1. ANATOMY OF THEEYEBALL ALFASHEROPHTHALMIC HOSPETAL By Dr Shawgi Adugory

2. ( ).ANATOMY OF THE 2 EYEBALL- dr Shawgi 3. The eyeball is embeded inorbital fat but it separated fromit by the fascial sheath of theeyeball. The eyeball cosists of 3 coatswhich from without inward,arefibrous coat, the vasscularbigmented coat &the nervouscoat.ANATOMY OF THE 3 EYEBALL- dr Shawgi 4. ( )ANATOMY OF THE4 EYEBALL- dr Shawgi 5. The fibrous coat made up of a posterior opaquepart.the sclera & an anterior transpartentpart the corneaThe scleraThe opaque part is composed of dense fibroustissue & is white.Posteriorly it is pierced by the optic nerve & isfused with the dural sheath of that nerve.The lamina cribrosa is area of sclera that ispierced by the nerve fibers of the optic nerve.the sclera is also pierced by the ciliaryarteties&nerves &their associated veins ,thevenae vorticosa.The sclera is directly continuous in front withthe cornea at the corneoscleral junction orANATOMY OF THE5limbus.EYEBALL- dr Shawgi 6. The cornea The transparent cornea is largelyresponsible for the refraction of the lightentering the eye. It is contact posteriorlywith the aqueous humor Blood supply:-the cornea is avascular&devoid of lymphatic drainge it isnourished by diffusion from the aqueous ANATOMY OF THE 6EYEBALL- dr Shawgi 7. humor& from the capillaries at the edge. Innervated by long ciliary nerves from theopthalmic diviation of the trigeminalnerve. ANATOMY OF THE7EYEBALL- dr Shawgi 8. Vascular pigment coatConsist from behind of the choroid, theciliary body & the iristhe choroid composed of an outer pigmentlayer & an inner,highly vascular layer >>the ciliary body is continuous posteriorlywith the choroid & anteriorly it lies behindthe peripheral margin of the iris ,itcomposed of the ciliary ring the ciliaryprocesses &the ciliary muscleANATOMY OF THE 8 EYEBALL- dr Shawgi 9. ANATOMY OF THE9EYEBALL- dr Shawgi 10. ANATOMY OF THE10EYEBALL- dr Shawgi 11. The iris &pupil The iris is a thin,contractile pigmented diaphragm withcentral aperture ,the pupil is suspended inthe aqueous humor b/w the cornea &thelens .the periphery of the iris is attached tothe anterior & a posterior chamberANATOMY OF THE11 EYEBALL- dr Shawgi 12. ANATOMY OF THE12EYEBALL- dr Shawgi 13. The nervous coat Retina which consist of an outerpigmented layer & an inner nervous layerits outer surface is in contact with thevitreous body,the posterior 0f the retinais the receptor organ ,its anterior edgeforms a wavy ring the ora serata & thenervous tissue end here. The anterior partof the retina in nonreceptive &consist 0fpigment cell with adeeper layer ofcolumnar epithelium ,this anterior part ofthe retina covers the ciliary processes &the back of the ANATOMY OF THE iris13EYEBALL- dr Shawgi 14. ANATOMY OF THE14EYEBALL- dr Shawgi 15. At the cener of the vposterior part of theretina is an oval yellowish area , theMacula lutea which is area of the retina forthe most distinct vision,it has centraldepression the Fovea centralis . The optic nerve leaves the retina about3mm to the medial side of the macula luteaby the optic disc.the optic disc is slightlydepressed at its center .where it is piercedby the central artery of the retina ,at theoptic disc is acomplete &is referred to asthe blind spot. ANATOMY OF THE 15 EYEBALL- dr Shawgi 16. The other part of the eyeball consist of the refractive media, the aqueous humer ,the vitreous body &the lens.the aqueous humer Is a clear fluid that fills the anterior &posterior chambers of the eyeball. the vitreous body fills the eyeball behind the lens & is a transparent gel. the lens is a transparent, biconvex structure enclosed in a transparent ANATOMY OF THE16EYEBALL- dr Shawgi 17. capsule .it is situated behindthe iris & in frontof the vitreousbody &is encircled by the ciliaryprocesses.ANATOMY OF THE 17 EYEBALL- dr Shawgi 18. ANATOMY OF THE18EYEBALL- dr Shawgi 19. Muscle of theeyeball&eyelids ALFASHEROPHTHALMICHOSPETAL By dr Shawgi AdugoryANATOMY OF THE19 EYEBALL- dr Shawgi 20. ANATOMY OF THE20EYEBALL- dr Shawgi 21. ANATOMY OF THE21EYEBALL- dr Shawgi 22. ANATOMY OF THE22EYEBALL- dr Shawgi 23. External muscle of theeyeball(striated skeletal muscle) Superior rectus Origin posterior ring oforbital cavity insertion superior surface ofeyeball just posterior to limbus . innervated byoculomotor nerve its action raises cornea upward & medialy inferior rectus Origin posterior wall ofthe orbital cavity insertion inferiorsurface of the eyeball just posteriorto limbus innervated by 3rd CN its actiondepresses cornea down ward &medially ANATOMY OF THE23EYEBALL- dr Shawgi 24. Medial rectus Origin posterior wall of theorbital cavity insertion medial surface of theeyeball just posterior to limbus innervated by 3rdCN its action rotate eyeball so that cornea looksmedially . Lateral rectus Origin posterior wall oforbital cavity insertion lateral surface of eyeballjust posterior to limbus innervated by 6th CN itsaction rotate eyeball so the cornea lookslaterallyANATOMY OF THE 24 EYEBALL- dr Shawgi 25. Superior oblique Origin posterior wall oforbital cavity insertion pass through the bulley &attached to superior surface of eye ball beneathsuperior rectus innervated by 4thCN its action rotate the eyeballso the cornea looksdown ward & laterally . Inferior oblique Origin floor of the orbitalcavity insertion lateral surface of eyeballbeneath the superior rectus innervated by3rdCN its action rotate the eyeball so thecornea looks up ward & laterally . ANATOMY OF THE25EYEBALL- dr Shawgi 26. ANATOMY OF THE26EYEBALL- dr Shawgi 27. Internisic muscle of theeyeball(smooth muscle) Sphinctor pupille of the iris innervated by parasympathetic via 3rdCN&its action constericts pupil Dilator pupille of the iris innervated by sympathetic&its action dilated pupil Ciliary muscle innervated by parasympathetic via 3rdCN&its action controls shape of lens; in accommodation makes lens more globularANATOMY OF THE27 EYEBALL- dr Shawgi 28. Muscle of the eyelids Orbicularis oculi contains 2 parts palpebral part &orbital part both originate from medial palpebral ligament &also both innervated bt 7thCN ,the palpebral part inserted into lateral palpebral raphe & its action closes eyelids dilated lacrimal sac while the orbital part inserted into loops return to origin& its action throws skin around orbit into folds to protect eyeball.ANATOMY OF THE 28 EYEBALL- dr Shawgi 29. Levator palpebrea superioris Originated from back of the orbital cavityinserted into anterior surface &margin ofsuperior tarsal plate innervated by thestriated musle by 3rdCN ;smooth musclesympathetic &its action raises upper lid ANATOMY OF THE29EYEBALL- dr Shawgi 30. Crenial Nerves assof the eyeballoptic The 2ndCN optic nerve consist ofnerve, optic chiasms ,optictract ,lateral geniculate body&thenoptic radiations Fiber from retina converge at the opticdisk & pass bachward as the optic nerve fibres from the nasal half of each retinadecussate at the optic chiasma while fibrefrom the temporal half remain on the sameside ANATOMY OF THE 30 . EYEBALL- dr Shawgi 31. ANATOMY OF THE31EYEBALL- dr Shawgi 32. ANATOMY OF THE32EYEBALL- dr Shawgi 33. The optic tract , thus formed ,containfibers from the temporal half of the retinaof the same side & the nasal half of theretina of the oppsite side The fiber of theoptic tract go to the latral geniculate body& then pass through the posterior limb ofthe internal capsule as the optic radiations. One group of optic radiation passesthrough the temporal lobe & other groupthrough the parietal lobe. ANATOMY OF THE 33EYEBALL- dr Shawgi 34. finally the are projected to thecalcarine sulcus (visual area)ofthe occipital lobe.The fiberconcerned with the light reflexdont relay in the geniculatebody & go to the superiorcalculi ; pretectal area of themidbrain & then 3rdCN nuclei ofboth sides. ANATOMY OF THE 34 EYEBALL- dr Shawgi 35. Examination for 1-visual acuity (eacheye examin separately the near vision ischucked by reading book & far vision withhelp of Snellen chart. 2-field of vision using Bjerrums screen(central vision)& the perineter (peripheralvision) if these are not available tested byconfrontation method. 3- color of vision is checked by using ofIshihara charts. 4-fundus by fundoscopy. ANATOMY OF THE 35EYEBALL- dr Shawgi 36. Lesions Optic nerve lesion complete loss of visionon the affected side, Optic chiasma *** involving crossed fibers>>> bitemporal hemianopia .*** involvinguncrossed fibers >>> binasal hemianopia. Optic tract ***left optic tract involved >>>left homonymous hemianopia (loss of lefthalves of visual fields of both side.)