Basic sciences for ophthalmology by Louise A Bye; Neil C Modi; Miles Stanford

By Louise A Bye; Neil C Modi; Miles Stanford

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Mesencephalic nucleus—a collection of nerve cells in the lateral grey matter around the cerebral aqueduct motor nucleus—medial to the main sensory nucleus. Sensations of pain, temperature, touch, and pressure are communicated along axons with cell bodies in the trigeminal ganglion. This lies on the apex of the petrous part of the temporal bone. The preganglionic cells enter the pons as ascending or C LINI CAL TI P Only the sixth nerve runs within the cavernous sinus and it becomes one of the first cranial nerves to be affected in cavernous sinus thrombosis.

Each lobule is separated by connective tissue. Acini are small round masses of columnar epithelial secretory cells with a central lumen. In order to produce the relatively large quantities of aqueous tears, each acinus is rich in rough endoplasmic reticulum, Golgi apparatus, and mitochondria. Lacrimal acini drain into lobular ducts that coalesce and then go on to drain into interlobular ducts. These ducts comprise a columnar or cuboidal epithelial lining with myoepithelial cells in the periphery.

On blinking, the deep heads of the pretarsal muscles pull the lids medially, shortening the canaliculi. At the same time, the lacrimal fascia and sac wall are pulled laterally by the contraction of the deep heads of the preseptal muscle. As a result, the punctae close and the tears in the canaliculi are pulled medially and sucked into the sac. After the blink, the lacrimal fascia and sac move medially again and the lids move laterally. The puncta reopen and the canaliculi refill with tears. In this way, there is a lacrimal ‘pump’ that drains tears from the ocular surface to the lacrimal sac.

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Basic sciences for ophthalmology by Louise A Bye; Neil C Modi; Miles Stanford
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