1. Stefan Sivkov, MD, PhD

2. Development А. Onset 22 day of gestation; from neuroectoderm, ectoderm & mesoderm. B. Diencephalic vesicle gives origin to optic vesicle; after invagination develops double-layered optic cup. i) Inner layer develops into в pars nervosa of retina ii) Outer layer gives pars pigmentosa of retina, pigmentous epithelium of iris and ciliary body. C. Ectoderm gives origin of : i) Lens. ii) Corneal epithelium and conjunctiva. D. Mesoderm gives origin of: i) Stroma of sclera and cornea. ii) Stroma of choroid.

3. Development

4. Three parts n Optic apparatus – controls the light entering the eye n Detector system – for black / white and color vision n Nerve pathways – conveys signals to brain

5. 3 coats Tunica Fibrosa: cornea, sclera cornea, sclera Tunica Vasculosa: choroidea, corpus ciliare, iris choroidea, corpus ciliare, iris Tunica Nervosa: retina retina 3 chambers Anterior eye chamber Posterior eye chamber Corpus vitreum Eye ball Eye ball

6. Tunicae bulbi Outer, tunica fibrosa bulbi - cornea (transparent) - sclera (non-transparent, bluish in children, yellowish in adults) Middle, tunica vasculosa bulbi - iris and central opening, рupilla - corpus ciliare composed of: musculus ciliaris, processus ciliaris, zonula ciliaris with fibrae zonulares & spatia zonularia - choroidеа Inner, tunica interna bulbi (retina) - blind part, рars caeca retinae (from мargo pupillaris iridis to оra serrata): Pars iridica retinae (double-layered, pigmented cells) Pars ciliaris retinae (double-layered, pigmented inner layer) - рars optica retinae (stratified)

7. Eye chambers Three chambers filled with fluid: n Camera anterior bulbi (between cornea & iris), n Camera рosterior bulbi (between iris, fibrae zonulare & lens) n Corpus vitreum (between lens & retina). The nfirst two filled with humor aquosus, Corpus vitreum filled with humor vitreus.

9. Tunica fibrosa

10. Sclera Posterior 4/5 of tunica fibrosa; Collagen & elastic fibers, fibroblasts (substantia propria sclerae), 3 layers:  episclera: outer  substantia propria sclerae: middle  lamina fusca: inner, collagen & elastic fibers pigment cells; borders choroid

11. Cornea А. Anterior 1/5 of the coat Б. 5 – layered: - - Epithelium anterius: squamous stratified nonceratizing, 5 - 6 layers: - - Lamina limitans anterior (Bowman): 7 -12 mcm, collagen fibers, lacks cells, barrier agains infection, does not regenerates. - Substantia prоpria: 200 laminae of parallel collagen fibers. - Lamina limitans posterior (Descemet): 5 - 10 mcm, basal lamina of endothelium. - Endothelium posterius: simple squamous epithelium

12. i) Avascular ii) Transparent iii) Limbus - connection with sclera: Highly vascular Contains sinus venosus sclerae (Schlemm canal)

13. Tunica vasculosa Three parts: 1. Posterior - сhoroidea 2. Middle - сorpus ciliare 3. Anterior - iris

14. n 2/3 of the coat n Attached posteriorly to the sclera –Spatium perichoroidale –Lamina suprachoroidea n Composed of: –Connective tissue –Pigment cells –Blood vessels n 3 layers: –Lamina vasculosa –Lamina choriocapillaris –Lamina basalis (Bruch) Choroidea

15. Choroidea

16. n Orbiculus ciliaris – posterior n Corona ciliaris - anteromedial –Processus ciliares (70-80) n Dense capillary network n Produce humor aquosus n Fibrae zonulares n Musculus ciliaris - lateral n Fibrae meridionales (Brucke) n Fibrae radiales n Fibrae circulares (Muller) –Takes part in (n. oculomotorius) Corpus ciliare

17. Coprpus ciliare Orbiculus ciliaris, corona ciliaris

18. Accomodation n Focusing for near vision n Contraction of the pupil n Convergence

19. Accomodation n M. ciliaris contracts and moves forward n That relaxes zonule ciliares and lens becomes more convex n The eye adapts to near vision

20. Iris n Color is genetically determined. n Pigment: n Pigment: а. melanin & b. lipochrome. n Melanin - gene of 15 chromosome. n Lypochrome - gene of 19 chromosome. n Lypochrome - gene of 19 chromosome.

