Anatomy of The Eye

2021 / 2020 ‫الدكتور يونس إسماعيل خلف الفهداوي‬

The Orbit

The orbital cavity is schematically represented as a pyramid of four walls that

converge posteriorly. The medial walls of the right and left orbit are parallel and
are separated by the nose. (fig. 1&2)
The volume of the adult orbit is approximately (30 mL) and the eyeball
occupies only about one-fifth of the space. Fat and muscles account for the bulk
of the remainder.
The anterior limit of the orbital cavity is the orbital septum which acts as a
barrier between the eyelids and orbit.
The orbits are related to the frontal sinus above ,the maxillary sinus below
,and the ethmoid and sphenoid sinuses medially.
The thin orbital floor is easily damaged by direct trauma to the globe resulting
in a "blowout" fracture with herniation of orbit contents into the maxillary
antrum.
Infection within the sphenoid and ethmoid sinuses can erode the paper-thin
medial wall (lamina papyracea) and involve the contents of the orbit.
Defects in the roof (e.g. neurofibromatosis) may result in visible pulsations of
the globe transmitted from the brain .

Orbital walls : (fig. 1)

I- The roof of the orbit is formed by the orbital plate of the frontal bone and
the lesser wing of the sphenoid bone posteriorly.( The lacrimal gland is located
in the lacrimal fossa in the anterior lateral aspect of the roof) .
II- The lateral wall is formed by the zygomatic (malar) bone this is the
strongest part of the bony orbit and the greater wing of the sphenoid bone
posteriorly .
III- The orbital floor is separated from the lateral wall by the inferior orbital
fissure, the orbital plate of the maxilla forms the large central area of the floor
(and is the region where blowout fractures most frequently occur), the frontal
process of the maxilla medially and the zygomatic bone laterally complete the

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 Anatomy of The Eye
2021 / 2020 ‫الدكتور يونس إسماعيل خلف الفهداوي‬

inferior orbital rim, the orbital process of the palatine bone forms a small
triangular area in the posterior floor.
IV-The medial wall is less distinct ; the ethmoid bone is paper-thin , the
lacrimal bone, the body of the sphenoid forms the most posterior aspect of the
medial wall and the angular process of the frontal bone forms a small part of it.

The eyeball

The normal adult globe is approximately spherical with an antero-posterior

diameter averaging 24.5 mm. ( fig 3,4,5)

The conjunctiva : fig. (4,10)

the conjunctive is the thin transparent mucous membrane that covers the
posterior surface of the lids( palpebral conjunctiva ) and the anterior surface of
the sclera ( bulbar conjunctiva ).
it is continuous with the skin at the lid margin(a muco-cutaneous junction) and
with the corneal epithelium at the limbus .
the palpebral conjunctiva lines the posterior surface of the lids and is firmly
adherent to the tarsus the conjunctiva is reflected back (at the superior and
inferior fornices ) and covers the episcleral tissue to become the bulbar
conjunctiva .
the bulbar conjunctive is loosely attached to the orbital septum in the fornices
and is folded many times this allows the eye to move and enlarges the secretary
conjunctival surface (the ducts of the lacrimal gland open into the superior
temporal fornix) .

The sclera & episclera :

the sclera is the fibrous outer protective coating of the eye .
it is dense and white and continuous with the cornea anteriorly and the dural
sheath of the optic nerve posteriorly, a few strands of scleral tissue pass across
the anterior portion of the optic nerve as the lamina cribrosa .

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 Anatomy of The Eye
2021 / 2020 ‫الدكتور يونس إسماعيل خلف الفهداوي‬

the outer surface of the anterior sclera is covered by a thin layer of fine elastic
tissue the episclera which contains numerous blood vessels that nourish the
sclera.
at the insertion of the rectus muscles the sclera is about 0.3 mm thick;
elsewhere it is about 1mm thick.
around the optic nerve the sclera is penetrated by the long and short posterior
ciliary arteries and the long and short ciliary nerves , the four vortex veins
draining the choroid exit through the sclera slightly posterior to the equator ,
usually one in each quadrant.
the nerve supply to the sclera is form the ciliary nerves.
histologically the sclera consists of many dense bands of parallel and interlacing
fibrous tissue bundles , the histologic structure of the sclera is remarkably
similar to that of the cornea.

