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    Annulus of Zinn

    Related terms:

    • Neoplasm
    • Ophthalmic Artery
    • Cavernous Sinus
    • Ligament
    • Muscle
    • Cranial Nerve
    • Orbit
    • Sphenoid
    • Extraocular Muscle
    • Optic Nerve

    Learn more about Annulus of Zinn

    Volume 1

    Shaan M. Raza , … Prem S. Subramanian , in Schmidek and Sweet Operative Neurosurgical Techniques (Sixth Edition) , 2012

    Muscle Cone and Annulus of Zinn

    The annulus of Zinn serves as the origin of six of the seven extraocular muscles (Fig. 50-2). Superiorly, the superior rectus arises from the annulus, which at this point is fused with the dura of the optic nerve. The levator palpebrae arises medial and superior to the superior rectus muscle but remains intimately associated with it. More medial and inferior to this are the origins of the medial rectus and superior oblique muscles. Although it is firmly fused to the optic nerve dorsally, the annulus of Zinn loops widely around the nerve laterally and inferiorly, giving rise to the lateral rectus muscle, in addition to the inferior rectus. The space between the insertion sites of these two muscles is known as the oculomotor foramen. Based on this arrangement, there are evident portals of entry of neurovascular structures into the orbit: the optic canal and the superior orbital fissure.

    FIGURE 50-2. The anulus of Zinn is a fibrous band giving rise to the origins of six of the seven extraocular muscles. This fibrous tissue is in continuity with the dural sheath of the optic nerve. The two heads of the lateral rectus loop around that portion of the superior orbital fissure known as the oculomotor foramen.

    Read full chapter

    Extraocular Muscles

    Lee Ann Remington OD, MS, FAAO , in Clinical Anatomy and Physiology of the Visual System (Third Edition) , 2012

    Origin of the Rectus Muscles

    The four rectus muscles have their origin on the common tendinous ring (annulus of Zinn). This oval band of connective tissue is continuous with the periorbita and is located at the apex of the orbit anterior to the optic foramen and the medial part of the superior orbital fissure. The upper and lower areas are thickened bands and sometimes are referred to as the upper and lower tendons or limbs. The medial and lateral rectus muscles take their origin from both parts of the tendinous ring. The superior rectus is attached to the upper limb, and the inferior rectus is joined to the lower (Figure 10-8) . The medial rectus and the superior rectus also attach to the dural sheath of the optic nerve.30

    FIGURE 10-8. Orbital apex with globe removed. The origin of the rectus muscles at the anulus of Zinn. Motor innervation of the extraocular muscles and the relationship between superior orbital fissure and common tendinous ring is shown.

    Clinical Comment: Retrobulbar Optic Neuritis

    RETROBULBAR OPTIC NEURITIS is an inflammation affecting the sheaths of the optic nerve. Generally, there are no observable fundus changes in this condition, but pain with extreme eye movement can be one of the early presenting signs.1,30 The optic nerve sheath is supplied with a dense sensory nerve network and because of the close association of muscle sheath and optic nerve sheath, eye movement can cause stretching of the optic nerve sheath, resulting in a sensation of pain.31

    The area enclosed by the tendinous ring is called the oculomotor foramen, and several blood vessels and nerves pass through the foramen, having entered the orbit either through the optic canal or the superior orbital fissure (see Figure 10-8). The optic nerve and ophthalmic artery enter the oculomotor foramen from the optic canal; the superior and inferior divisions of the oculomotor nerve, the abducens nerve, and the nasociliary nerve enter the oculomotor foramen from the superior orbital fissure (see Figure 10-8). These structures lie within the muscle cone, the area enclosed by the four rectus muscles and the connective tissue joining them. Thus the motor nerve to each rectus muscle can enter the surface of the muscle that lies within the muscle cone.

    In 1887, Motais described a common muscle sheath between the rectus muscles enclosing the space within the muscle cone.5 More recently, dissections by Koornneef32 revealed no definitive, continuous muscle sheath between the rectus muscles in the retrobulbar region.

