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Nishtar ken By Muhammad Ramzan UL Rehman 1
Nishtar ken By Muhammad Ramzan UL Rehman 
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Nishtar ken By Muhammad Ramzan UL Rehman 3
 Macula lutea 
 Area immediately surrounding fovea 
 Fairly high acuity 
 Fovea CENTRALIS 
 Pinhead-sized depression in exact 
center of retina 
 Point of most distinct vision 
 Has only cones 
 Macular degeneration 
 Leading cause of blindness in western 
hemisphere 
 “doughnut” vision 
Nishtar ken By Muhammad Ramzan UL Rehman 4
Nishtar ken By Muhammad Ramzan UL Rehman 5
 Total refractive power of 
reduced eye: 59 d 
 Ant. Surface of cornea 
provides: 40 d 
 Lens within eye provides: 19 d 
 IF WE BRING THE LENS 
OUT OF THE EYE ITS 
POWER WILL INCREASE 
Nishtar ken By Muhammad Ramzan UL Rehman 6
Nishtar ken By Muhammad Ramzan UL Rehman 7
Nishtar ken By Muhammad Ramzan UL Rehman 8
Nishtar ken By Muhammad Ramzan UL Rehman 9
Nishtar ken By Muhammad Ramzan UL Rehman 10
Nishtar ken By Muhammad Ramzan UL Rehman 11
Refraction Errors 
Normal vision 
Far sightedness 
Near sightedness 
Nishtar ken By Muhammad Ramzan UL Rehman 12
Vision Correction 
Myopia corrected with 
concave lens 
Hyperopia corrected 
with convex lens 
Nishtar ken By Muhammad Ramzan UL Rehman 13
Nishtar ken By Muhammad Ramzan UL Rehman 14
 It is the ability of the eye to 
keep the image focused on the 
retina (as the distance between 
the eyes & the object varies) 
Nishtar ken By Muhammad Ramzan UL Rehman 15
 Accommodation results from contraction of the ciliary muscle, which is 
like a sphincter muscle. 
 Under resting state ciliary muscle relax keep the aperture wide. 
 Relaxation of ciliary muscle apply tension on suspensary ligaments 
which pulls the lens taut. 
 Viewing an object 20 feet or more from a normal eye, the image is focused 
on the retina and the lens is in its more flat or least convex form. 
 As the object moves closer to the eyes the muscles of the ciliary body 
contract and narrows the aperture of the ciliary body that reduces the 
tension on zonular fibers that suspend the lens. 
 When tension is reduced, lens become more rounded and convex as a 
result of its inherent elasticity. 
 Changes in the shape of the lens permit accommodation 
 The ciliary muscle is controlled almost entirely by parasympathetic nerve 
signals transmitted to the eye through the third cranial nerve from the 
Nishtar ketn h i rBdy M nuhearmvmead nRaumzcalne UuL sR eihnma nt he brain stem. 16
Nishtar ken By Muhammad Ramzan UL Rehman 17
Contraction pulls 
ligament forward 
relaxing tension on 
suspensory ligament 
making the lens fatter 
ACCOMODATION 
Nishtar ken By Muhammad Ramzan UL Rehman 18
 The nearest point to the eye at which an object can be brought into clear focus by 
accommodation is called near point of vision. 
 Normally, it is 25 cm in young persons. 
 It shifts away from eyes in presbyopia. 
Nishtar ken By Muhammad Ramzan UL Rehman 19
 The three components of near response are: 
1. accommodation, 
2. convergence of the eyeballs & 
3. Pupillary constriction 
Nishtar ken By Muhammad Ramzan UL Rehman 20
As a person grows older, the lens grows larger and thicker and becomes 
far less elastic, partly because of progressive denaturation of the lens 
proteins. 
 The ability of the lens to change shape decreases with age. 
 The power of accommodation decreases from about 14 diopters in a child 
to less than 2 diopters by the time a person reaches 45 to 50 years 
 It may even decreases to essentially 0 diopters at age 70 years. 
 Treated by biconvex lenses 
Nishtar ken By Muhammad Ramzan UL Rehman 21
Nishtar ken By Muhammad Ramzan UL Rehman 22
 Eye is filled with 
intraocular fluid. 
 Aqueous humor and 
Vitreous humor. 
They maintain 
sufficient pressure in 
the eyeball to keep it 
distended. 
Nishtar ken By Muhammad Ramzan UL Rehman 23
Aqueous humor is 
continually being 
formed and reabsorbed 
. 
The balance between 
formation and 
reabsorption of 
aqueous humor 
regulates the total 
volume and pressure 
of the intraocular 
fluid. 
