Vision

Dr. Smrithi Shetty C.

M.B.B.S., M.D.
Associate Professor
Dept of Physiology
AJIMS & RC
Pupil

Sclera

Iris
Anatomy of eyeball
Layers of eyeball
 Coat Structure Function
Outer sclera Tough fibrous tissue Presreves shape of eyeball
Protective layer Protects delicate inner layers
Modified anteriorly--- Allow passage of light rays,refracts light
Cornea
Extrinsic muscles Permit & limit the movement of eyeball
are attached
Middle choroid Choroid-post-5/6th Blood vessels----nourishment,absorbs light
Layer Ciliary body Produces aqueous humor- clear, watery fluid
Rich in blood Ciliary muscle Contracts /relaxes
supply
Suspensory Relaxes to make lens more convex for near
ligament vision
Iris-coloured Controls size of pupil (depth of focus,amount
muscular ring of light

Anterior chamber Aqueous humor maintain shape of eyeball ,nourishes eye

Lens transparentbiconvex Focuses light upside down on the retina
Posterior Vitreous humor- Maintain shape,keeps retina attached to
clear jelly like choroid
substance
Inner retina Photoreceptors Convert light---electrical impulses
Light sensitive cone cells provide colour vision & acuity of vision
layer rod cells sensitive to dim light cannot detect colour.
Iris smooth muscles :
Circular smooth muscle
 SPHINCTER PUPILLAE-
 MIOSIS-
 pupil smaller in bright light

Radial fibers-
 DILATOR PUPILLAE-
 MYDRIASIS
 pupil large from light to dark,fear.pain
Responses of pupil to light
Structures forming refractive media of the
eye
From anterior to posterior:
Tear film
Cornea
Aqueous humor
Lens
Vitreous humor

(Cornea and lens are avascular)

 Tears
Fluid covering the cornea and conjunctiva
Composition : 98% water and 1.5% sodium chloride
-antibacterial substances like lysozyme, beta lysin and
lactoferrin
Secreted by lacrimal glands
Functions :
1. Keeps cornea and conjunctiva moist
2. Provides oxygen to avasular cornea
3. Washes away debris and irritants
4. Prevents infections
5. Facilitates movements of eye lids
Lacrimal apparatus
Crystalline lens
Cataract :
opacification
of lens or its
capsule
Aqueous humour
Formation
Theories
Composition
Drainage
Functions
Glaucoma
Aqueous humour
Thin watery fluid in the anterior and posterior
chambers of the eye
Formation : from plasma within the capillaries of the
ciliary processes at the rate of 2cumm/min
Theories of mechanism of formation:
1. Ultrafiltration
2. Diffusion
3. Secretion—active transport
Composition of aqueous humour
Water 98.7%, solids 1.3%
Same as plasma except that
 Protein content is low because of blood aqueous
barrier
 High concentrations of ascorbate, pyruvate and lactate
 Glucose content is less ( used up by lens and cornea)
 Aqueous humour drainage
Flows from posterior
chamber

Into anterior chamber

through the pupil

Trabecular outflow
 Ciliary processes

Aqueous in the posterior chamber

Via pupil into anterior chamber

Trabecular meshwork
Schlemm’ canal

Episcleral veins

Trabecular outflow=90%
Drainage of Aqueous humour
Functions
1. Maintains constant intraocular pressure (IOP)-helps
in image forming mechanisms
2. Provides nutrition and removes waste metabolites
from the avascular cornea and lens
3. Maintains optical transparency
4. Takes the place of lymph that is absent within the
eye ball
 Glaucoma

Condition of dangerously
increased IOP.

Resulting in irriversible
visual field defects
one of the leading cause of
blindness
can be prevented.

IOP measured using

tonometer
 Glaucoma
Open Angle Glaucoma
 drainage angle is open,
 fluid reaching cannot percolate through meshwork
 slow increase in pressure

Angle Closure Glaucoma

 the angle structures including the trabecular meshwork are blocked,
typically by the iris.
Congenital Glaucoma
 inborn anomaly of the drainage structures,
RETINA
Optic disc- blind spot

Macula lutea- yellow

spot
fovea centralis- central
depressed part
 10 layers of Retina
1) Pigment epithelium
2) Rods and cones
3) External limiting
membrane
4) Outer nuclear layer
5) Outer synaptic layer
6) Inner nuclear layer
7) Inner synaptic layer
8) Ganglion cell layer
9) Optic nerve
10) Internal limiting
membrane
 Normal retina

Temporal Nasal
Rods and cones
 Rods Cones
 Thin, rod-like appearance of  Thick inner segments and
their outer segments conical outer segments
 Disks are separated from the  Saccules are formed in the
cell membrane. outer segments by infoldings
 The rods are extremely of the cell membrane
sensitive to light and are the  The cones have a much higher
receptors for night vision threshold, but the cone
(scotopic vision). system has a much greater
 incapable of resolving the acuity and is the system
details and boundaries of responsible for vision in bright
objects or determining their light (photopic vision) and
color. for color vision.
 Predominant In extrafoveal  In foveal region
region
ROD CELL