    The lacrimal and frontal nerves and the superior ophthalmic vein lie above the common ring tendon, and the inferior ophthalmic vein lies below. They are outside the muscle cone (see Figure 8-15).

    Read full chapter

    Optic nerve

    Jean-Pierre Barral , Alain Croibier , in Manual Therapy for the Cranial Nerves , 2009

    Intra-orbital section

    At the exit of the optic canal, the optic nerve crosses the common tendinous ring (annulus of Zinn), to which are attached the four rectus muscles of the eye. The nerve occupies the center axis of the musculofascial cone of the bulb, in the middle of the orbital fat body. It is surrounded by three sheaths, which are extensions of the cranial meninges.

    Curves of the optic nerve

    The curves are important to know because they permit the optic nerve to adapt to movements of the eye. Also, we believe that the narrowing of the nerve where it meets the eyeball (from about 5 mm to 1.5 mm) is another factor that assists the mobility of the eyeball.

    The first curve is posterior, with a caudal and medial concavity.

    The second curve is anterior, with a lateral concavity.

    These two contours allow the optic nerve to be much longer than it would be if it were straight. The extra available length affords the eyeball even greater mobility.

    Note for manual therapists

    Mechanically, the curves of the optic nerve are important in facilitating the movement of the eye. Remember that it is the medial curve that is of particular interest in our manipulations. The techniques of compression–decompression of the eyeball are addressed to the optic nerve and its sheaths. During the decompression phase, a subtle sinuous movement can be perceived, which is probably due to these curves.

    Dural sheath of the optic nerve

    The dural sheath is quite thick and fibrous. It is continuous with the cranial dura mater (Fig. 11.2), and this feature allows us to have a general effect on the dura mater when we manipulate the optic nerve. The adherence of the optic nerve to the walls of the optic canal, through the intermediary of the meninges, implicates the nerve in the case of skull fractures and sinus infections.

    Fig. 11.2. Dural sheaths and the optic nerve.

    Useful relationships

    As it crosses the orbit, the optic nerve relates to:

    the ophthalmic artery, which goes around its lateral aspect, becoming superior to it, and the posterior ciliary arteries, which surround it

    the superior and inferior ophthalmic veins

    the long ciliary nerves and the ciliary ganglion located on its lateral aspect, where the middle third runs into the posterior third.

    Read full chapter

    Ophthalmic nerve

    Jean-Pierre Barral , Alain Croibier , in Manual Therapy for the Cranial Nerves , 2009

    Nasociliary nerve

    The nasociliary nerve passes through the superomedial aspect of the sphenoid fissure, within the common tendinous ring (annulus of Zinn). It runs towards the medial part of the orbital cavity to end at the medial anterior orbital foramen.

    Collateral branches

    The collateral branches of the nasociliary nerve are:

    the ophthalmic ganglion

    the ciliary nerves

    the spheno-ethmoidal branch (the posterior ethmoidal nerve), which supplies the sphenoidal and ethmoidal sinuses.

    Terminal branches

    The terminal branches of the nasociliary nerve (Fig. 15.4) are:

    Fig. 15.4. Terminal branches of the ophthalmic nerve in the orbit.

    The infratrochlear nerve (external nasal), a branch of which goes to the lacrimal canal and the medial eyelid. It can be palpated below the trochlea.

    The supratrochlear nerve. This branch is also called the ethmoidal filament for the cribriform plate, over which it passes.

    A branch supplies the frontal dura mater.

    Nasal branches.

    Note for manual therapists

    Through the branches of the nasociliary nerve, it is possible to have an effect on the ethmoidal and sphenoidal sinuses, the frontal dura mater and the lacrimal canal.

