Aqueous Humor

FORMATION, COMPOSITION AND
CIRCULATION OF
AQUEOUS HUMOR
PRESENTER : DR. J NATASHA MARIA

INTRODUCTION
Aqueous humor is a clear, colourless, watery solution
continuously circulated from posterior chamber into
the anterior chamber of the eye.
Functions
1. Maintenance of intraocular pressure
2. Metabolic role
Provides substrates and removes metabolites from
avascular ocular structures such as cornea and lens
3)Optical function
Under normal conditions, aqueous is optically clear.
4)Clearing function
It serves as a mechanism to clear blood, macrophages,
products of inflammation from anterior chamber of
eye.
ANATOMICAL CONSIDERATIONS
The principal ocular structures concerned with
aqueous humour are:
 Ciliary body
 Posterior Chamber
 Anterior Chamber
 Angle of the anterior chamber
 Aqueous outflow system
CILIARY BODY
It is the forward continuation of the choroid at Ora
Serrata
Divided into two parts:
1. Anterior part having finger-like ciliary processes is
called PARS PLICATA
2. Posterior smooth part is called PARS PLANA
CILIARY PROCESSES
These are the finger-like projections from the PARS
PLICATA part of the ciliary body
They are about 70-80 in number
They form the site of aqueous production
They are about 2mm long and 0.5mm in diameter

ULTRA STRUCTURE OF CILIARY PROCESS
The network of capillaries
Occupies the centre of each process
Stroma of ciliary processes

Consists of connective tissue fibres and separates the capillary
network from the epithelial layers
Two layers of epithelium

Arranged with apical surfaces in apposition to each other
ULTRA STRUCTURE OF CILIARY PROCESS
Pigmented and non-pigmented epithelium
Arranged with apical surfaces in apposition to each other.
The pigmented epithelium consists of numerous melanin

granules.
The non-pigmented epithelium is characterised by:

mitochondria, zonula occludens; and lateral and surface
interdigitations
POSTERIOR CHAMBER
Boundaries:
Anteriorly- Posterior surface of the iris and part of
ciliary body
Posteriorly- By Crystalline lens and its zonules
Laterally- By ciliary body
The freshly formed aqueous humour is poured into
this space
Contains about 0.06ml of aqueous humour
ANTERIOR CHAMBER
Boundaries:
Anteriorly- Back of cornea
Posteriorly- Anterior surface of iris and ciliary body
Aqueous from posterior chamber flows into the
anterior chamber through the pupil
Contains about 0.25ml of aqueous humour
ANGLE OF THE ANTERIOR CHAMBER
Structures forming the angle:
From posterior to anterior
Ciliary body band
Scleral spur
Trabecular meshwork
Schwalbe’s line
AQUEOUS OUTFLOW SYSTEM
1. Trabecular meshwork
Microscopic structure- Consists of three portions
 Uveal meshwork
 Corneoscleral meshwork
 Juxtacanalicular (Endothelial) meshwork
2. Schlemm’s Canal
3. Collector Channel
4. Episcleral veins
COMPOSITION OF AQUEOUS HUMOUR
1. Water: It constitutes 99.9% of the aqueous
humour
2. Proteins (Colloid Content)
 The main chemical difference between aqueous
humour and blood plasma is the level of protein
content (Plasma: 6-7g/100ml; Aqueous:
5-16mg/100ml)
 Human aqueous contains IgG and IgM; FGF, TGF-β .

3. Non-colloidal constituents:
 Sodium
 Chloride
 Potassium
 Ascorbic acid
 Amino acids
 Bicarbonate
 Glucose
 Phosphate
 Pyruvate and lactate
4. Inulin and Steroids
5. Prostaglandins
6. Cyclic-AMP
Component[mmol/kg AC aqueous humor Plasma
H2O]
Sodium 163 146
Chloride 126 117
Bicarbonate 22 26
Ascorbate 0.92 0.06
Glucose 3 6
FACTORS AFFECTING COMPOSITION
 Blood aqueous barrier
1)Tight junctions between cells of non-pigmented
epithelium.
2)Non-fenestrated endothelium of Iris capillaries.
• Diffusional exchange across the iris
• Metabolites
• Rate of aqueous drainage
FORMATION OF AQUEOUS HUMOUR
The mechanisms of aqueous humour formation are:
1. Diffusion: Movement of particles from areas of high

concentration to areas of low concentraiton
2. Ultrafiltration: It is a process by which a fluid and its

solutes cross a semipermeable membrane under a
pressure gradient is called ultrafiltration.
FORMATION OF AQUEOUS HUMOUR
3) Secretion (Active transfer): Water soluble substances
of larger size or greater charge are actively
transported across the cell membrane.
Active process( requires energy)

Against a concentration gradient.
STEPS OF AQUEOUS FORMATION
1. Formation of stromal pool
As blood passes through the capillaries of ciliary
processes, by the process of ultrafiltration most
substances pass from capillaries across stroma and
pigmented epithelial cells.
They accumulate behind the tight junctions of the

non- pigmented epithelium.
2. Active transport of stromal filtrates
 Majority of aqueous humor formation depends

on ions being actively secreted into the
intercellular clefts of the non-pigmented ciliary
epiithelium beyond the tight junctions.
 Substances like Sodium,Chloride ,Bicarbonate