40-60 micrometre

Outersegment – visual purple

ROD CELL
 Rhodopsin (visual purple)-
photosensitive substance

 Scotopic vision
120 million

 Absent in fovea
CONE CELL
40-80 micrometre

Iodopsin

Photopic vision and Color

vision
6.5million

Chlorolabe, erythrolabe,
cyanolabe- cone pigments
THE IMAGE-FORMING MECHANISM
The eyes convert energy in the visible spectrum into
action potentials in the optic nerve. The wavelengths
of visible light range from approximately 397 nm to 723
nm.(vibgyor)
 The images of objects in the environment are focused
on the retina
generate potentials in the rods and cones
 Impulses initiated in the retina are conducted to the
cerebral cortex, where they produce the sensation of
vision.
 POWER OF LENS
Reciprocal of focal length

S.I. - DIOPTERS
Visual pathway
 Visual pathway
Optic nerve

Optic chiasma ( nasal fibres cross)

Optic tract

Lateral geniculate body

Visual cortex (17)

 VISUAL ASSOCIATION AREAS
Area 18 -visuo psychic area

Visual orientation, depth perception

Area 19- occipital eye field- deviation and movement

of eye ball

Area 8- frontal eye field- conjugate deviation to

opposite side
VISUAL PATHWAY AND ITS DEFECTS
Described in terms of visual field

VISUAL FIELD
area visualized on the screen when the gaze is fixed
at an object
VISUAL PATHWAY AND ITS DEFECTS
ANOPIA
Complete loss of visual field
Homonymous hemianopia
Same halves of field of vision in both eyes lost
Heteronymous hemianopia
Different halves of field of vision
Quadrantanopia
1/4th visual field lost
Scotoma
VISUAL PATHWAY AND ITS DEFECTS
Macular sparing
Occipital lesions- normal complete macular vision

Separate , extensive representation of macula

Light reflex
Light reflex
Direct
Indirect
 LIGHT REFLEX
Light information

Optic nerve

Optic chiasma

Optic tract

Pretectal nucleus

Edinger westphal nucleus

(both sides)

Ciliary ganglion

Sphincter pupillae
Near reflex
Convergence reflex
/Accomodation reflex

Accomodation : ability of the

eye to focus an object at
varying distances

3C
1. Convergence of eye ball
2. Constriction of pupil
3. Contraction of ciliary
muscles
(*Purkinje images)
ACCOMODATION
 MECHANISM OF ACCOMODATION
Ciliary muscle
contraction

Relaxation of zonular
fibres

 anterior curvature of
lens
Accomodation reflex
Visual information
Via visual pathway
Primary visual cortex Area 17

Frontal eye field area 8

Edinger- Westphal nucleus ( III CN nucleus) midbrain

Via oculomotor nerve
Medial rectus Ciliary ganglion

sphincter pupillae ciliary muscle

Convergence pupillary relaxation of zonules
of eye ball constriction ( ant curvature lens )
Presbyopia: loss of accomodation
 APPLIED ASPECTS
ARGYLL ROBERTSON PUPIL (ARP)

Accomodation reflex present (ARP)

Pupillary Light reflex absent (PRA)

neurosyphilis
VISUAL FIELD
area visualized on the screen when the gaze is fixed at
an object

Superior – 60 degree
Inferior- 70 degree
Nasal- 60degree
Temporal- 90degree

PERIMETRY
Binocular single vision
Seeing single object with 2eyes
Image falls on the corresponding points in the two
retinae, 2 images are physiologically fused at the
cortical levels and give impression of a single image
Large part of visual fields of 2 eyes overlap
Depth perception
Diplopia : double vision, due to the image formation
on dissimilar points of the two retinae, in paralysis of
extra ocular muscles.
 Ocular motility
 Extra ocular muscles :4 recti and 2 obliques
Superior rectus
Inferior rectus
Lateral rectus
Medial rectus
Superior oblique
Inferior oblique

Nerve supply
occulomotor nerve
SO4
LR6
ACTIONS OF EXTRA OCULAR MUSCLES
Muscles Pry action Secondary Tertiary action
1. Med rectus Adduction - -
2. Lat rectus Abduction - -
3. Sup rectus Elevation Intorsion Adduction
4. Inf rectus Depression Extorsion Adduction
5. Sup oblique Intorsion Depression Abduction
6. Inf oblique Extorsion Elevation Abduction
 ACTIONS OF EXTRA OCULAR MUSCLES
Inf obl Sup rec Inf obl

Med rec
Lat rec Lat rec

sup obl Inf rec sup obl

Visual acuity
it is the degree to which the details and contours of
objects are perceived
Minimum separable distance by which 2 lines can be
seaparated and still be perceieved as two lines
Tested by
Distant vision – Snellen’s chart
(Near vision- Jaegers chart
Color vision- Ishihara s chart)
Snellen’s chart
Jaeger s chart
EMMETROPIA
Optically normal
eye: state of
refraction when
parallel rays from
infinity are
focussed on the
retina with
accmodation at
rest
 AMETROPIA
Refractive error