    Read full chapter

    Primary Optic Nerve Sheath Meningiomas

    Uta Schick , Werner Hassler , in Meningiomas , 2010

    PATHOLOGY AND PATHOGENESIS

    Primary ONSMs arise from the arachnoid cap cells surrounding the intracanalicular or intraorbital portion of the nerve and are almost always intimately associated with the nerve tending to surround the nerve.5,9,24,26 This results in a concentric thickening of the optic nerve diameter. ONSMs extend posteriorly into the annulus of Zinn. Therefore, ONSMs cannot be resected completely without compromising the integrity of the optic nerve.27

    There are different mechanisms for preoperative optic nerve injury: ischemia, compression, demyelization and tumor invasion.10,27 Compressive mechanical injury leads to small vessel compromise and demyelization, especially in patients with a long duration of visual loss before surgery. Assuming that there is no additional intraoperative trauma to the optic nerve, incomplete or no recovery of visual function after surgery may imply chronic severe preoperative ischemic or compressive damage and demyelization. In our study, preoperative disc pallor and location in the optic canal were negative prognostic factors for visual improvement. The bony optic canal is not enlarged in ONSMs and the tumor in the canal compresses the optic nerve. This compressive injury can at least be reversed by surgical bony decompression of the optic canal. This is the main argument in favor of surgery.

    Aggressive ONSMs are known with infiltration of the globe or optic nerve. Thus, deterioration of visual acuity may also result from direct tumor invasion into the intracranial optic nerve (n = 4, own series). Infiltration of the globe occurred in two patients and infiltration of the cavernous sinus in four patients (type IIb). Irregular margins in the orbit implied local invasion.26

    Read full chapter

    Volume 1

    John R. Floyd , Franco DeMonte , in Schmidek and Sweet Operative Neurosurgical Techniques (Sixth Edition) , 2012

    Long-Term Outcomes

    The recurrence or progression rate for hyperostosing sphenoid wing meningiomas varies from 6% to 60%, with an average time to recurrence or progression of 24 to 73 months4,8,10,21-23 (Table 37-5). Bonnal et al.6 describe six early recurrences (within less than 2 years) in their series of 21 patients. Three areas attributed to the early recurrence, or more likely progression, are the cavernous sinus, sphenoid body, and annulus of Zinn. Shrivastava et al.4 also reported one early recurrence (within less than 1 year) from direct extension from the superior orbital fissure. Maroon et al. in 1994 indicated that recurrences are multifactorial, including failure of early diagnosis, subtotal resection when tumor invades the cavernous sinus and superior orbital fissure, and incomplete removal of hyperostotic bone.26 Today, it is clear that hyperostotic bone is tumor-invaded bone.9,10 With advanced imaging by means of high-resolution CT scans and gadolinium-enhanced, fat-suppressed MRIs, corrected diagnosis is made earlier and more extensive resections are achieved. However, tumor invasion in the cavernous sinus, superior orbital fissure, and orbital apex remains problematic and is the main reason for tumor progression.7,21,29 In our series of 20 patients followed for an average of 42 months, 5 patients developed tumor recurrence or progression at an average of 32 months. The areas of progression resulted from residual tumors in the cavernous sinus, superior orbital fissure, and intraorbital and intraconal locations.

    Read full chapter

    The Eye and Vision

    R.A. Armstrong , R.P. Cubbidge , in Handbook of Nutrition, Diet and the Eye , 2014

    Extraocular Muscles

    There are six extraocular muscles that are attached to the eye by tendons at the sclera (the white outer coat of the eye). They function to move the eyes through 360° of gaze and are coordinated so that the two eyes move in unison, thus preventing double vision (diplopia). There are four rectus muscles: medial, lateral, superior, and inferior, which are attached to a common tendon ring at their posterior ends (the annulus of Zinn), which in turn, is attached to the posterior surface of the orbit. The primary action of the medial rectus is to pull the eye horizontally in the nasal direction, whereas the lateral rectus pulls the eye horizontally in the temporal direction. The primary action of the superior rectus is to pull the eye upward and the inferior rectus to pull the eye downward. The two remaining muscles, the superior and inferior oblique muscles are inserted more ‘obliquely’ into the upper and lower posterior temporal quadrants of the orbit. The inferior oblique, and superior, inferior, and medial recti muscles are controlled by the third cranial nerve (the oculomotor nerve) and the lateral rectus by the sixth cranial nerve (the abducens nerve). In addition, the superior oblique muscle is supplied by the fourth cranial nerve (the trochlear nerve). The primary actions of the superior and inferior oblique muscles are also to pull the eyes in an upward or downward direction, respectively. Nevertheless, only the primary muscle actions have been described, and several of the muscles act in concert to produce secondary and tertiary actions, which can move the eyes in more complex directions. The study of muscle action of the eyes and the coordination of eye movement is called ‘binocular vision’.

