The Eyeball

The eyeball (Bulbus oculi) is situated in the anterior part of the orbital cavity, protected in front by the eyelids and conjunctiva, in its middle by the complete orbital ring, and related behind to the bulbar fascia, fat, and ocular muscles.

It has the form approximately of an oblate spheroid, but is composed of the segments of two spheres of different sizes. The anterior, transparent, corneal segment has a radius of curvature of about 17 mm., and the posterior, opaque, scleral segment a radius of about 25 mm. The anterior segment therefore projects more strongly, and the junction of the two segments is marked externally by a broad, shallow groove, the sulcus scleræ. The central points of the anterior and posterior curvatures of the eyeball are termed respectively the anterior and posterior poles (Polus anterior, posterior), and the line connecting the poles is the optic axis (Axis oculi externa). The angle of divergence of the optic axes is about 137 degrees. The equator (Æquator) is an imaginary line drawn around the eyeball midway between its poles, and meridians (Meridiani) are lines drawn around it through the poles.

The average transverse diameter of the eyeball is about 5 cm., the vertical about 4.5 cm., and the axial about 4.25 cm. The distance from the anterior pole to the point of entrance of the optic nerve is about 3 cm.

The eyeball consists of three concentric tunics or coats, within which three refractive media are inclosed.

The Fibrous Tunic

The fibrous tunic (Tunica fibrosa oculi) is the external coat and is composed of a posterior opaque part, the sclera, and a transparent anterior part, the cornea.

The sclera, popularly termed the “white of the eye,” is a dense fibrous membrane which forms about four-fifths of the fibrous tunic. Thickest in the vicinity of the posterior pole (ca. 2 mm.), it thins at the equator (ca. 0.4 mm.), and increases in thickness toward the junction with the cornea (ca. 1.3 mm.). It is in general white, but may have a bluish tinge in its thinnest parts. Its external surface furnishes insertion to the ocular muscles and is covered by the conjunctiva scleræ in its anterior part. The episcleral tissue, which is richly supplied with vessels and nerves, attaches the conjunctiva to the sclera; it is abundant and loosely meshed except at the junction with the cornea. The inner surface is attached to the chorioid coat by a layer of delicate, pigmented, connective tissue, the lamina fusca. The anterior border is oval, the long axis being transverse, and is continuous with the cornea. The transition from the opaque scleral tissue to the transparent corneal substance occurs in such manner that the sclera appears to form a groove (Rima cornealis), into which the cornea fits somewhat as a watch-glass in the case. Near the corneo-scleral junction there is a circular venous plexus, the plexus s. sinus venosus scleræ, formerly called the canal of Schlemm. The optic nerve passes through the posterior part of the sclera a little below and external to the posterior pole. The opening for the nerve is crossed by interlacing fibrous strands, forming the lamina cribrosa scleræ.

The sclera consists of interlacing bundles of white fibrous tissue, associated with which there are a few elastic fibers. The bundles are arranged chiefly in meridional and equatorial layers. The very limited blood-supply is derived from the ciliary arteries, and the veins open into the venæ vorticosæ and ciliary veins. The lymphatics are represented by intercommunicating cell spaces. The nerves are derived from the ciliary nerves.

The cornea forms the anterior fifth of the fibrous tunic. It is transparent, colorless, and non-vascular. Viewed from in front it is oval in outline, the long axis being transverse and the broad end internal; it appears more nearly circular when viewed from behind. Its anterior surface (Facies anterior) is convex and is more strongly curved than the sclera; its central part is termed the vertex corneæ. The posterior surface (Facies posterior) is concave; it forms the anterior boundary of the anterior chamber, and is in contact with the aqueous humor. The margin (limbus corneæ) joins the sclera; the latter overlaps the cornea more in front than behind, and more above and below than at the sides, thus explaining the difference in outline of the two surfaces. The cornea is thinnest at the vertex.

The cornea consists, from before backward, of the following layers: (1) The epithelium corneæ is continuous with that of the conjunctiva scleræ, and is of the stratified squamous type. (2) The lamina limitans anterior is merely a condensation of the next layer. (3) The substantia propria forms the bulk of the cornea and is composed of interlacing bundles of connective tissue, arranged in part in lamellæ disposed parallel with the surface. In the amorphous cement substance between the lamellæ are flattened connective-tissue cells, the corneal corpuscles. These have branching processes which unite with those of other cells, thus forming a protoplasmic network. (4) The lamina elastica posterior, also termed the membrane of Descemet or Demours, is a thin and practically homogeneous membrane which is less intimately attached to the substantia propria than the anterior lamina. It is clear, glistening, and elastic. At the periphery the lamina divides into three sets of fibers. The anterior fibers join the sclera, the middle give attachment to the ciliary muscle, while the posterior pass into the iris and form the ligamentum pectinatum iridis. (5) The endothelium (cameræ anterioris) consists of a layer of flattened polygonal cells, and is reflected on to the anterior surface of the iris.