Images are formed – front / behind retina

ERRORS OF REFRACTION
Myopia

Hypermetropia

Astigmatism

Presbyopia
Myopia
near sightedness
Parallel rays of light from infinity –focused in front
of the retina, when accommodation is at rest
 MYOPIA
Axial myopia- length of
eyeball too long (most
common)

Index myopia- refractive

power of lens increases
Far point: at def
distance

Treatment : concave lens

 HYPERMETROPIA
LONG SIGHTEDNESS
Parallel rays of light from infinity –focused behind
the retina, when accommodation is at rest
HYPERMETROPIA
Axial

Index

Absence of lens
Near point moves
further away

Treatment : convex lens

ASTIGMATISM
Astigmatism
ASTIGMATISM
Refraction varies in
different meridian

Blurring of vision
ASTIGMATISM

Treatment
:
cylindrical
lens
 PRESBYOPIA
Old age

Physiological insufficiency- accommodation

Onset - 40 years

Receding of near point

PRESBYOPIA
PRESBYOPIA
PRESBYOPIA
CORRECTION
 LIGHT INDUCED CHANGES
Light falling upon the retina is absorbed by the visual
pigments and initiate photochemical changes which in
turn trigger a sequence of events that cause
PHOTOTRANSDUCTION
Photochemical changes :
Rhodopsin bleaching

Rhodopsin degeneration

Visual cycle
LIGHT INDUCED CHANGES
Visual cycle

Photochemicals bleached=Photochemicals regenerated

 PHOTOTRANSDUCTION
CONVERSION OF LIGHT ENERGY INTO VISUAL
IMPULSE

Incident of light leads to production of a nerve

impulse
PHOTOTRANSDUCTION
Metarhodopsin

Transducin activation

cGMP to GMP

Receptor potential
 DARK ADAPTATION
Ability of eyes to adapt itself to decreasing
illumination

Time taken – Dark adaptation time

Rods - sensitive
DARK ADAPTATION CURVE
Retinal sensitivity
increases with time in dark
Initially low, but in 1min,
retinal senstivity increases
10folds i.e. the retina can
respond to light of 1/10th
the previously required
intensity
At 20min- 6000fold
At 40min- 25000fold
 DARK ADAPTATION MECHANISM
Regeneration of visual pigment

Change in pupillary size

Neurological adaptation
 NIGHT BLINDNESS
Severe deficiency – Vit A

Threshold dark adaptation due to depletion of

photosenstive pigment

Nyctalopia
 LIGHT ADAPTATION
Dim light to bright light

Quick , 5 mins
 LIGHT ADAPTATION
Rhodopsin bleaching

Constriction of pupil

Neural adjustment
COLOUR VISION
 COLOUR VISION

Ability of eyes to discriminate between colors

 COLOUR VISION

Ability of eyes to discriminate between colors

• Function of cones
Primary colors- red, green, blue
All colors are a result of admixture in different
proportion of 3 primary colors
 COLOUR VISION

Color+complementary color= white

• Dim light , all colors are grey –

Purkinje shift phenomenon
 COLOUR VISION

TRICHROMATIC THEORY
 COLOUR VISION

TRICHROMATIC THEORY
• Young- Helmholtz theory

• Three different type of cones

• Each cone contains a different photopigment-

maximally sensitive to one of the three primary colors
 COLOUR VISION

TRICHROMATIC THEORY
• Red sensitive cone pigment(erythrolabe)
Yellow portion – 564 nm
• Spectrum extends far enough- red
 COLOUR VISION

TRICHROMATIC THEORY
• Green sensitive cone pigment(chlorolabe)
Green portion – 535 nm
 COLOUR VISION

TRICHROMATIC THEORY
• Blue sensitive cone pigment(cyanolabe)
Blue-violet portion – 440 nm
 COLOUR VISION

Genes for:
Blue sensitive cone- chromosome 7

Red and green – q arm of X chromosome

(Gene rhodopsin- chromosome 3)

 COLOR BLINDNESS
• Inability to appreciate one or more primary colors

• Defective (anomolous)
• Absent (anopia)
• Proto-red,
• Deuter-green,
• Trit-blue color defect or absent
 COLOR BLINDNESS
Trichromats
Individuals with 3 cone system
normal color vision
Anomolous color vision
Protanomaly- red weakness
Deuteranomaly- green weakness
Tritanomaly – blue weak
Dichromats
Individuals wit only two cone system
Protanopia – absent red
Deuteranopia –absent green
Tritanopia – absent blue
Monochromats
Only one cone system
COLOR BLINDNESS
 COLOR BLINDNESS
• Inherited X linked recessive

• Red-green gene short arm of X chromosome

• Common in males
COLOR BLINDNESS
 COLOUR VISION
TESTS
Holmgrens coloured wool test
 COLOUR VISION
TESTS
Edridge green lantern test
 COLOUR VISION
TESTS
Ishihara charts
THANK YOU