00:01
Now let's look at a
sagittal cross section
of the eyeball itself to see
some of the small structures
that lie within.
00:10
First of all, we have
the fibrous tunic,
which is composed of the
cornea and the sclera,
the cornea being very thin
and the sclera
being a very tough,
thick connective tissue layer.
00:24
We also have the vascular tunic,
which is comprised of the iris,
a structure called the ciliary
body at the edge of the iris
and the choroid
that carries much of
the vascular supply.
00:38
In the middle,
we have an avascular
structure called the lens.
00:44
The eyeball itself
can be divided
into an anterior and
posterior segment or cavity.
00:50
The anterior segment
is smaller and contains
what's called aqueous humor,
and can be divided into
an anterior chamber
and a posterior chamber on
either side of the iris.
01:04
The posterior cavity or segment
is composed of something
called the vitreous body,
which is a much thicker
gelatinous substance.
01:15
This is also where
we find the retina,
which is responsible for
sensing visual information.
01:22
So let's take a closer
look at that fibrous tunic.
01:26
So one component of that
fibrous tunic was the cornea.
01:30
And the cornea is one of
the few places in the body
that is avascular.
01:35
And it's avascular,
to help make it
more transparent,
so it doesn't distort any
light on its way to the retina.
01:44
The other part is much
tougher and thicker.
01:48
And that's the sclera.
01:50
It also doesn't have
a lot of blood supply.
01:53
And that's actually what gives
it its whitish appearance.
01:58
Now let's look at
the vascular tunic.
02:01
We have the iris,
or that circular portion
that you could look at
when you look at someone's eyes
and it's often where
we find eye color.
02:10
We have this structure
called the ciliary body
that it's surrounds the iris.
02:16
And then we have the vascular
layer called the choroid,
where much of the blood
supply comes from.
02:25
So if we were to look at the eye
from an anterior point of view,
we would again see the iris
and the space in the middle,
which is the pupil.
02:35
And the iris can act on
affecting the size of this pupil.
02:39
In situations where
the lights are bright,
the iris can
constrict that pupil
and it can also dilate the
pupil in areas of dim light
in order to let more light
through and hit the retina.
02:57
Back to a sagittal view,
we have the cornea,
the ciliary body, and
the ciliary body,
and the lens.
03:06
And the lens is held in place
by these suspensory ligaments.
03:11
If we're to look at this area
sitting in front of the lens,
we can divide the fluid
here into two chambers.
03:19
We have the anterior chamber
that sits anterior to the iris
and the posterior chamber
that sits posterior.
03:28
Now let's look at the
much larger cavity
the posterior cavity also
called the vitreous cavity.
03:36
So everything
posterior to the lens
is going to be called the
posterior or vitreous.
03:42
And we say vitreous because it has
something called vitreous humor,
which is much thicker
than the aqueous humor
of the anterior cavity.
03:53
And this is going to sit
directly on the retina.
03:57
Therefore, any movement
of this thick vitreous
can have an effect
on pulling in a sense
the underlying retina.
04:05
So let's look at
that aqueous humor
and how it flows.
04:11
So here we have
the ciliary body,
which again surrounds the iris.
04:17
And this is where we're going to
reduce the aqueous humor initially
behind the iris therefore
in the posterior chamber,
it will flow out and
overpass the pupil
and reach the anterior
chamber to fill it.
04:31
And then drainage
for aqueous humor
will be at this
scleral venous sinus,
also going by the eponym,
the canals of schlemm.
04:41
And this is a very
important area
because without proper drainage
of the canals of schlemm,
the amount of aqueous
humor could build up
and create too much pressure.
04:50
And that's essentially
the etiology of glaucoma.
04:57
Now let's look at the retina,
the part that's actually
perceiving vision for us.
05:05
Here we have the optic
part of the retina,
the part that's going to
actually have photoreceptors
and sense the changes
in patterns in light.
05:14
And then there's the
non visual retina
that will sit beyond this
border called the ora serrata.
05:22
A certain part of the retina
is going to have a
very high concentration
of certain types
of photoreceptors.
05:28
And we call that
the fovea centralis.
05:30
And that's going to be
the area where we sense
a real clear, sharp
central vision.
05:36
And then we're going
to have the optic disc,
which is the area where all of
the information from the retina
is coalescing to feed
into the optic nerve.
05:48
In terms of the microstructure,
if we're going from outside in,
we're going to start with that
fibrous tunic, the sclera,
deep to which we'll have the
vascular tunic, the choroid,
and then the retina.
06:03
And we're going to
have photoreceptors,
bipolar cells,
ganglion cells,
and all of this will lead
up to the optic nerve.
06:16
Just above the choroid layer
separated from the retina
is a little membrane
called Brooks membrane.