The cornea :
The cornea is a transparent tissue comparable in size and structure to the
crystal of a small wrist watch (fig. 3,4,5). it is inserted into the sclera at the
limbus; the circumferential depression at this junction being known as the
scleral sulcus .
the average adult cornea is 0.54mm thick in the center about 0.65mm thick at
the periphery and about 11.5mm in diameter .
from anterior to posterior it has five distinct layers :
- epithelium (which is continuous with the epithelium of the bulbar
conjunctiva) it has five or six layers of cells .
- bowman's layer is a clear acellular layer ; a modified portion of the stroma.
- stroma account for about 90% of the corneal thickness . it is composed of
intertwining lamellae of collagen fibrils about 1µm wide that run almost the full
diameter of the cornea. They run parallel to the surface of the cornea and by
virtue of their size and periodicity are optically clear.
- descemets membrane is a clear elastic membrane that appears amorphous
on electron microscopy and represents the basement membrane of the corneal
endothelium

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 Anatomy of The Eye
2021 / 2020 ‫الدكتور يونس إسماعيل خلف الفهداوي‬

- endothelium is the inner most (and only one layer), it is cannot regenerate
when damaged, by pumping action, it keeps the cornea in dehydrated state and
hence optically clear.
sources of nutrition for the cornea are the vessels of the limbus , the aqueous
and the tears . the superficial cornea also gets most of its oxygen from the
atmosphere.
the sensory supply of the cornea is by the first (ophthalmic) division of the fifth
(trigeminal) cranial nerve.
the transparency of the cornea is due to its uniform structure , avascularity
and deturgescence.

The uveal tract :

The uveal tract is composed of the iris , the ciliary body and the choroid (fig.
3,4,5 ) . it is the middle vascular layer of the eye and is protected by the cornea
and sclera.
Its structure is mainly vascular and hence nutrition to the adjacent structures is
the main function.
I- The Iris :
The iris is the anterior extension of the ciliary body. it presents as a flat
surface with a centrally situated round aperture "the pupil".
the iris lies in contiguity with the anterior surface of the lens dividing the
anterior chamber from the posterior chamber each of which contains aqueous
humor.
within the stroma of the iris are the sphincter and dilator muscles . the two
heavily pigmented layers on the posterior surface of the iris represent anterior
extensions of the neuro- retina and retinal pigment epithelium.
II- The ciliary body :
The ciliary body roughly triangular in cross section extends forward from the
anterior end of the choroid to the root of the iris (about 6mm).
it consists of a corrugated anterior zone the pars plicata and a flattened
posterior zone the pares plana , the ciliary processes arise from the pars plicata .

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 Anatomy of The Eye
2021 / 2020 ‫الدكتور يونس إسماعيل خلف الفهداوي‬

there are two layers of ciliary epithelium: an internal non pigmented layer
representing the anterior extension of the neuro retina and external pigmented
layer representing an extension of the retinal pigment epithelium. the cilliary
processes and their covering ciliary epithelium are responsible for the formation
of aqueous.
The ciliary muscle is composed of a combination of longitudinal , circular and
radial fibers ; the function of the circular fibers is to contract and relax the
zonular fibers which originate in the valleys between the ciliary processes (this
alters the tension on the capsule of the lens giving the lens a variable focus for
both near and distant objects . the longitudinal fibers of the ciliary muscle insert
into the trabecular meshwork to influence its pore size.

III- The choroid :

The choroid is the posterior segment of the uveal tract (lies between the retina
and the sclera). it is composed of three layers of choroidal blood vessels large,
medium and small. the internal portion of the choroid vessels is known as the
choriocapillaris.
blood from the choroid vessels drains via the four vortex veins one in each of
the four posterior quadrants.
the choroidal blood vessels serves to nourish the outer portion of the
underlying retina .