Potassium, Ascorbic acid and Amino acids are
actively transported across non-pigmented epithelial
cells.
3. Passive transport across non-pigmented ciliary
epithelium
 Active transport of substances across the non-
pigmented ciliary epithelium results in an osmotic
and electrical gradient.
To maintain the balance of osmotic and electrical
forces, water , chloride and other small plasma
constituents then move into the posterior chamber
by Ultrafiltration and Diffusion.
Sodium is primarily responsible for movement of

water into the posterior chamber and its secretion is
a major factor in the formation of aqueous.
AQUEOUS HUMOR DYNAMICS
Aqueous humor flows from posterior chamber into
the anterior chamber through the pupil against slight
physiologic resistance.
In the anterior chamber , there exists convection

(thermal) currents which results from a temperature
gradient between the anterior and posterior parts of
the anterior chamber.
Due to effect of convection current, the aqueous in the
posterior part of the anterior chamber moves up along
the warmer iris and in the anterior part moves down
along the cooler cornea.
AQUEOUS OUTFLOW
1. Trabecular (Conventional) outflow
2. Uveoscleral (unconventional) outflow
Uveoscleral outflow
It is responsible for 10-25% of the total aqueous
outflow.
Aqueous passes across the ciliary body into the supra
choroidal space and is drained by the venous
circulation in the ciliary body, choroid and sclera.
Trabecular ( conventional) outflow
It is the main outlet for aqueous from the anterior
chamber.
 75-90% of the total aqueous is drained via this
route.
Free flow of aqueous occurs from the trabecular

meshwork in the angle of anterior chamber upto
juxtacanalicular tissue, which along with the inner
wall of the Schlemm’s canal appears to provide some
resistance to the outflow.
MECHANISMS OF AQUEOUS TRANSPORT
ACROSS
INNER WALL OF SCHLEMM’S CANAL
1. Passive filter mechanisms
 Leaky endothelial cells
Leaky endothelial cells of the Schlemm’s canal
might allow aqueous drainage.
 Sonderman’s channels
It was suggested that these channels help aqueous to
flow from corneoscleral meshwork into Schlemm’s
canal.
 Vacuolation theory(pores and giant vacuole system)
This theory suggests that the mechanism of bulk

outflow of aqueous humor across the endothelium of
Schlemm’s canal is by the formation of vacuolar
trans cellular channels, which is a dynamic system of
pores.
STEPS
1. Membranous depression on the basal aspect of cell
surface.
2. Progressive enlargement of this depression leads to
formation of a macrovacuolar structure.
3. It eventually opens on the luminal aspect of the cell
surface.
4. After certain time interval, the depression is
occluded and the cell returns to its non-vacuolated
state.
2)Aqueous outflow active pump mechanism/
Biomechanical pump
 Oscillatory pressure transients
Pressure transients caused by the ocular pulse,

blinking and eye movement, forms the operating
force for the biomechanical pump.
Trabecular meshwork flexibility
Trabecular meshwork actively moves outward and

recoils backward in response to the oscillatory
pressure transients.
Aqueous valve mechanism
Valve mechanism has been reported to operate at the

level of inner wall of schlemm’s canal.
These valves allow one way passage of aqueous humor
from juxtacanalicular space to inside the schlemm’s
canal.
The pressure gradient between IOP(12-18mmHg) and

episcleral venous pressure(about 10 mmHg) also
facilitates this unidirectional pulsatile flow of aqueous
humor.
During diastole ,aqueous enters into Schlemm’s canal
and during systole flows out of it.
Aqueous pulse wave then enters the episcleral veins

through the collector channels.

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FORMATION, COMPOSITION AND

PRESENTER : DR. J NATASHA MARIA

They are about 70-80 in number

They form the site of aqueous production

They are about 2mm long and 0.5mm in diameter

Stroma of ciliary processes

Two layers of epithelium

The pigmented epithelium consists of numerous melanin

The non-pigmented epithelium is characterised by:

 Human aqueous contains IgG and IgM; FGF, TGF-β .

Chloride 126 117

Ascorbate 0.92 0.06

1. Diffusion: Movement of particles from areas of high

2. Ultrafiltration: It is a process by which a fluid and its

Active process( requires energy)

They accumulate behind the tight junctions of the

 Majority of aqueous humor formation depends

 Substances like Sodium,Chloride ,Bicarbonate

Sodium is primarily responsible for movement of

In the anterior chamber , there exists convection

Free flow of aqueous occurs from the trabecular

This theory suggests that the mechanism of bulk

 Oscillatory pressure transients

Pressure transients caused by the ocular pulse,

Trabecular meshwork actively moves outward and

Aqueous valve mechanism

Valve mechanism has been reported to operate at the

The pressure gradient between IOP(12-18mmHg) and

Aqueous pulse wave then enters the episcleral veins

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