Basic Anatomy of Eye😊

Basic Anatomy of Eye

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Canal of Petit

  • Small annular space in the eye.
  • Located between posterior zonules and anterior hyaloid membrane.
  • Also called Retrozonular space.
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General Features

  • Shape: Aspherical (Oblate spheroid)
  • Volume: 6 mL
  • Location: Orbit
    • Orbit Walls: 4 walls
      • Thinnest wall: 
        • Medial
      • Weakest wall: 
        • Floor
      • Most common orbital fracture: 
        • Blow out fracture
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Fracture floor of Orbit

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  • Known as Blow-out fracture.
  • Blunt Trauma to Orbit
  • Occurs due to tennis ball injury (trauma direct to orbit)
  • Orbit contents may herniate into maxillary sinus.
  • Floor is more susceptible than medial wall.
  • Radiological sign: Teardrop sign.
  • Infraorbital nerve is involved.
  • Other symptoms
    • Enophthalmos (sunken eye)
    • Diplopia on upward gaze
    • Loss of sensitivity over the cheek

Cone of Muscle & Annulus of Zinn

  • Annulus of Zinn:
    • Common tendinous ring.
      • Origin of Extraocular Muscles (EOM).
  • Orbit Shape:
    • Apex: Conical
    • Base: Quadrangular
    • Medial and lateral walls are present.

Routes of Local Anaesthesia

Site

  • Through the lower eyelid at the junction of middle 1/3 and lateral 1/3

Steps

Pull lower lid down
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Insert injection with
24–25G needle through lid along floor of eye
↓
Aspirate to rule out vessel injury
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Insert 5 mL of anaesthetic
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Post-injection compression over eye
  • Prevents rise in intraocular pressure

Eye related anasthesia and N supply

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Route
Target Space
Complications
Retrobulbar
Intraconal
More complications
Peribulbar
Extraconal
Fewer complications
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  • SET CEI

Nasociliary Nerve

  • Courses along medial wall of the orbit.
  • Branches
    • Posterior ethmoidal nerve
    • Anterior ethmoidal nerve
    • Infratrochlear nerve

Innervation

  • Lacrimal sac
  • Inner canthus
  • Lateral aspect of nose
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Anterior Ethmoidal Nerve Block

Anterior ethmoidal nerve block
Anterior ethmoidal nerve block
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  • Branch of nasociliary nerve.
  • Blocks distal external nasal branch.
  • Clinical Use
    • Provides pain relief during procedures involving:
      • Lacrimal sac
      • Inner canthus
      • Lateral nose
    • Infratrochlear Nerve Block Used in
      • Dacryocystorhinostomy (DCR)

Infraorbital nerve block :

External approach
External approach
Sublabial approach
Sublabial approach

Sphenopalatine ganglion block :

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  • Anaesthesia of internal nose.
    • Via nose
    • Via greater palatine foramen (Medial to 3rd molar)
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NOTE:

  • Biopsy above VC → anesthetize ILN at thyrohyoid membrane
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Layers of the Eyeball

Outermost Layer:

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  1. Cornea:
      • Transparent
      • Forms anterior 1/6th of eyeball.
      • Convex, refracts light.
  1. Sclera:
      • Opaque (white).
      • Forms posterior 5/6th of eyeball.
      • Covered by conjunctiva.
  1. Limbus:
      • Corneoscleral junction.
      • Contains stem cells.
        • Specific marker: ABCG2
        • Universal marker: CD34
      • Mnemonic: cornea → anterior 1/6th → 1+6 = 7 → ABCdefG → ABCG2

Middle Layer: Uvea (Vascular)

  1. Iris:
      • Sphincter pupillae: Responsible for miosis (constriction).
      • Dilator pupillae: Responsible for mydriasis (dilatation).
  1. Ciliary body:
      • Pars plicata (Anterior): Ciliary projections, secrete aqueous humor.
        • plicata - secrete
      • Pars plana (Posterior): Relatively avascular, entry point to fundus.
        • Plana - plane
          • Plane of entry
          • No blood supply
  1. Choroid:
      • Posteriormost layer.
      • Increased vascularity.

Inner Layer: Retina (Neurosensory)

  • Converts sensory impulses into neural signals.

Cross-section of Eyeball

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  • Pars plana: 
    • Site of entry into the vitreous.
  • Optic disc: 
    • Blind spot (no photoreceptors).
  • Fovea:
    • Maximum cones.
    • Center of visual field.
    • Provides best image.
    • Foveal fixation develops by 3-4 months.

A scan Ultrasonography

  • Determine Axial length of eyeball

Limbal dermoid:

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  • Benign, congenital tumor.
  • Composed of choriostomatous tissue.
  • May include bone, cilia, hair follicles.