Anatomy of Anterior Chamber
Angle
(DNB Teaching Programe)
Dr ADITI SINGH
(MBBS, M.S, FGRGUHS , FAICO)
DNB exam questions(2009-16)
1. Describe anatomy of angle of anterior chamber of eye.
2. Discuss the grading and various methods of gonioscopy.
3. Physiologyof aqueous humor production.
4. Discuss formationand drainage of Aqueous humour.
5. Describe components of blood ocular barrierand its clinical
importance.
Q: Anatomy of anterior chamber angle
• In brief : anterior chamber.
• Gonioscopic anatomy of AC Angle.
• Describe each structure
• Gonioscopy grading (if required)
• Diagram
Anterior Chamber
Angular Structure
Iris
3mm0.25 ml
0.11μl/yr
0.01mm
Hypermetropes
Elderly
Veryyoungchildren
Angle of the anterior chamber
CBB
Trabecular meshwork
Scleral Spur
Schwalbe’sLine
Fine ridge : infront of trabecular
meshwork.
Termination of Descment’s
membrane.
Glistening white structure on
gonioscopy.
Schwalbe’s Line
50 -150 μm
Variable hypertrophied
Delicate glistening ridge
into the anterior chamber
Pigmented line on/infront
eg: pseudoexfoliation
syndrome,
pigment dispersion
Applied Anatomy
Posterior embryotoxon Sampolesi’s Line
Trabecular Meshwork
• Just anterior to the scleral spur.
• No pigments at birth .
• Colour : faint tan to dark brown
• Sieve like stucture
• Made of : connective tissue , lined by
trabeculocytes.
• Contractile and phagocytic properties
Blood in Schlemm’s canal
Applied anatomyApplied Anatomy
Main function is drainage of aqueous humour.
Scleral spur
•Wedge shaped circular ridge.
•Prominent white line on gonioscopy.
•Anterior to ciliary body and posterior
to trabecular meshwork.
•Contraction of ciliary muscles pull the
spur posteriorly
•Scleral spur prevents ciliary muscle from
causing Schlemm’s canal to collapse
Applied Anatomy
•Only constant landmark in UBM.
•Location : trabecular meshwork meets
the interface line between the sclera
and ciliary body
Ciliary Body Band
•Posterior most part of the angle.
•Represents the anterior face of ciliary
body between its attachment to the
scleral spur and insertion of iris.
• Width depends on the level of iris
insertion.
•Dark brown band
INNERVATION:
• Derives from the supraciliary nerve plexus and the ciliary
plexus in the region of scleral spur.
• Both sympathetic adrenergic and parasympathetic and
sensory innervation .
• Nerve endings contain mechanoreceptors which are
located in scleral spur :
 act as proprioceptive tendon organs for the ciliary muscle,
 contraction myofibroblast scleral spur cells,
 baroreceptor function in response to change in IOP
Applied Anatomy
Angle recession
THANK YOU

Anatomy of the anterior chamber and angle

  • 1.
    Anatomy of AnteriorChamber Angle (DNB Teaching Programe) Dr ADITI SINGH (MBBS, M.S, FGRGUHS , FAICO)
  • 2.
    DNB exam questions(2009-16) 1.Describe anatomy of angle of anterior chamber of eye. 2. Discuss the grading and various methods of gonioscopy. 3. Physiologyof aqueous humor production. 4. Discuss formationand drainage of Aqueous humour. 5. Describe components of blood ocular barrierand its clinical importance.
  • 3.
    Q: Anatomy ofanterior chamber angle • In brief : anterior chamber. • Gonioscopic anatomy of AC Angle. • Describe each structure • Gonioscopy grading (if required) • Diagram
  • 4.
  • 5.
  • 6.
    Angle of theanterior chamber CBB Trabecular meshwork Scleral Spur Schwalbe’sLine
  • 7.
    Fine ridge :infront of trabecular meshwork. Termination of Descment’s membrane. Glistening white structure on gonioscopy. Schwalbe’s Line
  • 8.
  • 9.
    Variable hypertrophied Delicate glisteningridge into the anterior chamber Pigmented line on/infront eg: pseudoexfoliation syndrome, pigment dispersion Applied Anatomy Posterior embryotoxon Sampolesi’s Line
  • 10.
    Trabecular Meshwork • Justanterior to the scleral spur. • No pigments at birth . • Colour : faint tan to dark brown • Sieve like stucture • Made of : connective tissue , lined by trabeculocytes. • Contractile and phagocytic properties
  • 12.
  • 13.
    Applied anatomyApplied Anatomy Mainfunction is drainage of aqueous humour.
  • 14.
    Scleral spur •Wedge shapedcircular ridge. •Prominent white line on gonioscopy. •Anterior to ciliary body and posterior to trabecular meshwork. •Contraction of ciliary muscles pull the spur posteriorly •Scleral spur prevents ciliary muscle from causing Schlemm’s canal to collapse
  • 15.
    Applied Anatomy •Only constantlandmark in UBM. •Location : trabecular meshwork meets the interface line between the sclera and ciliary body
  • 16.
    Ciliary Body Band •Posteriormost part of the angle. •Represents the anterior face of ciliary body between its attachment to the scleral spur and insertion of iris. • Width depends on the level of iris insertion. •Dark brown band
  • 17.
    INNERVATION: • Derives fromthe supraciliary nerve plexus and the ciliary plexus in the region of scleral spur. • Both sympathetic adrenergic and parasympathetic and sensory innervation .
  • 18.
    • Nerve endingscontain mechanoreceptors which are located in scleral spur :  act as proprioceptive tendon organs for the ciliary muscle,  contraction myofibroblast scleral spur cells,  baroreceptor function in response to change in IOP
  • 19.
  • 20.