The lens : fig. (3,4,5)

The lens is a biconvex, a vascular ,colorless and almost completely transparent
structure about 4mm thick and 9mm in diameter.
it is suspended behind the iris by the zonule which connects it with the ciliary
body.
anterior to the lens is the aqueous while posterior to it, is the vitreous.
the lens capsule is a semi permeable membrane ( slightly more permeable than
a capillary wall)that will admit water and electrolytes.

The aqueous :

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 Anatomy of The Eye
2021 / 2020 ‫الدكتور يونس إسماعيل خلف الفهداوي‬

aqueous humor is produced by the ciliary body entering the posterior chamber.
it passes through the pupil into the anterior chamber and then peripherally
toward the anterior chamber angle . fig. 3

The anterior chamber angle : fig. 5

The anterior chamber angle lies at the junction of the peripheral cornea and
the root of the iris . its main anatomic features are schwalbes line , the
trabcular meshwork (which overlies schlemms canal ) and the scleral spur.
- Schwalbes line marks the termination of the corneal endothelium .
- the trabecular meshwork is triangular in cross-section with its base directed
toward the ciliary body, it is composed of perforated sheets of collagen and
elastic tissue forming a filter with decreasing pore size as the cannel of schlemm
is approached .
- the scleral spur is an inward extension of the sclera between the ciliary body
and schlemms canal to which the iris and ciliary body are attached.
Efferent channels from schlemms canal (about 30 collector channels and 12
aqueous veins) communicate with the episcleral venous system.

The retina :
The retina is a thin semitransparent multilayered sheet of neural tissue that
lines the inner aspect of the posterior two-thirds of the wall of the globe.
it extends almost as far anteriorly as the ciliary body ending at the point in a
ragged edge the ora serrate (fig. 4,6 )
the outer surface of the sensory retina is apposed to the retinal pigment
epithelium and thus related to bruchs membrane of the choroid and the sclera .
in most areas the sensory retina and the retinal pigment epithelium are easily
separated to from the sub retinal space such as occurs in retinal detachment
but at the optic disk and the ora serrata the retina and retinal pigment
epithelium are firmly bound together thus limiting the spread of sub retinal fluid
in retinal detachment . the inner surface of the retina is apposed to the vitreous.

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 Anatomy of The Eye
2021 / 2020 ‫الدكتور يونس إسماعيل خلف الفهداوي‬

the epithelial layers of the inner surface of the ciliary body and the posterior
surface of the iris represent anterior extension of sensory retina and retinal
pigment epithelium.
The layers of the retina starting from its inner aspect are:
(1)internal limiting membrane.
(2) nerve fiber layer : containing the ganglion cell axons passing to the optic
nerve.
(3) ganglion cell layer .
(4) inner plexifrom layer, containing the connections of the ganglion cells with
the amacrine and bipolar cells.
(5) inner nuclear layer of bipolar , amacrina and horizontal cell bodies (6) outer
plexifrom layer, containing the connections of the bipolar and horizontal cells
with the photoreceptors.
(7) outer nuclear layer of photoreceptor cell nuclei.
(8) external limiting membrane .
(9) photoreceptor layer of rods and cones .
(10) retinal pigment epithelium .

The vitreous : fig. (3,4)

The vitreous is a clear avascular gelatinous body that comprises two-thirds of
the volume and weight of the eye. it fills the space bounded by the lens retina
and optic disk .
the outer surface of the vitreous (the hyaloid membrane) is normally in contact
with the following structures: the posterior lens capsule , the zonular fibers , the
pars plana epithelium ,the retina and the optic nerve head .
the base of the vitreous maintains a firm attachment through our life to the pars
plana epithelium and the retina immediately behind the ora serrata.
the attachment to the lens capsule and the optic nerve head is firm in early life
but soon disappears.
the vitreous is about 99% water; the remaining 1% includes two components
collagen and hyaluronic acid which give the vitreous a gel-like from and
consistency because of their ability to bind large volumes of water.