The cornea is without blood-vessels except at its periphery, where the terminal twigs of the vessels of the sclera and conjunctiva terminate in loops. The nerves are derived from the ciliary nerves. They form a plexus around the periphery (Plexus annularis), from which fibers pass into the substantia propria, become non-medullated, and form the fundamental or stroma plexus. From this perforating branches pass through the anterior limiting layer and form a subepithelial plexus, from which filaments ascend between the epithelial cells. Other branches from the plexuses in the substantia propria end as fibrils which are in close relation with the corneal corpuscles.

The Vascular Tunic

The vascular tunic (Tunica vasculosa oculi) lies internal to the fibrous coat; it comprises three parts—the chorioid, the ciliary body, and the iris.

1. The chorioid (Chorioidea) is a thin membrane which lies between the sclera and retina. It is in general rather loosely attached to the sclera by the lamina fusca, but is intimately adherent at the point of entrance of the optic nerve and less closely in places where the ciliary vessels and nerves pass through. The inner surface is in contact with the layer of pigmented cells of the retina, which adhere so closely to the chorioid that they were formerly regarded as a part of the latter. The general color of the chorioid is dark brown, but an extensive semilunar area a little above the level of the optic papilla has a remarkable metallic luster, and is termed the tapetum of the chorioid (Tapetum chorioideæ). The appearance here varies in different individuals, but the prevailing colors in most cases are iridescent blue and green in various nuances shading into yellow. Posteriorly the chorioid is perforated by the optic nerve, and anteriorly it is continuous with the ciliary body.

The chorioid consists of four layers, which from without inward are as follows: (1) The lamina suprachorioidea consists of interlacing fine lamellæ of fibrous tissue, each containing a network of elastic tissue. Among these are large-branched, pigmented, connective-tissue cells. The spaces between the lamellæ are lined with endothelium, and form a system of lymph-clefts which together form the perichorioid space (Spatium perichorioideale). (2) The lamina vasculosa is the outer part of the proper tissue of the chorioid. It contains the larger blood-vessels, which are supported by connective-tissue and elastic fibers. (3) The lamina choriocapillaris consists of an extremely rich network of capillaries embedded in an almost homogeneous matrix. Between it and the lamina vasculosa is a layer of fibro-elastic tissue, the tapetum fibrosum, which causes the metallic luster mentioned above. (4) The lamina basalis is very thin and transparent. It is composed of an inner homogeneous part and an outer elastic part.

2. The ciliary body (Corpus ciliare), the middle part of the vascular coat, connects the chorioid with the periphery of the iris. In meridional section it has the form of a narrow triangle, the base of which is next to the iris. On its inner side are the ciliary processes and on its outer side the ciliary muscle. It consists of three parts—the ciliary ring, ciliary processes, and ciliary muscle. The ciliary ring (Orbicularis ciliaris) is the posterior zone, which is distinguished from the chorioid mainly by its greater thickness and the absence of the choriocapillaris. Its inner face presents numerous fine meridional ridges, by the union of which the ciliary processes are formed. The ciliary processes (Processus ciliares), more than a hundred in number, form a circle of radial folds which surround the lens and furnish attachment to the zonula ciliaris or suspensory ligament of the latter. They are small at their origin on the ciliary ring and become much thicker and higher toward their inner ends. The width of the circle formed by them is narrower at the inner side than elsewhere. Their bases extend forward to the periphery of the iris, and their inner ends are close to the margin of the lens. They bear numerous secondary folds. Their inner surface is covered by a continuation of the lamina basalis of the chorioid, on which there are two layers of epithelial cells which constitute the pars ciliaris retinæ. They consist of a rich network of tortuous vessels supported in pigmented connective tissue. The ciliary muscle (M. ciliaris) (Figs. , , ) constitutes the outer part of the ciliary body, and lies between the sclera and the ciliary processes. It forms a circular band of unstriped muscle, the fibers of which are for the most part directed meridionally. They arise from the inner surface of the sclera and from the ligamentum pectinatum iridis close to the corneo-scleral junction, and run backward along the sclera to be inserted into the ciliary processes and ring. When the muscle contracts, it pulls the processes and ring forward, thus slackening the ciliary zone or suspensory ligament of the lens, and allowing the latter to become more convex. This is the mechanism of accommodation for near objects.