    Read full chapter

    Oculomotor nerve

    Jean-Pierre Barral , Alain Croibier , in Manual Therapy for the Cranial Nerves , 2009

    12.1 ANATOMY

    12.1.1 Origin

    The fibers of the oculomotor nerve arise from the medial part of the cerebral peduncle. We can distinguish a medial or interpeduncular group of fibers, and a lateral group of fibers that emerge from the anterior surface of the peduncle. These fibers unite to form a nerve cord whose course we will examine.

    12.1.2 Pathway

    On leaving the peduncle, the oculomotor nerve runs forward, laterally and very slightly cephalad towards the lateral side of the posterior clinoid process (Fig. 12.1). Before the posterior clinoid process, it crosses the dura mater to enter the lateral wall of the cavernous sinus. From there, it penetrates the superior orbital fissure.

    Fig. 12.1. Course of the oculomotor nerve (superior view).

    12.1.3 Useful relationships

    With the basilar arterial system

    The basilar trunk separates the two oculomotor nerves, which then pass between the posterior cerebral and superior cerebellar arteries.

    In the cavernous sinus

    The oculomotor nerve lies on the most cephalic part of the wall of the cavernous sinus.

    In the superior orbital fissure

    The oculomotor nerve crosses this fissure at its widest part and pierces the orbit, crossing the common tendinous ring (annulus of Zinn) formed by the two tendons of the lateral rectus muscles (Fig. 12.2).

    Fig. 12.2. The oculomotor nerve in the superior orbital fissure. A: Intracranial view. B: Frontal section.

    12.1.4 Anastomoses and connections

    The oculomotor nerve has some anastomoses and connections:

    with the ophthalmic nerve (branch of the trigeminal nerve)

    with the sympathetic fibers, principally branches arising from the carotid plexus.

    12.1.5 Distribution

    The oculomotor nerve separates into two branches either on entering the orbit or just before (Fig. 12.3). It divides into a superior branch (cephalic branch) and an inferior branch (caudal branch). Here the nasociliary nerve (branch of the ophthalmic nerve) is found between the two divisions.

    Fig. 12.3. The oculomotor nerve (lateral view).

    Cephalad branches

    The superior branch ascends the lateral aspect of the optic nerve and meets the superior rectus muscle of the eye. A small branch goes to innervate the levator palpebrae superioris.

    Caudad branches

    The caudal branch is more important than the smaller cephalic branch. It divides into three filaments:

    a medial filament, supplying the medial rectus muscle

    a caudal filament, supplying the inferior rectus muscle

    an anterior filament, supplying the inferior oblique muscle.

    It furnishes the oculomotor root of the ciliary ganglion.

    12.1.6 Ciliary ganglion

    The ciliary ganglion is situated against the lateral surface of the optic nerve. It receives:

    the sympathetic root from the carotid plexus

    the nasociliary root from V

    the parasympathetic oculomotor root from III.

    The short ciliary nerves emerge from the ciliary ganglion.

    Read full chapter

    Periorbital and Intraorbital Trauma and Orbital Reconstruction

    Simon Holmes , in Maxillofacial Surgery (Third Edition) , 2017

    Intraorbital Anatomy

    This is a complex anatomical region, which is entirely devoted to the support and function of the globe itself.