Nishtar ken By Muhammad Ramzan UL Rehman 24
 Aqueous humor is formed almost 
as an active secretion by the 
epithelium of the ciliary processes. 
 Secretion begins with active 
transport of sodium ions into the 
spaces between the epithelial cells. 
 The sodium ions pull chloride and 
bicarbonate ions along with them 
to maintain electrical neutrality 
 All these ions together cause 
osmosis of water from the blood 
capillaries lying in intercellular 
spaces. 
 Resulting solution washes from the 
spaces of ciliary processes into the 
anterior chamber of eye. 
Nishtar ken By Muhammad Ramzan UL Rehman 25
 After forming …. flows first through 
the pupil into the anterior chamber 
of the eye. 
 Fluid flows anterior to the lens & 
into angle b/w cornea and iris. 
 Then meshwork of trabeculae to 
canal of schlemm which empties into 
extra ocular veins. 
Nishtar ken By Muhammad Ramzan UL Rehman 26
 It is a thin walled vein that extends circumferentially all 
around the eye. 
 Its endothelial membrane is permeable to large protein 
molecules and particulate matter up to the size of RBCs. 
Nishtar ken By Muhammad Ramzan UL Rehman 27
 It is a venous vessel but contains only aqueous humor 
instead of blood. 
Small veins drain aqueous humor from the canal of 
schlemm in to larger veins of the eye. 
These small veins are known as aqueous veins. 
Nishtar ken By Muhammad Ramzan UL Rehman 28
 IOP remains constant in the normal 
eye, which is 15mmHg (12-20) 
 It is determined by resistance to 
outflow of aqueous 
 It can be measured with the help of 
optical instrument called tonometer. 
TONOMETER 
Nishtar ken By Muhammad Ramzan UL Rehman 29
 Cornea is anesthetized with a local anesthetic 
 Footplate of the Tonometer is placed on the cornea. 
 A small force is then applied to a central plunger which push the cornea slightly 
inward. 
 The amount of displacement is recorded on the scale of the tonometer and this is 
calibrated in terms of intraocular pressure. 
Nishtar ken By Muhammad Ramzan UL Rehman 30
Glaucoma is one of the causes of blindness. 
 It is a disease of the eye in which the intraocular pressure 
becomes pathologically high sometimes rising acutely to 
60 to 70 mm Hg 
 Pressures above 25 to 30 mm Hg can cause loss of vision 
when maintained for long periods 
Nishtar ken By Muhammad Ramzan UL Rehman 31
Nishtar ken By Muhammad Ramzan UL Rehman 
32

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Eye physiology from guyton and halls physiology Part 1

  • 1. Nishtar ken By Muhammad Ramzan UL Rehman 1
  • 2. Nishtar ken By Muhammad Ramzan UL Rehman 2
  • 3. Nishtar ken By Muhammad Ramzan UL Rehman 3
  • 4.  Macula lutea  Area immediately surrounding fovea  Fairly high acuity  Fovea CENTRALIS  Pinhead-sized depression in exact center of retina  Point of most distinct vision  Has only cones  Macular degeneration  Leading cause of blindness in western hemisphere  “doughnut” vision Nishtar ken By Muhammad Ramzan UL Rehman 4
  • 5. Nishtar ken By Muhammad Ramzan UL Rehman 5
  • 6.  Total refractive power of reduced eye: 59 d  Ant. Surface of cornea provides: 40 d  Lens within eye provides: 19 d  IF WE BRING THE LENS OUT OF THE EYE ITS POWER WILL INCREASE Nishtar ken By Muhammad Ramzan UL Rehman 6
  • 7. Nishtar ken By Muhammad Ramzan UL Rehman 7
  • 8. Nishtar ken By Muhammad Ramzan UL Rehman 8
  • 9. Nishtar ken By Muhammad Ramzan UL Rehman 9
  • 10. Nishtar ken By Muhammad Ramzan UL Rehman 10
  • 11. Nishtar ken By Muhammad Ramzan UL Rehman 11
  • 12. Refraction Errors Normal vision Far sightedness Near sightedness Nishtar ken By Muhammad Ramzan UL Rehman 12
  • 13. Vision Correction Myopia corrected with concave lens Hyperopia corrected with convex lens Nishtar ken By Muhammad Ramzan UL Rehman 13
  • 14. Nishtar ken By Muhammad Ramzan UL Rehman 14
  • 15.  It is the ability of the eye to keep the image focused on the retina (as the distance between the eyes & the object varies) Nishtar ken By Muhammad Ramzan UL Rehman 15
  • 16.  Accommodation results from contraction of the ciliary muscle, which is like a sphincter muscle.  Under resting state ciliary muscle relax keep the aperture wide.  Relaxation of ciliary muscle apply tension on suspensary ligaments which pulls the lens taut.  Viewing an object 20 feet or more from a normal eye, the image is focused on the retina and the lens is in its more flat or least convex form.  As the object moves closer to the eyes the muscles of the ciliary body contract and narrows the aperture of the ciliary body that reduces the tension on zonular fibers that suspend the lens.  When tension is reduced, lens become more rounded and convex as a result of its inherent elasticity.  Changes in the shape of the lens permit accommodation  The ciliary muscle is controlled almost entirely by parasympathetic nerve signals transmitted to the eye through the third cranial nerve from the Nishtar ketn h i rBdy M nuhearmvmead nRaumzcalne UuL sR eihnma nt he brain stem. 16