In man the muscle has the form of a prismatic ring which is triangular in meridional section, the base being directed toward the periphery of the iris. It consists chiefly of meridional fibers, but a ring of circular fibers forms the inner angle of its base. In the horse the muscle is much less developed, and has the form of a flat band; it does not contain circular fibers, but the arrangement is rendered more or less plexiform by the existence of oblique and equatorial fibers.

3. The iris (Figs. , , ) is a muscular diaphragm placed in front of the lens, and is visible through the cornea. It is pierced centrally by an elliptical opening, the pupil (Pupilla), which varies in size during life and determines the amount of light admitted to act on the retina. In strong light the vertical diameter of the pupil is very short, but the opening is almost circular when the pupil is fully dilated. The ciliary border (Margo ciliaris) or periphery of the iris is continuous with the ciliary body and is connected with the corneo-scleral junction by the ligamentum pectinatum iridis. The ligament consists of strands of connective tissue which are attached externally to the corneo-scleral junction. Its bundles interlace and inclose spaces (Spatia anguli iridis) which are lined with endothelium and communicate with the anterior chamber. The pupillary border (Margo pupillaris) surrounds the pupil. Its upper part bears in its middle several black masses of variable size, termed the granula iridis or corpora nigra; similar, but much smaller, projections may be seen on the lower margin of the pupil. The anterior surface (Facies anterior) determines the color of the eye, which is dark brown usually. It is marked by delicate concentric lines (Plicæ iridis), which fade out near the pupil. The smooth, narrow, central part is termed the pupillary zone or annulus iridis minor, while the much broader plicated part is the ciliary zone or annulus iridis major. The posterior surface (Facies posterior) is usually black. It bears numerous fine radial lines except at the pupillary margin. Its central part is in contact with the anterior surface of the lens, but peripherally the two are separated by a narrow space termed the posterior chamber. The iris consists chiefly of the stroma iridis, a delicate framework of connective tissue, which supports numerous blood-vessels, and contains branched pigmented cells. The muscular tissue (unstriped) consists of a sphincter and a dilator of the pupil. The sphincter pupillæ lies in the posterior part around the pupil, with which the fibers are largely concentric. The dilatator pupillæ consists of fibers which radiate outward from the sphincter to the ciliary border. The anterior surface of the iris is covered by a continuation of the endothelium of the cornea. Beneath this is a condensation of the stroma, in which the cells are close together and are full of pigmented granules. There appear to be minute clefts here by which the lymph-spaces of the stroma communicate with the anterior chamber. The posterior surface is covered by a pigmented epithelium, the stratum pigmenti iridis, which is a continuation of that of the ciliary body.

The arteries of the vascular tunic come from the ciliary branches of the ophthalmic artery. The arteries of the chorioidea are derived chiefly from the short posterior ciliary arteries. These perforate the sclera around the posterior pole, run forward in the lamina vasculosa, and form the rich capillary network of the choriocapillaris. The two long ciliary arteries perforate the sclera obliquely near the optic nerve; they run forward in the lamina suprachorioidea in the horizontal meridian, one on the inner, the other on the outer, side of the eyeball. On reaching the ciliary body each divides into diverging branches; the subdivisions of these unite with each other and with twigs of the anterior ciliary arteries to form a circular anastomosis, the circulus arteriosus major. From this branches go to the ciliary muscle and processes and to the iris. The two anterior ciliary arteries, dorsal and ventral, form an episcleral plexus around the corneo-scleral junction, and give off branches which perforate the sclera. These supply twigs to the ciliary muscle and recurrent branches to the chorioid, and assist in forming the circulus arteriosus major.

The blood is carried away from the vascular tunic chiefly by four or five venous trunks, the venæ vorticosæ, which are formed by the convergence in whorls of numerous veins, coming not only from the chorioid, but also from the ciliary body and iris. The venæ vorticosæ perforate the sclera about at the equator and join the veins of the ocular muscles.

The nerves come from the long and short ciliary nerves. They form a plexus in the lamina suprachorioidea, which contains ganglion cells, and sends numerous non-medullated fibers chiefly to the blood-vessels of the chorioid. At the ciliary muscle a second plexus (P. gangliosus ciliaris) is formed, which supplies the muscle and sends fibers to the iris. The sphincter pupillæ is supplied by fibers derived from the oculomotor nerve, while the dilatator pupillæ is innervated by the sympathetic.