BLOOD AND NERVE SUPPLY OF EYE

• All structures are supplied by branches of
Internal Carotid Artery
• Except eyelids and conjunctiva which receives
blood supply from the branches of both
internal and external carotid artery
Central retinal artery
• First branch from the ophthalmic artery
• End arteries
• Divides into equal superior & inferior branches,
then another division (nasal & temporal)

1. BLOOD AND NERVE SUPPLY OF
EYE AND OPTIC NERVE
Presenter –Dr. Om Patel
Moderator –Dr. RashiSharma

2. Arterialsupply
•Internal carotid artery
•External carotid artery

3. Arterial supply
•All structures are supplied by branches of
Internal Carotid Artery
•Except eyelidsand conjunctivawhich receives
blood supply from the branches of both
internal and external carotid artery

4. INTERNAL CAROTID
CERVICAL
PETROUS
CAVERNOUS
CEREBRAL
OPHTHALMIC

6. Post.Ciliary
(supply the
choroid and
parts of the
optic nerve)
Internal carotid a.
Supratrochleara. &
Dorsal Nasal a.
Ant. ethmoidala.
Post. ethmoidala.
Ophthalmic a.
Lacrimal a.
Muscular Branches.
(Ant.ciliaryarteries
are derived from it)
Central Retinal Art.
Branches of ophthalmic artery:

7. Central retinal artery
•First branch from the ophthalmic artery
•End arteries
•Divides into equal superior & inferior branches,
then another division (nasal & temporal)

8. Central retinal artery
Runs along optic nerve, then at about 1.25cm behind eyeball it pierces the
dural& arachnoid sheaths of optic nerve, enters eyeball through lamina
cribrosa

9. Central retinal artery
9
Meningeal Branches
Central Collateral
Branches
PialSheath
Macular Nerve
Fibres

10. TwoCiliaryarteries(oneachsideof
theopticnerve)
•Divideinto2longposteriorciliary
arteriesand~20shortposterior
ciliaryarteries
•Theshortposteriorciliaryarteries
directlysupplythechoroidandtake
partinformationofCircleofZinn
•Thelongposteriorciliaryarteries
travelinthesuprachoroidalspace
anteriorlythensupplythechoroid
anteriorlyviarecurrentbranches
Ciliaryarteries

11. Circle Of Zinn
•Circular anastomosis
between short posterior
ciliaryarteries when they
are piercing the sclera
•Gives branches to choriod,
optic nerve and pial
network
•Cilioretinalartery–helps to
maintain vision in case of
CRA occlusion

12. Anterior Ciliaryarteries
–7 arteries 2 for each rectus
muscle except LR muscle
–Takes part in formation of
Major arterial circlealong
with long posterior ciliary
artery
–Supplies ciliarybody and
iris

13. Eyelids
•Arterialbloodsupply:
–LateralPalpebralartery
(fromlacrimalartery)
–MedialPalpebralartery
(fromdorsalnasalartery)
•Marginalandperipheral
palpebralarcades

14. Venous drainage:
•Medially: to
angular vein
•Laterally: to
superficial
temporal vein

15. Nerve supply:
Sensory Supply
•Lower lid:
–infra-orbital (from V2)
–Medial Aspect infra-
trochlear nerve (V1)
•Upper lid:
–Supra-orbital nerve
–Supra-trochlear nerve
–Lacrimal nerve (v1)

16. Nerve Supply -Eyelids
•Arrangement of sensory nerves
–Submuscularplane
–Site of injection for anesthesia
•Motor Supply
–Facial Nerve –Orbicularis muscle
–Oculomotornerve –LPS

17. Conjunctiva
•Palpebral conjunctivamarginal and peripheral arcades
(from medial and lateral palpebral artery)
•Bulbar conjunctiva anterior and posterior conjuctival
arteries

18. Conjunctiva
•Venous drainage:
–superior and inferior ophthalmic vein
•Nerve supply:
–Long ciliarynerve (nasociliarybranch of ophthalmic nerve)

19. Blood supply of the AC
Long posterior ciliaryartery anastomose with anterior ciliaryartery
–Major arterial arcade (ciliary stroma)
–Minor arterial arcade (At the collareteof the iris)
•They are the major blood supply to the iris and ciliary body
•Venous drainage: minor venous circledirectly into the
vortex veins (not into the corresponding major circle)

