ABO Certification Training. Part I: Anatomy and Physiology
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1 ABO Certification Training Part I: Anatomy and Physiology
2 Major Ocular Structures Centralis Nerve
3 Major Ocular Structures
4 The Cornea Cornea Layers Epithelium Highly regenerative: Cells reproduce so rapidly that a mild scratch can heal within 24 hours Bowman s Membrane Stroma Comprises 90% of total corneal thickness Desemet s Membrane Endothelium
5 Major Ocular Structures Centralis Nerve
6 Accommodation and Convergence During accommodation, the eye adjusts for viewing objects at various distances. This is done by the crystalline lens changing shape through the action of the ciliary muscle. Associated with accommodation is convergence and the constricting of the pupils. Accommodation 1. The ciliary muscle relaxes allowing for a thickening of the crystalline lens. 2. The eyes converge. 3. The pupils constrict.
7 Accommodation and Convergence Since the eyes converge when viewing an object at near distance (as when reading) the PD for near vision is narrower than that for distance vision. Distance PD Less than 62 mm Subtract for Near 2 mm mm 3 mm More than 66 mm 4 mm
8 Major Ocular Structures Centralis Nerve
9 The Retina The Film of the Camera Contains about 120 million rods and 6 million cones The greatest density of cones are found in the fovea. Cone density gradually decreases radiating outward from the fovea while the population of rods increases. Cones Rods Day Vision Night Vision Detail Color Peripheral Vision Black and White
10 Major Ocular Structures Centralis Nerve
11 Visual Pathway Transparent Structure of the Eye Vitreous Humor 1.33 Cornea 1.37 Index of Refraction Crystalline Lens 1.42 Aqueous Humor 1.33
12 Visual Pathway
13 Structures of the Eye Certain structures of the eye may be grouped together to form what are called tunics or coverings. Fibrous Tunic Vascular Tunic Neural Tunic Tunics Outer protective coat of the eye. Consists of the Sclera and Cornea Also known as the uveal tract. Consists of three parts; The iris, ciliary body and the choroid Consists of the retina
14 Extra-Ocular Muscles
15 Extra-Ocular Muscles Phoria: A constant tendency for the eyes to turn from the normal position for binocular vision Tropia: A definite and obvious turning of the eyes from the normal position for binocular vision Examples Exo: Out Right exophoria Eso: In Left esotropia Hyper: Up Right hyperphoria Hypo: Down Left hypotropia A tendency of the right eye to turn outward A definite turning inward of the left eye A tendency of the right eye to turn upward A definite turning downward of the left eye
16 Emmetropia and Ametropia Emmetropia: Light comes to focus directly on the retina when accommodation is relaxed. No corrective lenses are needed for distance viewing. Myopia: Or nearsighted. Light comes to focus in front of the retina requiring corrective lenses. (minus power) Hyperopia: Or farsighted. Light comes to focus in behind the retina often requiring corrective lenses (plus lenses)
17 Emmetropia and Ametropia Simple Myopic Astigmatism: One point comes to focus on the retina and one point comes to focus in front of the retina. Simple Hyperopic Astigmatism: One point comes to focus on the retina and one point comes to focus behind the retina. Compound Myopic Astigmatism: Both points of light some to focus in front of the retina.
18 Emmetropia and Ametropia Compound Hyperopic Astigmatism: Both points of light come to focus behind the retina. Mixed Astigmatism: One point of light comes to focus in front of the retina, while the other comes to focus behind the retina.