    The globe itself measures 7.5 cc and is ovoid in shape. Surrounding the globe, there are tendinous attachments of the extraocular muscles that join to a fascia called Tenon capsule. The fascia itself is attached laterally to Whitnall tubercle and medially to the posterior lacrimal crest. The inferior part is thickened to form a hammock known as the suspensory ligament of Lockwood.

    The rest of the orbital volume is made up of periorbital fat, extraocular muscles, and neurovascular components. The periorbital fat provides a cushion against which the eye can rotate. Within this fat volume is a large number of connecting fibrous septa interspersed throughout. These are the eponymous ligaments of Korneef.

    The volume of the soft tissues, the integrity of the ligaments, and the positioning of the orbital walls will largely dictate the position of the globe.

    There are six extra ocular muscles, which attach from Tenon capsule, four of which attached to a common tenderness ring called the annulus of Zinn at the back of the orbit surrounding the optic foramen. Two additional muscles attach to the bony orbit itself. The superior oblique arises from the lessor wing of the sphenoid bone just medial to the annulus; the inferior oblique arises from the anterior orbital floor just lateral to the nasolacrimal sac. It is the addition of these two muscles that allows for more complex movements. These movements are so complex that three cranial nerves are required to produce them, and a robust interconnecting neuronal system links them. Elevation of the globe is produced by the superior rectus and inferior oblique muscles; depression of the globe is produced by inferior rectus and superior oblique muscles.

    The optic nerve is 3 cm in length and emerges from the optic foramen in a robust and dense lesser wing of sphenoid and runs with a sheath of dura mater into the posterior pole of the globe.

    The oculomotor in its superior and inferior divisions, trochlear, and abducens nerves enter the orbit by the superior orbital fissure, along with the ophthalmic nerve with its lacrimal, frontal, and nasociliary branches.

    The ophthalmic artery is a branch of the internal carotid artery travelling in the cavernous sinus. Its branches follow all the divisions of the ophthalmic nerve.

    Of surgical importance are the anterior and posterior ethmoidal arteries, which enter the orbit at variable distances along the medial wall. Any learned measurements from the anterior aspect are often quoted but unreliable.11,23

    Venous drainage is via the superior and inferior ophthalmic veins, which drain into the cavernous sinus posteriorly, and anastomose to the facial vein anteriorly.

    Read full chapter

    Vitamin D

    Jawaher A. Alsalem , … Graham R. Wallace , in Vitamin D (Fourth Edition) , 2018

    Introduction

    The eye has unique physical and physiological properties expressing a spectrum of surface molecules, cytokines, and immune cells hosting specialized immune responses. Diseases may be restricted to the eye or the eye may be the target organ for multisystem diseases where ocular manifestations may precede systemic diagnoses.

    The eye is an essential sensory organ that developmentally and anatomically forms part of the central nervous system linked by the neural axons of the optic nerve. Derived from neuroectoderm, the eye is mechanically protected by the bony structures of the skull called the orbit suspended in a fascial sheath. Six extraocular muscles, four recti, and the superior and inferior oblique muscles attach the globe to the Annulus of Zinn and are critical to movement of the eye. The orbit also contains adipose tissue that mechanically cushions and insulates the eye, together with the efferent and afferent blood vessels, sensory-motor nerves, the lacrimal gland, and an additional muscle involved in the movement of the eyelid (the levator palpebrae superioris). The eyeball itself is composed of three coats: fibrous, vascular pigmented, and neural (see Fig. 114.1). The outermost coat is comprised of dense, collagen fibrous forming the sclera, which is continuous anteriorly with the transparent cornea. The sclera is pierced posteriorly by the optic nerve at the lamina cribrosa, where it fuses with its dural sheath. The ocular surface consists of an ocular mucosa derived from the conjunctiva that lines the posterior aspects of the eyelids and is continuous with the skin at the mucocutaneous junction and the corneal epithelium at the limbus that houses the limbal corneal epithelial stem cells. The vascular pigmented layer is composed of a highly vascular choroid that is continuous anteriorly with the ciliary body and the iris, a thin contractile tissue with radial dilator, and circumferential contractile muscles that alter the pupil size. Suspended from the ciliary body is the crystalline lens. The inner most layer is the retina comprised of an outer pigmented epithelial layer (retinal pigment epithelium (RPE)) in contact with the choroid and an inner highly sensitive neuro-sensory layer. Three clear biofluids are essential for the function of the eye: the tear film lubricating the ocular mucosa, the aqueous humor in the anterior segment of the eye, and vitreous humor filling the posterior segment of the eye.

