Anatomy and Physiology
Ophthalmology (Ophth) is study of the eye
Eyeball
Organ of sight
Transmits external image using sensory impulses
via optic nerve to brain
Brain translates sensory impulses into image
Anatomy and Physiology
External structures important for vision
In addition to eyeball
Eye muscles
Eyelids
Conjunctiva
Lacrimal apparatus
The Eyeball
Composed of three layers:
Sclera
Choroid
Retina
Sclera
Outermost layer
Tough protective layer
Another term for sclera
is white of eye
Anterior portion is
cornea
Iris and Pupil
Iris
Colored portion of eye
Smooth muscle that changes size of pupil
Pupil
Opening in center of iris
Allows light to enter into eyeball
Ciliary Body and Lens
Lens
Behind iris
Not actually part of
choroid layer
Attached to ciliary body
Ciliary body
Pulls on edge of lens
Changes shape of lens
so it can focus light onto
retina
Retina
Contains sensory receptor
cells that detect light rays
Rods
Active in dim light
See gray tones
Cones
Active only in bright light
Color vision
Retina
Macula lutea
Area of retina where image forms
Fovea centralis
Depression in center of macula lutea
High number of cones
Point of clearest vision
Optic Disk
Point where the optic nerve
leaves eyeball
Retinal blood vessels enter and
leave through optic disk
No rods or cones
Results in blind spot in each eye’s
field of vision
Muscles of the Eye
Six muscles that connect eyeball to skull
4 rectus muscles pull straight
2 oblique muscles pull on an angle
Contract in combination to change direction
in which each eye is looking
Eyelids
A pair cover each eyeball
Provide protection from foreign particles, injury,
sun, and trauma
Both upper and lower edges have eyelashes or
cilia that protect eye from foreign particles
Sebaceous glands located in eyelids secrete a
lubricating oil onto surface of eyeball
Lacrimal Apparatus
Lacrimal gland
Located under outer upper corner of each eyelid
Produces tears
Tears wash and lubricate anterior surface of eyeball
Lacrimal ducts
Located in inner corner of eye socket
Collect tears
Drain into nasolacrimal duct
Ultimately drain into nasal cavity
Vision
Vision requires four mechanisms:
Coordination of external eye muscles so that
both eyes move together
Correct amount of light admitted by pupil
Correct focus of light upon retina by lens
Optic nerve transmitting sensory images to
brain
Eye Vocabulary
emmetropia
\em-ə-trō-pē-ə\
state of normal vision
legally blind severely impaired vision; having 2 0/2 00 acuity
Nyctalopia
\nik-tə-lō-pē-ə\
difficulty seeing in dim light; also called night blindness
ophthalmology diagnosis and treatment of diseases of the eye
optician specialist in grinding corrective lenses
Eye Vocabulary
optometry
specializing in examining eyes, testing vision,
and prescribing corrective lenses
Papilledema
\pap-əl-ə-’dē-mə\
swelling of the optic disk; also called choked
disk
photophobia strong sensitivity to bright light
presbyopia visual loss due to old age
Xerophthalmia
\zir-äf-thal-mē-ə,
dry eyes
Eyeball Pathology
achromatopsia
\ā-krō-mə-täp-sē-ə\
unable to perceive one or more colors; color
blindness
monochromatism unable to perceive one specific color
amblyopia
\am-blē-ō-pē-ə\
loss of vision not as a result of eye pathology;
commonly called lazy eye
corneal abrasion scraping injury to cornea
Eyeball Pathology
astigmatism
blurred vision due to uneven cornea; light rays do not
focus sharply on retina
hyperopia
image comes into focus behind retina; can see clearly at
a distance but not up close; also called far sightedness
myopia
image comes into focus in front of retina; can see clearly
up close but not at a distance; also called
nearsightedness
Eyeball Pathology
cataract damage to lens causing it to become cloudy
glaucoma
chronic increase in intraocular pressure; results in
atrophy of optic nerve
macular
degeneration
deterioration of macula lutea area of retina
Click here to view a video on cataracts.
Cataracts Video
Click here to view a video on macular degeneration.