19 Glossary Accommodation: Focusing of the eye on a near object through relaxation of the ciliary muscle and thickening of the lens. Amblyopia: The loss of vision without any apparent disease of the eye. Ametropia: A refractive error in which the eye, when in a state of rest, does not focus the image of an pbject upon the retina; includes hyperopia, myopia and astigmatism. Aniseikonia: A condition in which the ocular image of an object as seen by one eye differs so much in size or shape from that seen by the other eye that the two images cannot be fused into a single impression. Anisemetropia: A condition in which the refractive error of one eye significantly differs from that of the other; each eye must have the same sign, i.e. both eyes are myopic or hyperopic. Antimetropia: The refractive condition whereby the signs in each eye are opposite; one eye is hyperopic, while the other is myopic Aphakia: An absence of the crystalline lens of the eye. Aqueous Humor: The clear watery fluid that fills the anterior and posterior chambers within the front part of the eye. Astigmatism: A refractive error that prevents the light rays from coming to a single focus on the retina because of different degrees of refraction in the various meridians of the eye. Cataract: A condition in which the crystalline lens of the eye, or it s capsule, or both, become opaque, with consequent loss of visual acuity. Choroid: The vascular intermediate coat that furnishes nourishment to other parts of the eyeball. Ciliary Body: The portion of the vascular coat between the iris and the choroid. It consists of ciliary processes and the ciliary muscle. Compound hyperopic astigmatism: The refractive error which results in two points of focus falling behind the retina. Compund hyperopic astigmatism: The refractive error which results in two points of focus falling in front of the retina. Cornea: The clear transparent portion of the outer coat of the eyeball forming the covering of the aqueous chamber. Crystalline lens: A transparent colorless body suspended in the front part of the eyeball, between the aqueous and vitreous, the function of which is to bring the rays of light to a focus on the retina. Diplopia: The seeing of one object as two. Emmetropia: The refractive condition of the normal eye when the eye is at rest, the image of distant objects is brought to focus on the retina. Fovea: A small depression of the retina at the back of the eye; the part of the macula adapted for most acute vision. Fusion: The power of coordination by which images received by the two eyes become a single image.
20 Glossary Glaucoma: An ocular disease having its primary characteristic a sustained increase in intraocular pressure that the eye cannot withstand without damage to its structure or impairment of its function. Hyperopia: A refractive error in which, because the eyeball is short or the refractive power of the lens is weak, the point of focus for rays of light from distant objects falls behind the retina; accommodation to increase the refractive power of the lens is necessary for distance vision as well as near vision. Iris: The colored circular membrane suspended behind the cornea and immediately in front of the lens, The iris regulates the amount of light entering the eye by changing the size of the pupil. Irregular Astigmatism: A refractive condition caused by a cornea which is damaged and irregular so that rays of light come to many focal points on the retina; is not correctable by cylinders. Iseikonic Lenses: Spectacle lenses specially designed to manipulate image size when dissimilar sizes makes it difficult or impossible for fusion to occur; such as in aniseikonia. Macula: The small area of the retina that surrounds the fovea and that with the fovea, comprises the are of the retina that gives distinct vision. Mixed Astigmatism: The refractive condition in which light comes to two points of focus where one point it in front of the retina, and the other is behind the retina. Myopia (nearsightedness): A refractive error in which the eyeball is too long in relation to its focusing power; thus the point of focus for rays of light from distant objects is in front of the retina. Oculus Dexter (O.D.): The right eye. Oculus Sinister (O.S.): The left eye. Oculus Uterque (O.U.): Each eye. Optic Nerve: The special nerve of the sense of sight that carries impulses from the retina to the brain. Phoria: A root word denoting a latent deviation in which the eyes have a constant tendency to turn from the normal position to the binocular vision; used with a prefix to indicate the direction of such deviation (for example, hyperphoria, esophoria, exophoria). Presbyopia: A gradual lessening of the power of accommodation due to a physiologic change that becomes noticeable about the age of 40 years. Ptosis Crutch: A small spring wire attached nasally to a spectacle frame to lift a drooping lid. Pupil: The central opening of the iris through which light is permitted to enter the eye. Regular Astigmatism: A refractive condition in which rays of light come to two focal points and is correctable by cylinders.
21 Glossary Retina: Innermost coat of the eye, formed of sensitive nerve elements and connected with the optic nerve. Rods and Cones: Two different kinds of cells that form a layer of the retina and act as light receiving media. Cones are concerned with visual acuity and color discrimination; whereas rods are employed for motion and vision at low degrees of illumination (night vision). Sclera: The white part of the eye a tough covering which, with the cornea, forms the external protective coat of the eye. Scotoma: A blind area of reduced vision in the visual field. Simple hyperopic astigmatism: The refractive condition where one point of focus falls on the retina and the other point of focus falls behind the retina. Simple myopic astigmatism: The refractive condition where one point of focus falls on the retina and the other point of focus falls in front of the retina. Strabismus: Failure of the two eyes to simultaneously direct their gaze at the same object because of muscle imbalance. Also known as squint. Suspensory Ligaments: The suspensory apparatus of the lens. Numerous fine tissue strands that stretch from the ciliary processes to the lens equator and support the lens in place. Tropia: A root word denoting an obvious deviation from normal of the axis of the eyes; used with a prefix to denote the type of strabismus (for example, heterotropia, esotropia, exotropia). Vitreous Humor: The transparent, colorless mass of soft, gelatinous material filling the eyeball behind the lens.
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