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 Anatomy of The Eye
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The ocular muscles

I-Rectus muscles : fig. (7,8)

The four rectus muscles originate at a common ring tendon (annulus of zinn)
surrounding the optic nerve at the posterior apex of the orbit.
they are named according to their insertion into the sclera on the medial ,
lateral , inferior and superior surfaces of the eye.
the principal action of the respective muscles is thus to adduct , abduct ,
depress and elevate the globe accordingly.
the muscles are about (40)mm long becoming tendinous (4-9)mm from the
point of insertion where they are about 10mm wide.
the approximate distance of the points of insertion from the corneal limbus are
as follows : medial rectus 5mm, inferior rectus 6mm , lateral rectus 7mm and
superior rectus 8mm .

II-Oblique muscles : fig. (7,8)

The two oblique muscles control primarily torsional movement and to a lesser
extent upward and downward movement of the globe.
i- Sup. Oblique : (is the longest and thinnest of the ocular muscles).
- it originates above and medial to the optic foramen and partially overlaps the
origin of the levator palpebrae superioris muscle .
- the superior oblique has a thin fusiform belly (40mm long ) and passes
anteriorly in the form of a tendon to its trochlea or pulley, it is then reflected
backward and downward to attach in a fan shape to the sclera beneath the
superior rectus.( the trochlea is a cartilaginous structure attached to the frontal
bone 3mm behind the orbital rim).
ii- Inf. Oblique :
- it originates from the nasal side of the orbital wall just behind the inferior
orbital rim and lateral to the nasolacrimal duct.

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 Anatomy of The Eye
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- it passes beneath the inferior rectus to insert onto the sclera with a short
tendon at the postero-temporal segment of the globe just over the macular
area.
Nerve supply :
1-The oculomotor nerve (III) innervates the medial, inferior and superior rectus
muscles and the inferior oblique muscle.
2- The abducens nerve(VI) innervates the lateral rectus muscle.
3- The trochlear nerve (IV) innervates the superior oblique muscle.

III-Levator palpebrae superioris muscle:

- the levator palpebrae muscle arises with a short tendon from the
undersurface of the lesser wing of the sphenoid above and ahead of the optic
foramen.

- the two extremities of the levator aponeurosis are called its medial and
lateral horns. The medial horn is thin and is attached into the medial palpebral
ligament , the lateral horn inserts into the orbital tubercle and the lateral
palpebral ligament.

- the levator belly passes forward forms an aponeurosis and spreads like a fan.

- the levator is supplied by the superior branch of the oculomotor nerve(III) .

- the muscle including its smooth muscle component (mullers muscle) and its
aponeurosis form an important part of the upper lid retractor .
( the palpebral segment of the orbicularis oculi muscle acts as its antagonist).

IV-Orbicularis oculi muscle: see later

The ocular adnexia

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 Anatomy of The Eye
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I- Eye brows :
The eyebrows are folds of thickened skin covered with hair . the skin fold is
supported by underlying muscle fibers. the glabella is the hairless prominence
between the eyebrows. Fig. (9)

II- Eye lids :

The upper and lower eyelids (palpebrae) are modified folds of skin that can
close to protect the anterior eyeball . fig. (10)
blinking helps spread the tear film which protects the cornea and conjunctiva
from dehydration . the upper lid ends at the eyebrows; the lower lid merges
into the cheek. the eyelids consist of five principal planes of tissues .
Structures of the eyelids :
1. skin layer: the skin of the eyelids is thin loose and elastic and possesses few
hair follicles and no subcutaneous fat .
2. orbicularis oculi muscle: the function of the orbicularis oculi muscle is to
close the lids. its muscle fibers surround the palpebral fissure in concentric
fashion the segment outside the lids is called the orbital portion . the
orbicularis oculi is supplied by the facial nerve.
3. areolar tissue: the submuscular areolar tissue that lies deep to the orbicularis
oculi muscle communicates with the subaponeurotic layer of the scalp
4. tarsal plates: the main supporting structure of the eyelids is a dense (fibrous
tissue layer) that- along with a small amount of elastic tissue- is called the tarsal
plate. the lateral and medial angles and extensions of the tarsal plates are
attached to the orbital margin by the lateral and medial palpebral ligaments .
5.palpebral conjunctiva: the lids are lined posteriorly by a layer of mucous
membrane ,the palpebral conjunctiva, which adheres firmly to the tarsal plates .
a surgical incision through the gray line of the lid margin splits the lid into an
anterior lamella (of skin and orbicularis muscle) and a posterior lamella (of
tarsal plate and palpebral conjunctiva).
Lid margins :
The free lid margin is 25-30 mm long and about 2 mm wide it is divided by the
gary line (mucocutaneous junction) into anterior and posterior margins

