ANATOMI DAN FISIOLOGI MATA

Agus Riansyah
C111 10 335
2
3
4
5
6
ORBITA
 ORBITA

Piramid Bola mata

Saraf
Otot
Jaringan lemak

40 mm
35 mm
30 cc

40 mm
Dinding Orbita :

Atap orbita Os frontale

Os Sphenoid ala parva
Berhubungan : Fossa kranii ant
Sinus frontalis
Dinding lateral Os Zygoma
Os frontale
Os Sphenoid ala magna
Berhubungan : Fossa kranii media
Fossa pterygopalatina
Dinding medial Os Ethmoid
Os Frontale
Os Lakrimal
Os Maksila bgn frontal
Berhubungan : Sinus Ethmoid &
Sphenoid
Kavum nasi
Dasar orbita Os Maksila
Os Palatina
Os Zygoma
Berhubungan : Sinus maksila
Rongga tulang
palatina
 Jaringan Lunak Rongga
Orbita
Peri orbita Periost
Kanal Optik Duramater
Anterior Septum orbita
N.Optika
Diselubungi Selubung otak
Otot ekstra okuler
Diselubungi Fascia, Ligamen dan jar ikat.
Jar lemak
Kel lakrimal
Pemb.darah ( art & vena ) + saraf
Bulbus Okuli Jar orbita

Art/vena ophthalmika ( + Cabang )

Saraf : optik,III,IV,VI dan perifer

Dinding orbita keras/kaku

Perub isi orbita

Proptosis / Eksophthalmos
 Kelainan orbit

Orbit dangkal
Orbit dalam
Fraktur orbit
Tumor orbit
Radang/infeksi orbit (cellulitis orbita)
Enophthalmos
Exophthalmos
Graves ophthalmology

14
Anatomi dan Faal Otot Ekstra Okuli
16
17
Pergerakan bola mata dilakukan oleh 6 pasang otot
ekstra okuli yaitu :

Cara Kerja
Otot Nervus
Primer Sekunder Tertier
Rektus medial adduksi - - III
Rektus lateral abduksi - - VI
Rektus superior elevasi intorsi adduksi III
Rektus inferior depresi ekstorsi adduksi III
Oblikus superior intorsi depresi abduksi IV
Oblikus inferior ekstorsi elevasi abduksi III
 Duksi (monocular movement) mata kanan.
Tanda panah menunjukkan arah gerakan mata dari
posisi primer
Anatomi Palpebra

20
Anatomi Palpebra

21
Anatomi Palpebra

22
Anatomi Palpebra

23
 KELOPAK MATA
Fungsi :
Melindungi bola mata
Pembilasan dan pelicinan
Air mata
Sekresi kelenjar

Jalan masuk sinar ( fissura palpebra )

Berkedip menyingkirkan debu / kotoran
yang masuk

24
Menutup mata :

- Otot orbikularis okuli N. VII ( N. Facialis )

Membuka mata :

- Otot levator palp N. III ( N. Okulomotor )

Otot tarsalis memegang tarsus

25
 Kelainan
palpebra

Radang Kongenital Posisi Tumor

Abses
Kelenjar Tepi palpebra Koloboma Entropion Jinak
Palpebra

Hordeolum Blefaritis Epikantus ektropion Ganas

Khalazion Ptosis

Ankyloblefaron

26
Otot otot orbikularis preseptal dan pretarsal
origo diatas fascia kantong/sakus lakrimalis
bila kontraksi ekskresi lakrimalis ke d.n.l

Otot levator palpebra n.III

- Aponeurosisnya insersi kepermukaan ant. tarsus &
kulit
- Fungsi : mengangkat kelopak mata

27
Infeksi dan Radang ke Kelopak Mata

1. Hordeolum
Infeksi stafilokokus
Tanda tanda infeksi +
Interna : kelenjar meibom Relatif besar
Eksterna : Kelenjar Zeiss dan moll.
Kompres hangat, drainage, salep
antibiotika
Kx. Sellulitis

28
29
2. Khalasion

Radang steril granulomatus kelenjar meibom

Biasanya pembengkakan mengarah ke sisi konj.

Khalazion yang besar menekan kornea

astigmatism

Tanda radang (-)

R/. drainage

30
LENSA
ANATOMI MATA & LENSA

Biconvex
Avascular
Transparan
Tebal 4mm, diameter 9 mm
Ant : humor akuos
Post : vitreous
Posisi : lig suspensorium (zonula)
zinn
 ISI LENSA

65% air
35% Protein, mineral, glutation, Potasium,
Ascorbid acid, dll
Tidak ada syaraf nyeri, pembuluh darah
Nutrisi : cairan intraokuler
 KATARAK

1. Developmental : Katarak Kongenital

Katarak Juvenil
2. Degeneratif : Katarak Senil
3. Komplikata : Katarak karena : Uveitis, DM
4. Trauma : Katarak Traumatika
 ANATOMI FISIOLOGI LENSA?