***rightoptic tract involve >>>right hom0nymoushemianopia. ANATOMY OF THE 36 EYEBALL- dr Shawgi 37. Optic radiation ***temporal optic radiation ;representupper quadrants 0f visual field &damagewill lead to superior qadrantanopia of theoppsite side. ***parietal optic radiations ; representlower quadrant of visual field & its lesionlead to inferior quadrantanopia of theoppsite side.ANATOMY OF THE37 EYEBALL- dr Shawgi 38. The 3rdCN Oculomotorsupplies all extraocular muscles except superior oblique &lateral rectus. in addition ,it also contains parasympathetic fibers which relay in the ciliarybganglion ;the post ganglionic fibers supply ciliary muscles &sphincter pupillae,the4thCN Trochlear Supply superior oblique muscle. ANATOMY OF THE38EYEBALL- dr Shawgi 39. &the6thCN Abducent nerves supply lateralrectus muscle The group of the external muscles ofeyeball (superior rectus ,inferior rectus,medial rectus ,lateral rectus , superioroblique &inferior oblique)&the one musclefrom the group of eyelid (levator palpebraesuperioris) make Extraocular muscles. The group of the internisic muscle of theeyeball (ciliary muscle ,sphincter pupillae ANATOMY OF THE 39EYEBALL- dr Shawgi 40. &dilator pupillae)make Intraocularmuscles. lateral & medial recti move the eyeballlaterally(abduction)&medially (adduction)Respectively In the midposition , superior rectus&inferior oblique move the eyeballupwards(elevation);& ,inferior rectus &superior oblique move the eyeballdownwards(depression) ANATOMY OF THE 40EYEBALL- dr Shawgi 41. If the eyeball is moved laterally ,upwards &downward movements are carried out bythe superior &inferior rectus respectively If the eyeball is moved medially ,upwards&downward movements are carried out bythe inferior &superior oblique respectively oblique muscle move the eyeball in thedirection opposite to their name. ANATOMY OF THE 41EYEBALL- dr Shawgi 42. . levator palpebrae superioris elevates the upper eyelid. All The extraocular muscles are suppliedby the 3rdCN except superior obliquewhich are supplied by the 4thCN & thelateral rectus which is supplied by the 6thCN.ANATOMY OF THE 42 EYEBALL- dr Shawgi 43. Intraocular muscles these are ciliarymuscles , sphincter pupillae &dilaterpupillae .the ciliary muscle make circle towhich suspensory ligament attached , theycontract when near objects are focused;the lens capsule relaxes &convexity of thelens is increased .there are 2 muscles inthe iris ;concentric fibers or sphincterpupillae constrict the pupil& radial fibersor dilater pupillae dilate the pupil. ANATOMY OF THE43EYEBALL- dr Shawgi 44. Ciliary muscle &sphincter pupillae aresupplied by the parasympathetic fibers ofthe 3rdCN .dilator pupillae is supply by thesympathetic fibers which travel alongcarotid opthalmic artery from superiorcervical ganglion. ANATOMY OF THE44EYEBALL- dr Shawgi 45. examination include:-Palpebral fissure,-Ocular movements-Pupil (size ,shape & test light &accomm0dation reflexes).-Nystagmus. ANATOMY OF THE45EYEBALL- dr Shawgi 46. Lesions of 3rdCN External ophthalmoplesia External strabismus(squint) Diplopia *ptosis*dilated pupil Loss of visualreflexes&accomodation ANATOMY OF THE46EYEBALL- dr Shawgi 47. ANATOMY OF THE47EYEBALL- dr Shawgi 48. LESIONS of 4thCN Vertical diplopia LESIONS of 5thCNHorizontal diplopia , _Internal strabismus,_Lateral gaze &_paralysis (nucl.communication ANATOMY OF THE48EYEBALL- dr Shawgi 49. ANATOMY OF THE49EYEBALL- dr Shawgi 50. ANATOMY OF THE50EYEBALL- dr Shawgi 51. ANATOMY OF THE51EYEBALL- dr Shawgi 52. Sensation of the eyesupply by the opthalmic division (1st part of 5thCN) it carries (touch, pain &temperature) to upper eyelid , conjunctiva, cornea & intraocular structuresANATOMY OF THE52 EYEBALL- dr Shawgi 53. The motor branch of the 7thCNsupplies all the muscles of thefascial expression . SO in thecase of 7thCN palsy the ptinable to close the eyelid besidedry conjectiva. ANATOMY OF THE 53EYEBALL- dr Shawgi 54. ANATOMY OF THE54EYEBALL- dr Shawgi 55. Our bOss dr/OsmanYOusif&mY seniOrs dr/dalia & dr/lana.if i saY Thank YOu i dOnT give YOu ,001 degree fOr all YOur Times 0f Teaching me &fOr all chances ThaT given me fOr Training & learning abOuT abc Of OphThalmOlOgY in This hOspiTal. ANATOMY OF THE55EYEBALL- dr Shawgi 56. dugory9@gmail.com ANATOMY OF THE56EYEBALL- dr Shawgi