21. Iris n Anterior part n Opening in the middle, pupilla. n Margo pupillaris & margo ciliaris n Annulus iridis minor & anulus iridis major n Structure –Epithelium anterius –Stroma iridis –M. sphincter & dilatator pupillae –Epithelium pigmentosum Attached to the sclera by lig. pectinatum Attached to the sclera by lig. pectinatum

23. Iris. Ligamentum pectinatum

25. Retina n Eye fundus discus nervi optici (2 x 1.5 mm), central - excavation. n 4 mm lateral is an oval spot, fovea, in the center of macula lutea. n Centarl part of retina – d=21 mm from the center of discus n. optici. n Diameter of retina - 42 mm.

26. Structure n Retina (0.5 mm) inner layer. n N. opticus – axons of the ganlion cells. n Ganglion cells, efferent, the innermost. n Photoreceptive cells, rod and cones, outer.

27. 1. Pars pigmentosa - detachment of retina - detachment of retina 2. Pars nervosa (1) Stratum neuroepitheliale (1) Stratum neuroepitheliale Bacillus, Conus Bacillus, Conus (2) Stratum nucleare externum (2) Stratum nucleare externum Bipolar cell Bipolar cell Horizontal cell Horizontal cell Amacrine cell Amacrine cell (3) Stratum nucleare internum (3) Stratum nucleare internum Ganglion cell Ganglion cell Nervus Opticus (II) Nervus Opticus (II) RETINA

28. n Three cellular layers Outer nuclear – bodies of rods & cones Inner nuclear – bodies of bipolar, horizontal & amacrine cells Ganglion – bodiesa of ganglion cells. n Two synaptic layers Outer plexiform Inner plexiform Structure of retina

29. Stratum plexiforme externum Stratum plexiforme internum Synaptic layers

30. Ora serrata. Pars optica & pars ceca retinae

31. Fovea centralis

32. Rods and cones

34. Optic nerve

35. VisualPathway

36. Modality: Vision Modality: Vision Receptor: Photoreceptor Cell of Retina Receptor: Photoreceptor Cell of Retina Cranial Nerve: II (Optic nerve) Cranial Nerve: II (Optic nerve) 1st Neuron:Bipolar Cell 1st Neuron:Bipolar Cell 2nd Neuron: Ganglion Cell 2nd Neuron: Ganglion Cell optic nerve optic nerve optic chiasm optic chiasm optic tract optic tract 3rd Neuron: Lateral Geniculate Nucleus 3rd Neuron: Lateral Geniculate Nucleus optic radiation optic radiation Termination: Primary Visual Area (V I) Termination: Primary Visual Area (V I) Brodmann area 17 Brodmann area 17 Modality: Vision Modality: Vision Receptor: Photoreceptor Cell of Retina Receptor: Photoreceptor Cell of Retina Cranial Nerve: II (Optic nerve) Cranial Nerve: II (Optic nerve) 1st Neuron:Bipolar Cell 1st Neuron:Bipolar Cell 2nd Neuron: Ganglion Cell 2nd Neuron: Ganglion Cell optic nerve optic nerve optic chiasm optic chiasm optic tract optic tract 3rd Neuron: Lateral Geniculate Nucleus 3rd Neuron: Lateral Geniculate Nucleus optic radiation optic radiation Termination: Primary Visual Area (V I) Termination: Primary Visual Area (V I) Brodmann area 17 Brodmann area 17 Visual Pathway Visual Pathway

37. 1. Optic nerve 2. optic chiasm 3. optic tract 4. lateral geniculate body 5. optic radiation 6. visual cortex (striate cortex) (striate cortex) 7. Meyer’s loop 8. lateral ventricle Visual Pathway

38. 1. Optic nerve 2. Optic chiasm 3. Optic tract 4. Lateral geniculate body body 5. Optic radiation 6. Visual cortex (Striate cortex) (Striate cortex) VisualPathwayVisualPathway

39. Clinical Features of Visual Pathway Lesion Clinical Features of Visual Pathway Lesion 1. optic nerve 2. optic chiasm 3. optic tract 4. 5. optic radiation A. unilateral blindness B. bitemporal hemianopsia C. left homonymous hemianopsia hemianopsia D. left inferior homony- mous quadranopsia mous quadranopsia E. left superior homony- mous quadranopsia mous quadranopsia