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BLOOD AND NERVE SUPPLY OF EYE AND OPTIC NERVE

Presenter – Pushkar Dhir

Moderator – Dr .Samiksha Choudhary

INTERNAL CAROTIDCERVICAL PETROUS CAVERNOUS CEREBRAL

•Caraticotympanic•Pterygoid

•To Trigeminal Ganglion•Sup.& Inf. Hypophyseal•Meningeal

•Ant. & Middle Cerebral•Ant.& Post. Communicating•Ophthalmic

Supra trochlearSupra orbital

Lacrimal Artery Central Retinal artery

1. Ant. Ethmoidal2. Post. Ethmoidal3. Dorsal Nasal4. External Nasal5. Internal Nasal

Lacrimal & Muscular Art

Long & ShortPosterior ciliary arteries

Ant.ciliary art.

Ophthalmic artery

1st intracranial portion of the internal carotid artery.

It passes beneath the optic nerve and accompanies

it through the optic canal into the orbit.

1st intraorbital branch is the central retinal artery, which enters the optic nerve .

Anterior branches of the ophthalmic artery forms the arterial arcades of the eyelids.

And further makes anastomosis with the external carotid circulation via the facial artery.

Post.Ciliary(supply the choroid and parts of the optic nerve)

Internal carotid a.

Supratrochlear a. &Supra-orbital

Supra-orbital a

Ant. ethmoidal a.

Post. ethmoidal a.

Ophthalmic a.(pierces the dural sheath of optic nerve at apex & lie below & then lateral to optic nerve)

Lacrimal a.(supply lacrimal gland and upper eyelid)

Muscular Branches.(Ant.ciliary arteries are derived from it)

Central Retinal Art.

LONG POSTERIOR CILIARY ARTERIES supply Ciliary body and anastomose with each other and with the anterior ciliary arteries to form the major arterial circle of the iris.

ANTERIOR CILIARY ARTERIES (7 in no.- (2 from each MR, SR, IR & 1 from LR) are derived from the MUSCULAR BRANCHES to the rectus muscles. Pass anteriorly in episclera & supply the anterior SCLERA, EPISCLERA, LIMBUS, AND CONJUNCTIVA

Finally penetrate sclera near Limbus Ciliary Muscle Anastomose with Long Post.Ciliary

MAJOR ARTERIAL CIRCLE OF THE IRIS.

Supratrochlear a.

Supra-orbital a

Post.Ciliary(supply the choroid and parts of the optic nerve)

Internal carotid a.

Supratrochlear a. &Supra-orbital

Supra-orbital a

Ant. ethmoidal a.

Post. ethmoidal a.

Ophthalmic a.

Lacrimal a.(supply lacrimal gland and upper eyelid)

Muscular Branches.(Ant.ciliary arteries are derived from it)

Central Retinal Art.

Supplies retina & optic nerve

CRA Course•Runs a wavy course , adherent to the dural sheath of optic nerve .•10-15mm behind eye ball it pierces Dura & Arachnoid of optic nerve.•In sub-arachnoid space it bends forwards & after a short course bend at approx right angle &

invaginates piamater to enter centre of the nerve.• In Optic nerve --- it runs a straight course & pierce the lamina cribrosa to appear on o.disc. •In Optic nerve head --- it lies superficially in nasal part of optic cup & divides into Sup. & inf. Tempoal & nasal branches

ARTERIAL CIRCLE OF ZINN /HALLER (in lamina cribrosa)

INL

IpL

NFL

Macula RegionB/S:- Superior & Inferior temporal branches**In 20% population Cilioretinal Artery supplies macula.(in case of CRA occlusion it helps to retain vision)**Retinal art. are END ARTERIES.

Outer-plexiform layer B/S:- CRA + partially by Choriocapillaries

INL,IPL,Ganglion cell layer,NFL,ILM B/S:- CRA

RPE, R&C,ELM,ONLB/S:- Choriocapillaries

B/S OF OPTIC NERVEINTRAOCULA

R PART

INTRAORBITAL

PART

INTRACANALICULAR

PART

INTRACRANIAL

PART

•Periaxial System (derived 4m Ophthalmic art, Long & short ciliary art, lacrimal art ,CRA )supplies periaxial part of optic nerve.

•Axial system derived 4m CRA, collateral arteries , intraneural branches supplies axial part

Supplied by periaxial system of vessels formed by ophthalmic & collaterals arteries.