    Figure 114.1. Eye structure.

    The human eye is a highly specialized sensory organ, which is part of the anterior brain. It comprises an outer collagen coat (sclera and cornea), an intermediate uveal tract (iris, ciliary body, and choroid), and an inner retinal layer (neurosensory retina and retinal pigmented epithelium). The lens is suspended via ligaments attached to the ciliary body. Anterior to the lens are the anterior and posterior chambers, which are filled with aqueous humor produced by the ciliary processes. The vitreous is located behind the lens in the posterior segment of the eye. The macular area with the fovea is a critical area in the retina responsible for central vision. Retinal ganglion cells synapsing with the photoreceptors (rods and cones) are the predominant source of retinal nerve fibers that converge to form the optic nerve that connects the eye to the brain.

    The ocular environment has evolved to limit inflammation to maintain optical clarity through mechanisms delivered by a highly specialized and rapidly self-renewing ocular surface mucosal barrier composed of the conjunctiva, corneoscleral limbus, and cornea, together with the intraocular blood-aqueous and blood-retinal barriers contributing to an immune-privileged status of the eye. Tissues are constantly undergoing repair in response to environmental stress that ranges from minor injuries that rapidly repair to destructive trauma that signal inflammatory, immune, and fibrotic cascades. One emerging factor, in consideration of these signaling pathways, is vitamin D. In this chapter, we will review vitamin D bioprocessing in the context of major, often sight threatening or debilitating ocular diseases: infection, dry eye disease, cataract, glaucoma, uveitis, age-related macular degeneration, and diabetic retinopathy.

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    Annulus of Zinn

    From Wikipedia, the free encyclopedia

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    Annulus of Zinn
    Eyemuscles.png

    Rectus muscles:
    2 = superior , 3 = inferior , 4 = medial , 5 = lateral
    Oblique muscles: 6 = superior , 8 = inferior
    Other muscle: 9 = levator palpebrae superioris
    Other structures: 1 = Annulus of Zinn, 7 = Trochlea , 10 = Superior tarsus , 11 = Sclera , 12 = Optic nerve
    Eye orbit anterior.jpg

    Anterior view
    Details
    Identifiers
    Latin Anulus tendineus communis
    TA A15.2.07.015
    FMA 49071
    Anatomical terminology

    [ edit on Wikidata ]

    The annulus of Zinn, also known as the annular tendon or common tendinous ring, is a ring of fibrous tissue surrounding the optic nerve at its entrance at the apex of the orbit . It is the common origin of the four rectus muscles ( extraocular muscles ).

    It can be used to divide the regions of the superior orbital fissure . [1]

    The arteries surrounding the optic nerve are sometimes called the “circle of Zinn-Haller” (“CZH”). [2] This vascular structure is also sometimes called “circle of Zinn”.

    The following structures pass through the tendinous ring (superior to inferior):

    • Superior division of the oculomotor nerve (CNIII)
    • Nasociliary nerve (branch of ophthalmic nerve )
    • Inferior division of the oculomotor nerve (CNIII)
    • Abducens nerve (CNVI)
    • Optic nerve

    Parts[ edit ]

    Some sources distinguish between these terms more precisely, with the anulus tendineus communis being the parent structure, divided into two parts: [3]

    • a lower, the ligament or tendon of Zinn, which gives origin to the Rectus inferior , part of the Rectus internus, and the lower head of origin of the Rectus lateralis .
    • an upper, which gives origin to the Rectus superior , the rest of the Rectus medialis , and the upper head of the Rectus lateralis . This upper band is sometimes termed the superior tendon of Lockwood.