21. Macula Region
Supplied by Superior & Inferior temporal branches of central retinal artery
**In 20% population CilioretinalArtery supplies macula.(in case of CRA occlusion it helps to retain vision)
•Outer-plexiformlayer
•CRA + partially by choriocapillaries
•Inner nuclear layer, Inner PlexiformLayer,
Ganglion cell layer, Nerve FibreLayer,
Internal Limiting Membrane
•Supplied by Central Retinal Artery
•RPE, Rodesand Cones ,External Limiting
Membrane, Outer Nuclear Layer
•Supplied by choriocapillaries
Retina

22. Venous Drainage Of Eye
•No valves
•Tortuous & freely anastomose with one
another

23. Venous Channels
•Superior ophthalmic vein
•Inferior ophthalmic vein
•Middle ophthalmic vein
•Medial ophthalmic vein
•Angular Vein
•Cavernous Sinus

24. Venous drainage of eye

25. Superior ophthalmic vein
•Formed by union of supraorbital & angular veins
•Communicates with Central Retinal Vein, receives
Inferior Ophthalmic Vein & 2 vorticoseveins from the
upper part of the eyeball
•Leaves the orbit through superior orbital fissure to
join the cavernous sinus

26. Inferior Ophthalmic Vein
•Arises from venous plexus in orbital floor
•Communicates with pterygoidvenous plexus
•Receives muscular branches & 2 inferior vorticosevein
•Joins superior ophthalmic vein or drains directly into the
cavernous sinus

27. Angular Vein
•Formed by supratrochlearand supraorbital veins
•Runs down the side of nose about 8 mm from the
medial canthus
•Important landmark for lacrimal sac surgery
•Continues as facial vein

28. Blood supply of Optic Nerve:
A. Intraocular part/ optic nerve head
•Cilioretinalartery
•Peripapillarychoroidalvessels
•Vessels from zinnand heller
Surface nerve
fiber layer and
Prelaminarpart
•Short Posterior CiliaryArteries
Lamina cribrosa
region
•Central retinal artery
•Pialvessels
Retrolaminar

29. PeriaxialSystem Axial System
DerivedFrom branches of ICA Derivedfrom branches of Central Retinal Artery
OphthalmicArtery CentalRetinal Artery
Long posterior ciliaryartery Centralcollateral branches
Short posterior ciliaryartery Intraneuralbranch
LacrimalArtery
Central Retinal Artery
B. Intraorbitalpart :

30. •The anterior portion of the nerve derives its blood supply from the posterior
ciliary arteries (PCA) and the choroid (C)
•The posterior optic nerve derives its blood supply from penetrating pialarteries
(Col br) and branches of the central retinal artery (CRA)

31. C .Intracanalicularpart :
Periaxialsystem of vessels
D . Intracranial part :
Pialsystem of vessels

32. Venous drainage :
Optic nerve
head
•Central
retinal vein
Orbital part
•Peripheral
pialplexus
•Central
retinal vein
Intracranial
part
•Pialplexus
which ends
in anterior
cerebral &
basal vein

33. NERVE SUPPLY
•Sensory N/S –*Trigeminal nerve
(Mixed nerve) V
*Ophthalmic (V1) &
Maxillary(V2)
divisonplay main role of
eye sensation
•Motor N/S --*Cranial nerve 3
rd
,4
th
,6
th
for ocular movements
*Cranial nerve 7
th
for
eyelid closure
•Sympathetic N/s --* Nasociliarybranch of
ophthalmic nerve
•Parasympathetic N/S:--* Occulomotor(3
rd
)

34. TRIGEMINAL NERVE
OPHTHALMIC MAXILLARY MANDIBULAR

35. •SUPRA-ORBITAL
•SUPRA-TROCHLEAR
•Ant.Ethmoidal–-----Supplies EthmoidalSinus
•Post.Ethmoidal------Supplies SphenoidalSinus
•Infratrochlear--------Medial Eyelid
•Long CiliaryNerves---Pierces Sclera & Supply
Cornea, Iris, CiliaryBody
•Sympathetic Fibres---Dilate Pupil
Supply
Forehead + Scalp +
Conjunctiva +
upper & central
eyelid
Supplies to
lateral eyelid +
lacrimalgland
+ conjunctiva
OPHTHALMIC
Frontal Nerve
Lacrimal Nerve
NasociliaryNerve

36. The nerves of the orbit that enter through the superior orbital fissure
and supply the ocular muscles :
•Oculomotor(CN III)
•Trochlear (CN IV)
•Abducent(CN VI)

37. Thank You