Macular Degeneration Video
Eyeball Pathology
retinal detachment
separation of retina from choroid layer; damages blood
vessels and nerves causing blindness
retinitis pigmentosa
progressive disease in which retina becomes hard and
pigmented, then atrophies
retinoblastoma malignant eye tumor occurring in young children
Conjunctiva Pathology
Pterygium
\te-rij-ē-əm\
hypertrophied (excessively developed) conjunctival
tissue in inner corner of eye
trachoma chronic bacterial infection of conjunctiva
Pronunciation: \te-ˈrij-ē-əm\
Eyelid Pathology
hordeolum
purulent infection of sebaceous gland of eyelid; also
called a stye (or sty)
Brain-related Vision Pathology
hemianopia
loss of vision in half of visual field; often result of a
stroke
nystagmus jerky involuntary eye movements; indicator of brain injury
Eye Examination Tests
color vision tests
use of multicolored charts to determine ability to
recognize colors
fluorescein
angiography
injection of fluorescein dye into bloodstream to observe
blood flow within eye
fluorescein staining
applying fluorescein eye drops to cornea to look for
corneal abrasions
Eye Examination
Tests
keratometry measures curvature of cornea
ophthalmoscopy examination of interior of eye
refractive error test
vision test for defect in ability of eye to focus image
on retina; tests for hyperopia and myopia
slit lamp microscopyexamining posterior surface of cornea
Eye Examination Tests
Snellen chart used for testing distance vision
tonometry measures intraocular pressure
visual acuity (VA)measures sharpness of vision
Surgical Treatments
cryoextraction
use of extremely cold probe to lift
cataract from lens
Phacoemulsification
\fak-ō-i-məl-sə-fə-kā-shən\
use of high-frequency sound waves to
liquefy lens with a cataract which is then
removed with a needle
keratoplasty
surgical repair of cornea with a cornea
transplant
enucleation
ē-nü-klē-āt\
surgical removal of eyeball
Surgical Treatments
laser-assisted
In-situ keratomileusis
(LASIK)
\ker-ət-ō-mil-ü-səs\
correction of myopia using laser surgery to
remove corneal tissue
photorefractive keratectomy
(PRK)
use of laser to reshape cornea; treats myopia
radial keratotomy(RK)
spoke-like incision around cornea to flatten it;
treats myopia
Surgical Treatments
cryoretinopexy surgical fixation of retina using extreme cold
laser photocoagulation
use of laser to destroy very small precise areas of
retina
scleral buckling
placing band around outside of sclera to stabilize
detached retina
strabotomy incision into eye muscles to correct strabismus
Eye Pharmacology
anesthetic
ophthalmic solution
eyedrops to deaden pain
Ocu-Caine,
Pontocaine
antibiotic
ophthalmic solution
eyedrops to treat bacterial infection
Del-Mycin,
Ilotycin
ophthalmic
decongestant
constricts arterioles of eye to
reduce redness and itching
Visine, Murine
Anatomy and Physiology
Otology (Oto) is study of the ear
Audiology is study of hearing disorders
Ear responsible for two senses:
Hearing
Equilibrium or sense of balance
Sensory information carried to brain by
vestibulocochlear nerve
Cochlear nerve – hearing information
Vestibular nerve – balance information
The Ear
Ear is subdivided into three regions:
External ear
Middle ear
Inner ear
External Ear
Auricle or pinna
Only portion visible
Captures sound
waves
Directs them
through external
auditory meatus
External Ear
Auditory canal
Sound moves along
canal
Cerumen
Produced by oil
glands in auditory
canal
Oily wax slowly
flows out of ear
canal removing dirt
that has stuck to it
External Ear
Tympanic
membrane
Commonly called
eardrum
Sound waves strike
membrane
Causes it to vibrate
Tympanic membrane
separates external
ear from middle ear
Ossicles
Tympanic membrane
vibrates incus
Vibrations amplify as
they move from one
ossicle to next
Stapes transmits
vibration to oval
window
Start of inner ear
Eustachian Tube
Also called auditory tube
Connects nasopharynx with middle ear
Opens with each swallow
Equalizes pressure between middle ear
cavity and atmospheric pressure
How We Hear
Sound waves travel down external auditory
canal, strike eardrum
Eardrum vibrates
How We Hear
Ossicles conduct vibrations across middle
ear from eardrum to oval window
Oval window movements initiate vibrations
in fluid that fills cochlea
How We Hear
Fluid vibrations strike hair cells, bending small
hairs and stimulating nerve endings
Nerve ending sends electrical impulse to brain on
cochlear portion of vestibulocochlear nerve
Click here to view an animation on inner ear anatomy.