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 Anatomy of The Eye
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A . anterior margin:
1. Eyelashes :- the eyelashes project from the margins of the eyelids and are
arranged irregularly, the upper lashes are longer and more numerous than the
lower lashes and turn upward ; the lower lashes turn downward.
2. glands of zeis :- these are small modified sebaceous glands that open into
the hair follicles at the base of the eyelashes.
3. glands of moll :- these are modified sweat glands that open in a row near
the base of the eye lashes.
B. posterior margin:
the posterior lid margin is in close contact with the globe and along this
margin are the small orifices of modified sebaceous glands ( meibomian or
tarsal glands).

C. lacrimal punctum:
at the medial end of the posterior margin of each lid a small elevation with a
central small opening can be seen on the upper and lower lids.
the puncta serve to carry the tears down through the corresponding canaliculus
to the lacrimal sac.
Sensory nerve supply :
the sensory nerve supply to the eyelids is derived from the first and second
divisions of the trigeminal nerve(V).

III- the lacrimal apparatus :

It consists of the lacrimal gland(with the accessory glands) and nasolacimal
drainage system. (fig. 9 )
The lacrimal gland consists of the following structures:
(1) the almond-shaped orbital portion located in the lacrimal fossa in the
anterior upper temporal segment of the orbit .
(2) the smaller palpebral portion is located just above the temporal segment
of the superior conjunctival fornix . lacrimal secretory ducts which open by
approximately ten fine orifices connect the orbital and palpebral portions of
the lacrimal gland to the superior conjunctival fornix. Removal of the

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 Anatomy of The Eye
2021 / 2020 ‫الدكتور يونس إسماعيل خلف الفهداوي‬

palpebral portion of the gland cuts off all of the connecting ducts and thus
prevents secretion by the entire gland.
The accessory lacrimal glands (of Krause and wolfring) are located in the
substance propria of the palpebral conjunctiva.
Tears drain from the lacrimal lake via the upper and lower puncta and
canaliculi to the lacrimal sac which lies in the lacrimal fossa , the nasolacrimal
duct continues outward and slightly backward from the sac and opens into
the inferior meatus of the nasal cavity .
Tears are directed into the puncta by the combined forces of capillary
attraction in the canaliculi, gravity and the pumping action of horners muscle
(which is an extension of the orbicularis oculi muscle).
Nerve supply by lacrimal nerve(sensory) , great superficial petrosal nerve
(secretory) and sympathetic fibers .

Ciliary ganglion
The parasympathetic ciliary ganglion is located about (1 cm) in front of the
annulus of zinn on the lateral side of the ophthalmic artery, between the
optic nerve and the lateral rectus muscle. Fig. (11)
It receives three roots :
I- a long (sensory) root from the nasociliary nerve . it contains sensory fibers
from the cornea, the iris ,and the ciliary body.
II- a short (motor) root arises from the lower division of the oculomotor
nerve (which also supplies the inferior oblique muscle).
the fibers of the motor root synapse in the ganglion and carry
parasympathetic axons to supply the iris sphincter.
III- the sympathetic root comes from the plexus around the internal carotid
artery, the fibers passes through the ganglion and innervates vessels of the
eye and possibly the dilator fibers to the iris.
Branches of the ciliary ganglion : (short ciliary nerves)

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 Anatomy of The Eye
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The postganglionic short ciliary nerves are (6 to 10)and these arise from the
ciliary ganglion .
each short ciliary nerve contains sympathetic, parasymbathetic and sensory
fibers.
Only the parasympathetic fibers are thought to synapse in the ciliary ganglion
((sympathetic fibers from cell bodies in the superior cervical ganglion and
sensory fibers from cell bodies in the trigeminal ganglion , all passing directly
through the ciliary ganglion without synapsing)).
The short ciliary nerves travel on both sides of the optic nerve and together
with the long ciliary nerves pierce the sclera around the optic nerve, they
pass anteriorly to from a plexus in the ciliary muscle that supplies the cornea,
the ciliary body, and the iris.