06:23
And then an area of
pigmented epithelium.
06:29
Then we're going to have the
processes of the photoreceptor cells
and photoreception is
actually working outside in,
in the sense that the
photoreceptors are actually
on the layer closest to the
retinal pigmented epithelium.
06:46
Then there's a tiny membrane,
called the outer
limiting membrane
separating it from the actual
nuclei of these photoreceptor cells.
06:56
Then these areas of connection
called the outer plexiform layer,
giving rise to the
nuclei of bipolar cells,
which are therefore
communicating
the information from
this photoreceptor cells
up to the inner plexiform layer,
where we have the nuclei of
what are called ganglion cells.
07:17
And finally, the
nerve fiber layer,
which are the nerve
fibers heading off
along the inner
limiting membrane
towards the optic disc
to feed the optic nerve.
07:30
And the retina has different
types of photoreceptors.
07:34
They're named off
of their shape,
and they're the rod shaped rods,
and they're sensitive to
levels of illumination
or how much light there is.
07:42
They're really good
for night vision.
07:46
Then there are the cones.
07:48
And they're the ones
used for daylight vision
and specifically color vision.
07:52
Therefore, they come in three
types red, blue, and green.
07:55
These are the ones that are heavily
concentrated in that fovea centralis.
08:02
Let's look at the vascular
supply of the eyeball itself.
08:07
Here we have the optic nerve
as it enters the optic cup.
08:12
And we see that the central
retinal artery and vein
are traveling inside
the optic nerve,
hence the term central.
08:21
We also had the short
ciliary arteries
and the long ciliary arteries
going into the choroid layer
rather than the retina.
08:30
And we had drainage
coming out of the vorticose,
also called choroid veins.
08:38
More anteriorly,
we're going to find
some anastomosis.
08:43
The arteries that are supplying
the extra ocular muscles
will actually enter
the eyeball here
in anastomose at an area called the
major arterial circle of the iris.
08:55
There's also a smaller
minor arterial circle.
09:01
Here's a view as if you
were looking at an eye
during an ophthalmic exam.
09:06
What you would see in
the center of your view
would be this macula lutea.
09:11
And the center of which
would be the fovea centralis,
which is going to be a
little more pigmented
than the surrounding retina.
09:20
Just off to the side is where you
would actually find the optic disc.
09:24
The optic disc being where
all of these nerve fibers
are coalescing to
form the optic nerve
wouldn't be an area
that has photoreceptors,
therefore, there's no actual vision
taking place in this little area.
09:38
What you can see is all
of these blood vessels
are heading towards that area.
09:43
Because of the relationship of the
central retinal artery and vein
to the optic nerve.
09:48
So we see superior nasal
arterioles and venules,
inferior nasal ones,
superior temporal ones,
and inferior temporal ones,
just based off of
their location.
10:05
We also have some branches
close to the macula.
10:09
And those are therefore called
the superior macular
arterioles and venules
and the inferior macular
arterioles and venules.
10:20
Here's another view as if you were
looking from an ophthalmoscope.
10:25
And you can again find
this macula and fovea
based off of the
darker pigmentation.
10:32
More nasally, we find the
very bright optic disc.
10:37
And again, it's bright here because
there is no retina covering it.
10:40
This is where all the nerve
fibers are coalescing.
10:44
Based off the location,
we can call these blood vessels,
the superior nasal ones.
10:51
These ones the
inferior nasal ones.
10:54
The ones more laterally as
the superior temporal ones,
and the inferior temporal ones.
11:00
And the ones that are
closer to the macula
would be the superior and
inferior macular ones.
11:06
Now let's look at how light
actually affects vision
when it hits the retina.
11:11
As we mentioned, the
cornea is a vascular
in order to not distort
any of the images
before they actually
reach the retina.
11:19
Then light will pass through the opening
of the iris that we call the pupil,
then through the lens,
which is by convex
but it is flexible and can
change its shape a little bit.
11:32
And it can do that through
the ciliary muscle.
11:35
And changing its shape
to help things focus
is a process called
accommodation.
11:41
If all of that goes well,
light should hit
the fovea centralis,
the area where we have our
sharpest clearest central vision.
11:51
Then this image
is actually inverted
on the retina,
so it's actually turned
upside down initially.
12:00
Now this leads us
to some problems
in what we would call refraction
of the bending of the light
before it actually
gets to the retina.
12:08
In myopia,
or nearsightedness,
the overall shape
makes it very difficult
for the image to focus where
it's supposed to on the retina,
making it hard to see things
that are further away.
12:23
To correct this, a concave lens
can actually direct the
image where it needs to be.
12:31
Conversely,
with what was called a
hyperoptic eye or farsightedness,
near vision is affected,
and correcting that
would use a convex lens.