Supplied by periaxial system of vessels formed by cerebral & anterior communicating arteries.

1.Surface NFL:-Supplied by capillaries from retinal arterioles.

2.Pre-laminar region:-Supplied by vessels of ciliary region i.e peripapillary choroidal vessels.

3.Lamina Cribrosa :-Supplied by ciliary vessels derived from short Post Ciliary & arterial circle of zinn.

4.Retrolaminar Region:-Supplied by both retinal & ciliary circulation

Central Retinal Art.

Intraorbital + intracanalicular partIntraocular + Intraorbital part

Main B/S of 1.Optic Chiasma :- branches from Ant.cerebral & internal carotid.2.Optic tract :-branches from Post.communicating art.,Ant.choroidal art. & MCA.3.LGB:- Post.cerebral Artery -> supply postero-medial part of LGB & therefore the Superior quadrents fibres. Ant.choroidal artery -> supply antero-lateral part of LGB -> inferior quadrents fibres. *Hilum region in LGB is supplied by both PCA and Ant.choroidal4.Optic radiations :- Ant.choroidal art , Calcarine branches of PCA, branches of MCA.5.Visual Cortex :- Post.cerebral artery via calcrine arteries + post.temporal & parieto-occipital arteries.

• VENOUS DRAINAGE OF THE INNER RETINA occurs via the central retinal vein to the superior ophthalmic vein cavernous sinus internal

jugular vein.

• THE OUTER RETINA, CHORIOCAPILLARIS, AND CHOROID are drained through the vortex veins join the central retinal vein superior ophthalmic vein cavernous sinus and jugular vein circulation.

• The vortex veins drain the choroidal circulation via superior and inferior ophthalmic veins.

Venous Drainage

Facial v.

Sup. Ophthalmic v.

Cavernous sinus

Pterygoid plexus

Inf. Ophthalmic v.

Retromandibular v.

NERVE SUPPLY• Sensory N/S – *Trigeminal nerve (Mixed nerve) V *Ophthalmic (V1) & Maxillary(V2) divison play main role of eye sensation.

• Motor N/S -- *Cranial nerve 3rd ,4th,6th for ocular movements. *Cranial nerve 7th for eyelid closure.

• Sympathetic N/s --* Nasociliary branch of ophthalmic nerve

• Parasympathetic N/S:-- * Occulomotor (3rd).

TRIGEMINAL N.

OPHTHALMICMAXILLARY

(gives infraorbital nrv)

MANDIBULAR

FRONTAL N. LACRIMAL N. NASOCILIARY N.

•SUPRA-ORBITAL•SUPRA-TROChLEAR

•Ant.Ethmoidal –----- Supplies Ethmoidal Sinus , Internal & Ext.Nasal

•Post.Ethmoidal ------ Supplies Sphenoidal Sinus

•Infratrochlear -------- Medial Eyelid•Long Ciliary Nerves---Pierces Sclera & Supply Cornea, Iris, Ciliary Body

•Sympathetic Fibres---Dilate Pupil

Supply Forehead + Scalp + Conjunctiva + upper & central eyelid

Supplies to lateral eyelid + lacrimal gland + conjunctiva

Ophthalmic nrv.

Abducens nrv.

• The nerves of the orbit include those that enter through the superior orbital fissure and supply the ocular muscles :

• Oculomotor (CN III), • Trochlear (CN IV), and • Abducent (CN VI) nerves. • The trochlear and abducent nerves pass directly to the single muscle supplied by each nerve. • The oculomotor nerve divides into a superior branch supplying superior rectus & LPS inferior branch supplying the medial & inferior rectus and inferior oblique, + carry presynaptic parasympathetic fibers (miosis) to the ciliary ganglion.

B/S & N/S Of Various Structure of Eye(Review)

Conjunctiva –B/S:- Ant.Ciliary Artery.N/S:-Superiorly Supraorbital nerve, Supratrochlear nerve Infratrochlear nerve

Inferior:-Infraorbital nerveLateral:-Lacrimal nerve Circumcorneal:-Long ciliary nerves

Cornea –B/S:- avascularN/S:- long ciliary nerves (nasociliary nerves)

IRIS -B/S:- Ant .& Post. Ciliary arteriesNS:- Long ciliary nerves

Sclera:-B/S:- AvascularN/S:- long ciliary nerves anteriorly& short ciliary nrv. Behind equator

Episclera :-B/S:- long & short ciliary arteries

Thank You