Healthy lens Lens with a cataract

Can be compared to a window

Clouding of the that is frosted or yellowed.
normally clear lens
of the eye.
35
 What is a Cataract ?

A clear lens refracts light A cloudy lens prevents

light from focusing
onto the retina and fine- sharply on the retina.
tunes our focusing
ability.
36
VITREORETINA
 VITREOUS
Transparent gel structure that fills the posterior cavity of the
globe

OPTIC NERVE HEAD (N II)

Round, 1.5 mm, C/D ratio

NEUROSENSORY RETINA
Transparent
Why orange ?? pigment from melanocytes of the choroidal
stroma and retinal pigmented epithelium (RPE)

RETINAL VESSEL
Artery: Straight,white reflex
Vein : Darker, turtous
A/V ratio : 2/3
 FOVEA
Central retinal depression, 1.5 mm ( 1 DD)
Ophthalmoscopically : light reflex
Darker than surroundings
(FAZ,melanin,xantophyl)
Fovea avascular zone ( 0.5 mm)
Basic Anatomy
 The Vitreous

Vitreous contains water (99%), collagen,

hyaluronic acid
Vitreous base : straddles the ora
serrata
Vitreous body : central & cortex
vitreous
Outermost part of the vitreous (hyaloid)
: Vitreous cortex, divided into anterior
cortex & posterior cortex
The Vitreoretinal Interface

Posterior vitreous
cortex attached to
the retina at
internal limiting
membrane (ILM)
Young individual :
strong adhesion
 Diseases of the vitreous

Vitreous
hemorrhage
Traumatic
Non traumatic :
Diabetic retinopathy
Retinal break
Posterior vitreous
detachment
Retinal
neovascularization
Vitrectomy
Tx :
Bed rest
Vitrectomy
 Diseases of the vitreous

Posterior Vitreous
Detachment (PVD)
Age vitreous
liquefies, loss of
hyaluronic acid
loss of gel volume
contractile force

Detachment
 Diseases of the vitreous

Asteroid hyalosis
Minute white
opacities
Calcium-containing
phospolipids
Relationship :
Diabetes &
hypertension (+)
Tx :
Vitrectomy
 The Retina

Thin membranous structure that lines the

posterior aspect of the eye
Divided : central zone & peripheral zone
Retinal base : anterior ora serrata
posterior N II
Retinal cells are stratisfied in 10 layers
 Ten Layers of The Retina

1. Internal limiting membrane

2. Nerve fiber layer
3. Ganglion cell layer
4. Inner plexiform layer
5. Inner nuclear layer
6. Outer plexiform layer
7. Outer nuclear layer
8. Photoreceptor cell (rod &
cone)
9. Retinal pigment epithelium
(RPE)
10. Bruch membrane
 Photoreceptor Cells

ROD CONE
92 million 5 million
Perifer >> Central >>
Scotopic vision Photopic vision (
(vision in dim light) vision in bright,
color)
Rod & Cone Cortex
17,18,19

Bipolar cells Lateral corpus

geniculatum

Ganglion cells Optic tract

Optic nerve Chiasma

 Retinal Pigment Epithelium

Single layer of hexagonally shaped

cuboidal cells, lying between Bruchs
membrane & retina
Contributes to retinal function :
Absorbs light
Maintain subretinal (RPE-fotoreceptor)
space
Phagocytosizes rod & cone outer segment
Forms the outer blood-ocular barrier
Retinol (vit A) metabolisme
 BRUCHS MEMBRANE
Basal portion of the RPE
Throughout life, lipids & oxidatively damaged
materials build up between Bruchs
membrane
CHOROID
Richly vascularized
Enveloping the retina & RPE
Blood Suply to the Retina

Two sources :
Central retinal artery
2/3 inner retina
Choroidal blood
vessels (65-85%)
1/3 Outer retina
(particularly
photoreceptor)
Fovea avascular
zone
Choroidal blood
vessels
 The Macula

SYNONIM :
Posterior pole
Macula lutea
Central retina
Area centralis
 The Macula
Histologic Definition
Contains two / more
ganglion cell layers
It contains xantophyll
pigment
(Clinical observation size)
Round area at
posterior pole, 5.5
mm (3.5 DD)
4 mm temporal, 0.8
Fovea
mm inferior to the Makula
center of the optic disc
 Synonim : Fovea centralis The Fovea
Histologic definition :
Depression in the
inner retinal surface
Photoreceptor layer
which is entirely cones
RPE : taller,
melanosome
Clinical observation :
Concave central
retinal depression
1.5 mm (1 DD)
Cross-section of Fovea