sps y2-2013

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

OBJECTIVESIdentify 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

Cornea

Sclera*

Limbus

Pupil Iris

*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. Bulbar2. Palpebral

Conjunctiva

Bulbar; Forniceal; Palpebral

Conjunctiva

Bulbar

Forniceal

Palpebral

Conjunctiva

1. Bulbar2. Palpebral [hidden]3. Forniceal [hidden]

Conjunctiva

• Transparent• Very vascular• Protective• Tear Film• Vascularity

Conjunctiva

1. Which part? Palpebral2. Whats wrong? Red, Papillae3. Allergic Conjunctivitis

Conjunctiva

1. Which part? Bulbar2. Whats wrong? ‘Pink’ 3. Viral Conjunctivitis

TENON’S CAPSULE

Tenon’s Capsule

Tenon’s Capsule

• ‘Barrier’ Protection

EPISCLERA

Episclera

• Inflammation of Episclera

Episcleritis

Episcleritis

Episcleritis

CONJUNCTIVITIS??

• Blanching test…

Episcleritis Vs. Conjunctivitis

• Transparent• Vascular• Nutritive

Episclera

SKINS/ COVERINGS

THE WALLS/ COATS/ LAYERS

Protection

NutritionCrucial

Protection

NutritionCrucial

Protection

Nutrition

Crucial

WALLS/ COATS/ LAYERS

WALLS/ COATS/ LAYERS

CHAMBERS & SEGMENTS

Anterior Chamber

PosteriorChamber

AnteriorSegment

PosteriorSegment

AC ANGLE

Fibrous Tunic/ Layer‘Sclera’ & ‘Cornea’

Sclera

5/61/6

Sclera

Sclera

Perforation

Cornea

Cornea

1. Epithelium2. Bowman’s3. Stroma4. Basement

membrane5. Endothelium

5. ENDOTHELIUM:Na-K PumpKeeps Cornea ‘Dry’

3. STROMA:Heals by scarring

1. EPITHELIUMBarrierRichly innervated

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

IRIS

CORNEA

SCLERA

MUSCLES

Pars PlicataPars Plana

Anterior

Constricts

Ciliary Body

Ciliary Body

• Supports Lens• Aids Accommodation• Produces Aqueous Humor

Iris2. MUSCLES

Dilator

Sphincter

3. STROMA4.

ANTERIOR SURFACE Vessels

1. POSTERIOR SURFACE:Cells

IrisIRIS

CORNEA

SCLERA

Ciliary Body

Iris

• Controls light entry • Attraction• Color is more than just

pigment!• Crypts!

• LENS• ANTERIOR CHAMBER

ANGLE

AREAS OF INTEREST

Lens

Cataract

AGE

Lens

Anterior Chamber Angle

Anterior Chamber AngleIRIS

CORNEA

SCLERA

Ciliary Body

Iris/ CB

Schwalbe’s Line

Trabecular Meshwork

Sceral spur


Under drainage (High Pressure)

Over drainage (Low Pressure)

Retina

Retina –Ora Serrata

Retina

Retina

…pigment it completely blocks the scleral view

Retina

View obtained via an ophthalmoscope = fundus

Retina

Retina

CHO

ROID

ALRETIN

AL

Arterial Occlusion

Venous Occlusion

Arterial Venous

Retina

Retina

• Light to electrical signals• All sorts of visual info

Optic Disk

GLIAL TISSUE

NEURAL TISSUE

MARGIN

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 to distinguish two points as separate [study guide]No opacities (remember inflammation causes these)A normal anterior chamber [study guide]A pupil that reacts normally to light [study guide]No pathology seen in the retina (ophthalmoscopy)No opacities (no cataract)

sps y2-2013

Documents