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PHYSIOLOGY OF CORNEA
Dr. Joseph John
CORNEA
Transparent anterior part of the eyeball
Smooth convex outer surface &
concave inner surface
Sclera overlaps cornea all around
periphery
Junction b/n two is limbus or sulcus
sclerae
Dimensions of cornea
surface shape
Horizont Vertical
al
diamete
diamete r
r
Radius
of
curvatur
e
ANTERIOR
elliptical
11-12mm
9-11mm
7.5-8.8mm
POSTERIOR
rounded
11.5mm
11.5mm
6.5-6.8mm
Index of refraction
Corneal
Weight
of a fresh cornea-180mg
Elasticity:
Strength:
anterior
central
Layers
15 microns thick
6th layer
Duas
layer
Harminder S. Dua, MD, PhD, from
the University of Nottingham in
the United Kingdom, and
colleagues discovered the layer
by examining the separation that
often occurs along the last row of
keratocytes during the big bubble
(BB) technique.
Epithelium
functions
1) to form a barrier between the
environment & stroma of the
corne[fluid loss,pathogen,abrasive
pressure]
2)light refraction & transmittance
[smooth ,wet apical surface
along with tear film & its
transparency-scarcity of cell
organelles & enzyme crystallins]
3)survival over an avascular bed
flattened cells
polygonal or wing cells
basal columnar cells
basement membrane
BOWMANS LAYER
DESCEMETS MEMBRANE
Posterior
limiting layer
Basal lamina of corneal endothelium
Strong resistant sheet , sharply defined
Plane of seperation from stroma is used in
lamellar keratoplasty
Thickens with age
Major protein is type 4 collagen
Descemets membrane can be reformed
after degeneration
ULTRASTRUCTURE-DESCEMETS
Corneal Endothelium
Single
It
shows
polymegathism[hetyerogeneity in cell
size]&polymorphism[heterogeneity in
cell shape with age& .as a result of
trauma,infection
Cells are closely interdigitated with
jn.complexes[zonulae
occludens&macula adherens]
Cell
Endothelial Barrier
basis
Endothelial pump
most
Mechanism:
Na+
Blood supply
Avascular
Small
Invaded
by new vessels in
infections& inflammations
Corneal Nutrition
oxygen
Closed
carbon
Glucose
Corneal Sources of
Oxygen
atmospheric
oxygen dissolved in
Corneal Innervation
most
immediate repair
Bowmans layer: none
Stroma: keratocyte activated to
produce ECM and collagen
Descemets Membrane:
resecreted by endothelial cells
Endothelium: cell migration over
defect
Foetal
embryology
Epithelium-surface
ectoderm
Stroma&bowmans
layer-mesenchymal
cells between surface
ectoderm&developing lens.
Endothelium&descemets
Transparency of cornea
Transparency
is the quality or
state of transmitting light
without appreciable scattering so
that bodies lying beyond are
entirely visible.
factors
1)PHYSICAL
avascularity of cornea
cellular factors
Relative dehydration
Epithelium
Endothelium
The
Endothelium
Tear film
It
It
acts as a lubricant
Fills
Abnormalities
transparency
Maurice theory[1957]
Collagen
Goldmann &benedek
theory[1967]
Lattice
arrangement not
required.
Fibrils wont affect transmission
of light unless they are >1/3rd of
wavelength
Refractive elements <2000A do
not scatter light.
Corneal avascularity
Chemical
theory
[meyer
&chafre]:sulfate ester of
hyaluronic acid acts as VIF
Campell&michaelson:release
of a
VSF,thought to be a vasoactive
amine at site of inflammation
MECHANICAL
[Cogan]-blood vessels
cant jnvade cornea due to its
compactness
COMBINED
[maurice
et al]Both
VSF&compactness of corneal
stroma
Hydration of cornea
Relative
IMBIBITION PRESSURE
2)factors preventing inflow of water
BARRIER ACTION
3)factors drawing water into cornea
ACTIVE PUMP
4)Evaporation of water from surface
WATER
COLLAGEN
TYPE 1
TYPE 3
TYPE 4
TYPE 6
-78 %
-15%
- 50-55%
- 1%
- 8-10 %
-25-30%
OTHER PROTEIN
- 5%
KERATAN SULPHATE - O.7
%
CHONDROITIN/DERMATANO.3%
HYALURONIC ACID
+
SALTS
1%
Thank you