  • 17. Nishtar ken By Muhammad Ramzan UL Rehman 17
  • 18. Contraction pulls ligament forward relaxing tension on suspensory ligament making the lens fatter ACCOMODATION Nishtar ken By Muhammad Ramzan UL Rehman 18
  • 19.  The nearest point to the eye at which an object can be brought into clear focus by accommodation is called near point of vision.  Normally, it is 25 cm in young persons.  It shifts away from eyes in presbyopia. Nishtar ken By Muhammad Ramzan UL Rehman 19
  • 20.  The three components of near response are: 1. accommodation, 2. convergence of the eyeballs & 3. Pupillary constriction Nishtar ken By Muhammad Ramzan UL Rehman 20
  • 21. As a person grows older, the lens grows larger and thicker and becomes far less elastic, partly because of progressive denaturation of the lens proteins.  The ability of the lens to change shape decreases with age.  The power of accommodation decreases from about 14 diopters in a child to less than 2 diopters by the time a person reaches 45 to 50 years  It may even decreases to essentially 0 diopters at age 70 years.  Treated by biconvex lenses Nishtar ken By Muhammad Ramzan UL Rehman 21
  • 22. Nishtar ken By Muhammad Ramzan UL Rehman 22
  • 23.  Eye is filled with intraocular fluid.  Aqueous humor and Vitreous humor. They maintain sufficient pressure in the eyeball to keep it distended. Nishtar ken By Muhammad Ramzan UL Rehman 23
  • 24. Aqueous humor is continually being formed and reabsorbed . The balance between formation and reabsorption of aqueous humor regulates the total volume and pressure of the intraocular fluid. Nishtar ken By Muhammad Ramzan UL Rehman 24
  • 25.  Aqueous humor is formed almost as an active secretion by the epithelium of the ciliary processes.  Secretion begins with active transport of sodium ions into the spaces between the epithelial cells.  The sodium ions pull chloride and bicarbonate ions along with them to maintain electrical neutrality  All these ions together cause osmosis of water from the blood capillaries lying in intercellular spaces.  Resulting solution washes from the spaces of ciliary processes into the anterior chamber of eye. Nishtar ken By Muhammad Ramzan UL Rehman 25
  • 26.  After forming …. flows first through the pupil into the anterior chamber of the eye.  Fluid flows anterior to the lens & into angle b/w cornea and iris.  Then meshwork of trabeculae to canal of schlemm which empties into extra ocular veins. Nishtar ken By Muhammad Ramzan UL Rehman 26
  • 27.  It is a thin walled vein that extends circumferentially all around the eye.  Its endothelial membrane is permeable to large protein molecules and particulate matter up to the size of RBCs. Nishtar ken By Muhammad Ramzan UL Rehman 27
  • 28.  It is a venous vessel but contains only aqueous humor instead of blood. Small veins drain aqueous humor from the canal of schlemm in to larger veins of the eye. These small veins are known as aqueous veins. Nishtar ken By Muhammad Ramzan UL Rehman 28
  • 29.  IOP remains constant in the normal eye, which is 15mmHg (12-20)  It is determined by resistance to outflow of aqueous  It can be measured with the help of optical instrument called tonometer. TONOMETER Nishtar ken By Muhammad Ramzan UL Rehman 29
  • 30.  Cornea is anesthetized with a local anesthetic  Footplate of the Tonometer is placed on the cornea.  A small force is then applied to a central plunger which push the cornea slightly inward.  The amount of displacement is recorded on the scale of the tonometer and this is calibrated in terms of intraocular pressure. Nishtar ken By Muhammad Ramzan UL Rehman 30
  • 31. Glaucoma is one of the causes of blindness.  It is a disease of the eye in which the intraocular pressure becomes pathologically high sometimes rising acutely to 60 to 70 mm Hg  Pressures above 25 to 30 mm Hg can cause loss of vision when maintained for long periods Nishtar ken By Muhammad Ramzan UL Rehman 31
  • 32. Nishtar ken By Muhammad Ramzan UL Rehman 32