Visual pathway

The visual pathway transmitted neural stimuli( image) formed by the retina
mainly to the visual centre in the occipital cortex. Fig. (12)
Some fibers conveys stimuli to the mid brain to serve the pupillary reaction
or reflex.

I- Optic nerve : ((the second cranial nerve))

it is evident that the optic nerve not a nerve but actually a nerve fiber
tract of the central nervous system formed by axons of the retinal ganglion
cells, the macular projections are located centrally in the optic nerve and
constitute 80% to 90% of the total volume of the optic nerve and the
chiasmal fibers. it has three main parts :
a- Intraocular portion : the intraocular portion of the optic nerve can be
divided into three parts: pre-laminar, laminar,and retro-laminar. the surface
of the prelaminar portion is visible ophthalmoscopically. Fig. (6)

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 Anatomy of The Eye
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it is a 1.5 by 1.75 mm, oval ,with a disc shaped depression ( the physiologic
cup) . the main branches of the central retinal artery and vein pass through
the center of the cup. Fig 6
b- orbital portion : this part extends from the globe to the apex of the orbit.
c- Intracranial portion : after passing through the optic foramen the optic
nerves lie above the ophthalmic arteries and above and medial to the
internal carotid arteries. the optic nerves then pass posteriorly over the
cavernous sinus to join the optic chiasm.
**{lesion of the optic nerve causes ipsilateral field loss (and blindness) with
ipsilateral afferent pupillary defect}.

II- Optic chiasm :

the optic chiasm "makes up" part of the floor of the third ventricle. it is
surrounded by pia and arachnoid and is richly vascularized.
it is approximately 12 mm wide, 8 mm in the anteropostrior direction and
4mm thick .
the nasal retinal fibers cross in the chiasm passing into the opposite optic
tract while temporal fibers remain uncrossed in the chiasm and optic tract.
approximately 53% of the optic nerve fibers are crossed and 47% are
uncrossed.
**{ lesion of the central part of the chiasm causes "bitemporal heminopia
while lesion of peripheral part of the chiasm causes binasal heminopia ,
pupillary fibers may be involved }.

III - Optic tract :

each optic tract contains ipsilateral temporal and contralateral nasal fibers
from the optic nerves fibers.(from the upper retinal projections, both crossed
and uncrossed travel medially in the optic tract) while lower projections
move laterally.
Pupillary fibers leaves the tract before entering the lateral geniculate body
passing to the pretectal area then to the mid brain approaching the
oculomotor nerve nucleus.

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**{ optic tract lesion causes contralateral heminopia}.

IV - Lateral geniculate nucleus :

the lateral geniculate nucleus or body is the synaptic zone for the higher
visual projections . it is an oval or cap-like structure which receives
approximately 70% of the optic tract fibers.
within its six alternating layers of gray and white matter; layers 1,4 and 6 of
the lateral geniculate body contain axons from the contralateral optic nerve
while layers 2,3and 5 arise from the ipsilateral optic nerve.
**{ lesion of L.G.N. causes contralateral heminopia without pupillary
reaction defect }.

V - Optic radiation :
the optic radiation connects the lateral geniculate body with the visual cortex
of the occipital lobe. the fibers of the optic radiation leave the lateral
geniculate body and run around the temporal horn of the lateral ventricle
approaching the anterior tip of the temporal lobe ( loop of meyer ) they then
sweep back ward toward the visual area of the occipital lobe.
**{ lesion causes visual defects similar to L.G.N. }

VI - Visual cortex :
the visual cortex has six cellular layers, is the thinnest area of the human
cerebral cortex , and occupies the superior and inferior lips of the calcarine
fissure on the posterior and medial surfaces of the occipital lobes.
macular function is extremely well represented in the visual cortex and
occupies the most posterior position at the tip of the occipital lobe.
The posterior cerebral artery, a branch of the basilar artery supplies the
visual cortex almost exclusively.
**{lesion causes visual defects similar to L.G.N. and radiation but with
macular sparing }.

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