Inner Ear Anatomy Animation
Hearing Loss
Conductive
hearing loss
Disease or malformation
of outer or middle ear
All sound is weaker and
muffled since it is not
conducted correctly to
inner ear
Sensorineural
hearing loss
Damage or malformation of
inner ear (cochlea) or the
cochlear nerve
Sounds are distorted
because nerve impulse is
incorrect
Word Building with acous/o, audi/o &
audit/o
–gram audiogram record of hearing
–meter audiometer instrument to measure hearing
–logist audiologist hearing specialist
–tic acoustic pertaining to hearing
–ory auditory pertaining to hearing
Word Building with aur/o, auricul/o,
cochle/o and salping/o
–ar auricular pertaining to ear
–al aural pertaining to ear
–ar cochlear pertaining to cochlea
–itis salpingitis inflammation of eustachian tube
–otomy salpingotomy incision into eustachian tube
Word Building with labyrinth/o &
myring/o
–itis myringitis inflammation of eardrum
–ectomy myringectomy removal of eardrum
–plasty myringoplasty surgical repair of eardrum
–ectomy labyrinthectomy removal of labyrinth
–otomy labyrinthotomy incision into labyrinth
Word Building with ot/o
–algia otalgia ear pain
–ic otic pertaining to ear
–itis otitis inflammation of ear
–logist otologist ear specialist
–rrhagia otorrhagia bleeding from ear
Word Building with ot/o
–scope otoscope instrument to view ear
–plasty otoplasty surgical repair of ear
myc/o
–osis
otomycosis abnormal condition of ear fungus
py/o
–rrhea
otopyorrhea discharge of pus from ear
Word Building with tympan/o
–ic tympanic pertaining to eardrum
–itis tympanitis inflammation of eardrum
–meter tympanometer instrument to measure eardrum
–plasty tympanoplasty surgical repair of eardrum
–rrhexis tympanorrhexis ruptured eardrum
–otomy tympanotomy incision into eardrum
–ectomy tympanectomy removal of eardrum
Word Building with –otia
macro– macrotia large ears
micro– microtia small ears
Ear Vocabulary
American Sign
Language (ASL)
nonverbal method of communicating using hands and
fingers to represent words and concepts
binaural referring to both ears
monaural referring to one ear
decibel (dB) measures loudness of sound
hertz (Hz) measures pitch of sound
Ear Vocabulary
otorhinolaryngology (ENT)
diagnosis and treatment of diseases of ear,
nose, and throat
presbycusis normal loss of hearing with age
residual hearing
amount of hearing remaining after damage has
occurred
tinnitus ringing in ears
vertigo dizziness
Hearing Loss Pathology
anacusis total absence of hearing; total deafness
deafness
inability to hear or having some degree of hearing
impairment
External Ear Pathology
Ceruminoma
\sə-rü-mə-nəs\
excessive accumulation of earwax forming hard wax
plug
otitis externa (OE)
external ear infection; often by fungus; also called
otomycosis or swimmer’s ear
Middle Ear Pathology
otitis media (OM)
infection of middle ear; most commonly seen in
children; watery fluid (serous otitis media) or pus
(purulent otitis media) accumulates in middle ear cavity
otosclerosis
loss of mobility of stapes bone; leads to hearing loss as
it cannot vibrate
Inner Ear Pathology
acoustic neuroma
benign tumor of cochlear nerve; symptoms include
tinnitus, headache, dizziness, and hearing loss
labyrinthitis
inner ear infection; causes hearing and equilibrium
symptoms
Ménière’s disease
progressive hearing loss, vertigo, and tinnitus; causes
not well understood
Audiology Tests
audiometry
test of hearing ability in regards to both intensity and
pitch person is able to hear
Rinne & Weber
tuning fork tests
use of a tuning fork placed either next to ear or
against skull to assess both nerve and bone
conduction of sound
Otology Tests
otoscopy examination of ear canal and eardrum
tympanometry
measurement of movement of tympanic membrane
to asses pressure inside middle ear
Click here to view a video on audiometry.
Audiometry Video
Balance Tests
falling test
assesses equilibrium;
balancing on one foot with
eyes open and then
closed
Audiology Procedures
hearing aid mechanical device used to amplify sound
Surgical Treatments
cochlear implant
mechanical device surgically placed behind outer
ear; converts sound into magnetic impulses to
stimulate auditory nerve; treats sensorineural
hearing loss
Myringotomy
\mir-ən-gät-ə-mē\
incision into eardrum to drain fluid accumulated in
middle ear cavity
pressure equalizing
tube (PE tube)
surgical placement of tube in eardrum to allow for
continuous drainage of fluid from middle ear cavity
stapedectomy replacement of damaged stapes