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SPS Y2-2013 What is different • 3 Weeks • No Assignments! • Combined assessment [MFS] Schedule Nitty Gritty • • • • • SDL Can be converted to an interactive discussion Email: ([email protected]) Content MUST be decided! 10ish C2, all working days (almost) THE EYE BALL …A clinicians Perspective OBJECTIVES Identify the Multi-layered structure of the eye Associate structure of each layer with its function Infer the loss of integrity to loss of function of each layer of the eye Advocate workplace safety in reference to protection of ocular structures Sclera* Limbus Pupil Iris Cornea *Covered by a transparent vascular ‘skin’ -Conjunctiva • 3 Skins/ Coverings • 3 Walls/ Layers/ Coats/ Tunic THE SKINS/ COVERINGS • Conjunctiva • Tenon’s Capsule • Episclera SKINS/ COVERINGS CONJUNCTIVA Conjunctiva 1. Bulbar 2. Palpebral Conjunctiva Bulbar; Forniceal; Palpebral Conjunctiva Forniceal Bulbar Palpebral Conjunctiva 1. Bulbar 2. Palpebral [hidden] 3. Forniceal [hidden] Conjunctiva • Transparent • Very vascular • Protective • Tear Film • Vascularity Conjunctiva 1. Which part? Palpebral 2. Whats wrong? Red, Papillae 3. Allergic Conjunctivitis Conjunctiva 1. Which part? Bulbar 2. Whats wrong? ‘Pink’ 3. Viral Conjunctivitis TENON’S CAPSULE Tenon’s Capsule Tenon’s Capsule Tenon’s Capsule • ‘Barrier’ Protection EPISCLERA Episclera Episclera Episcleritis • Inflammation of Episclera Episcleritis Episcleritis CONJUNCTIVITIS?? Episcleritis Vs. Conjunctivitis • Blanching test… Episclera • Transparent • Vascular • Nutritive SKINS/ COVERINGS THE WALLS/ COATS/ LAYERS Protection Nutrition Protection Crucial Crucial Nutrition WALLS/ COATS/ LAYERS Protection Nutrition Crucial WALLS/ COATS/ LAYERS CHAMBERS & SEGMENTS Posterior Chamber AC ANGLE Anterior Segment Anterior Chamber Posterior Segment Fibrous Tunic/ Layer ‘Sclera’ & ‘Cornea’ Sclera 5/6 1/6 Sclera Sclera Sclera Perforation Cornea 1. EPITHELIUM Barrier Richly innervated 3. STROMA: Heals by scarring 5. ENDOTHELIUM: Na-K Pump Keeps Cornea ‘Dry’ Cornea 1. Epithelium 2. Bowman’s 3. Stroma 4. Basement membrane 5. Endothelium Cornea Cornea –Epithelial Injury Metallic foreign body Cornea –Stromal Injury Opacity (Inflammation) Cornea –Endothelial Injury Cornea Vascular Tunic aka ‘Uveal’ Tract: Iris/ Ciliary body/ Choroid Choroid/ Ciliary Body/ Iris Choroid Choroid • Vascular • Loads of Pigment • So much pigment it completely blocks the scleral view Ciliary Body Ciliary Body Ciliary Body SCLERA CORNEA Anterior MUSCLES IRIS Constricts Pars Plana Pars Plicata Ciliary Body Ciliary Body • Supports Lens • Aids Accommodation • Produces Aqueous Humor Iris Iris Iris 4. ANTERIOR SURFACE 3. STROMA 2. MUSCLES Vessels Dilator Sphincter 1. POSTERIOR SURFACE: Cells Iris Iris IRIS Iris Iris Iris Iris • Controls light entry • Attraction • Color is more than just pigment! • Crypts! AREAS OF INTEREST • LENS • ANTERIOR CHAMBER ANGLE Lens Lens Lens Lens Lens Cataract Lens Lens AGE Anterior Chamber Angle Anterior Chamber Angle Anterior Chamber Angle Anterior Chamber Angle IRIS Iris/ CB Sceral spur Trabecular Meshwork Schwalbe’s Line Anterior Chamber Angle Anterior Chamber Angle Under drainage (High Pressure) Over drainage (Low Pressure) Retina Retina Retina –Ora Serrata Retina –Ora Serrata Retina Retina Retina …pigment it completely blocks the scleral view Retina View obtained via an ophthalmoscope = fundus Retina Retina Retina RETINAL CHOROIDAL Retina Arterial Occlusion Venous Occlusion Arterial Venous Retina Retina Retina Retina • Light to electrical signals • All sorts of visual info Optic Disk NEURAL TISSUE MARGIN GLIAL TISSUE Cup Size = 3/10 of disk Size Optic Disk • Visible portion of CN II • aka optic nerve head • Afferent for visual information to the brain Optic Disk Cup Size = 8/10 of disk Size Optic Disk GLAUCOMA A minute more… Ability NoNo Aopacities pupil to pathology A distinguish normal that(remember No reacts anterior seen opacities two in normally points the chamber inflammation (no retina as to cataract) separate light [study (ophthalmoscopy) [study causes guide] [study guide] these) guide]
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