    Eponym[ edit ]

    It is named for Johann Gottfried Zinn . [4] [5] It should not be confused with the Zonule of Zinn , though it is named after the same person.

    References[ edit ]

    1. ^ Shi X, Han H, Zhao J, Zhou C (2007). “Microsurgical anatomy of the superior orbital fissure”. Clin Anat. 20 (4): 362–6. doi : 10.1002/ca.20391 . PMID   17080461 .

    2. ^ Ko MK, Kim DS, Ahn YK (1999). “Morphological variations of the peripapillary circle of Zinn-Haller by flat section” . Br J Ophthalmol. 83 (7): 862–6. doi : 10.1136/bjo.83.7.862 . PMC   1723100 . PMID   10381675 .
    3. ^ “eMedicine – Orbit Anatomy : Article by Guy J Petruzzelli” . Archived from the original on 24 March 2008. Retrieved 2008-03-17.
    4. ^ synd/3938 at Who Named It?
    5. ^ J. G. Zinn. Descriptio anatomica oculi humani. Göttingen, B. Abrami Vandenhoeck, 1755.
    • v
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    Anatomy of the globe of the human eye
    Fibrous tunic (outer)
    Sclera
    • Episcleral layer
    • Schlemm’s canal
    • Trabecular meshwork
    Cornea
    • Limbus
    • layers
      • Epithelium
      • Bowman’s
      • Stroma
      • Dua’s layer
      • Descemet’s
      • Endothelium

    1:posterior segment 2:ora serrata 3:ciliary muscle 4:ciliary zonules 5:Schlemm's canal 6:pupil 7:anterior chamber 8:cornea 9:iris 10:lens cortex 11:lens nucleus 12:ciliary process 13:conjunctiva 14:inferior oblique muscule 15:inferior rectus muscule 16:medial rectus muscle 17:retinal arteries and veins 18:optic disc 19:dura mater 20:central retinal artery 21:central retinal vein 22:optic nerve 23:vorticose vein 24:bulbar sheath 25:macula 26:fovea 27:sclera 28:choroid 29:superior rectus muscle 30:retina

    About this image
    Uvea/vascular tunic (middle)
    Choroid
    • Capillary lamina of choroid
    • Bruch’s membrane
    • Sattler’s layer
    Ciliary body
    • Ciliary processes
    • Ciliary muscle
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    Iris
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    Layers
    • Inner limiting membrane
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    • Inner plexiform layer
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    • External limiting membrane
    • Layer of rods and cones
    • Retinal pigment epithelium
    Cells
    • Photoreceptor cells ( Cone cell , Rod cell ) → ( Horizontal cell ) → Bipolar cell → ( Amacrine cell ) → Retina ganglion cell ( Midget cell , Parasol cell , Bistratified cell , Giant retina ganglion cells , Photosensitive ganglion cell ) → Diencephalon: P cell , M cell , K cell , Muller glia
    Other
    • Macula
      • Perifoveal area
      • Parafoveal area
      • Fovea
        • Foveal avascular zone
        • Foveola
    • Optic disc
      • Optic cup
    • Ora serrata
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    • Anterior chamber
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        Common tendinous ring

        The common tendinous ring consists of fibrous tissue located at the apex of the orbit. It surrounds the optic canal and its contents (optic nerve and ophthalmic artery) as well as the medial end of the superior orbital fissure and its contents (superior and inferior divisions of the oculomotor nerve, nasociliary branch of the ophthalmic nerve and the abducens nerve). The ring blends with the dural sheath of the optic nerve, medially.

        Inferior rectus, part of medial rectus and the lower fibres of lateral rectus all attach to the upper part of the ring; while superior rectus, part of middle rectus and upper fibres of lateral rectus attach to the lower part of the ring. Some fibres of lateral rectus also originate from the greater wing of the sphenoid bone.