterior segment.
4. Intraocular regularity.
III. Koroid
A tissue localize in the external part of retina.
Bruch membrane of choroid have function in active transport
Of tissue fluid from choroidal capillary to retina.

Lens

Lens is a bicnvex structure, avascular, and tranparans.

Consists of 66% water dan and the others are protein.
Function :
1. Refraction media
2. Involving in accommodation process.
3. To absorb ultraviolet .

Lens and dan Accommodation

Lens profile

Accommodation

Aksium siliaris
Diameter cincin siliaris
Tekanan zonula
Bentuk lensa
Diameter ekuator
Ketebalan aksial
Kurvatur anterior
Kurvatur posterior
Kekuatan dioptri

contraction
decrease
decrease
convex
decrease
Increase
Convex
Minimal change
Increase

Without Accommodation
Relaksation
Increase
Increase
concave
Increase
decrease
concave
Minimal change
decrease

RETINA

Visual processes
The physics of light and eye:

Transmission
The retina: Transduction and
organization
Sensory receptors: No axons
Graded receptor potentials

The visual pathways: Projection

Visual cortex: Perception

Retinal layer

Visual pathway

Visual Pathway is the nerve fiber sistems connecting the

retina and visual cortex in the occipital lobe of the brain.

Visual pathway consists of :

- Retina
- Optic nerve
- Optic chiasma
- Optic tract
- Lateral geniculatum body
- Optic radiation
- Visual cortex area

Visual Pathway is the nerve fiber sistems connecting the

retina and visual cortex in the occipital lobe of the brain.

MOTOR PHYSIOLOGY OF THE EYE

Basic Principles and Terms

Terminology of eye movements explained by two
concepts : The axes of Fick and Listings plane.
1. The axes of Fick designed as X, Y, and X
The X axis is transverse axis passing through the center of
the eye at the equator needed for voluntary vertical
rotations of the eye.
The Y axis is a saggital axis passing through the pupil necessary
for involuntary torsional rotation of the eye
The Z axis is a vertical axisof the eye for being voluntary
horizontal rotation.

2. Listings equatorial plane

Listing equatorial plane passes through the center of rotation
and includes the x dan z. The y axis is perpendicular to listing
plane

Position of Gaze
Basic terminology of the position of gaze :
- Primary position is straight ahead.
- Secondary positions are straight up, straight down, right
gaze, abd left gaze.
- Tertiary positions are four oblique positions of gaze : up and
right, up and left, down and right, and down and left.
- Cardinal positions are up and right, up and left, right, left,
down and right, and down and left.

Primary, Secondary, and Tertiary Action

Muscle
Medial rectus
Lateral rectus
Inferior rectus
Superior rectus
Inferior oblique
Superior oblique

Primary
Adduction
Abduction
Depression
Elevation
Extorsion
Intorsion

Secondary
Extorsion
Intorsion
Elevation
Depression

Tertiary
Adduction
Adduction
Abduction
Abduction

Eye Movements
I. Monocular eye movements (ductions)
1. Adduction is movement of the eye nasally.
2. Abduction is movement of the eye temporally
3. Elevation (supraduction) is an upward rotation of the eye.
4. Depression (infraduction) is a downward rotation of the eye.
5. Intorsion (incicloduction)is a nasal rotation of the superior
portion of the vertical corneal meridian.
6. Extorsion (excycloduction) is a temporal rotation of the
superior portion of the vertical cornea meridian

Sherringtons law

The important terms in monocular eye movements :

Agonis, the primary muscle moving the eye in a given direction.
Synergis, the muscle in the same eye acts with the agonist to
produce a given movement.
Antagonis, the muscle in the same eye acts in the direction
opposite to that of the agonist

II. Binocular eye movements : Consists of two types :

1. Version (conjugate binocular eye movements) ;
the eyes move in the same direction.
Right gaze (dextroversion)
Left gaze (levoversion)
Upgaze (sursumversion)
Downgaze (doursumversion)
Dextrocycloversion
Levocycloversion
Yoke muscle is used to describe two muscle (one in each eye)
that are prime movers of their respective eyes in the given
position of gaze
Herings law

2. Vergences (disconjugate binocular eye movement)

Convergence
Divergence
Incyclovergence
Excyclovergence

TerimaKasih