Specially helpful for exams....while answering a long question

1. Anatomy of Anterior Chamber
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 of anterior chamber angle
• In brief : anterior chamber.
• Gonioscopic anatomy of AC Angle.
• Describe each structure
• Gonioscopy grading (if required)
• Diagram

4. Anterior Chamber
Angular Structure
Iris

5. 3mm0.25 ml
0.11μl/yr
0.01mm
Hypermetropes
Elderly
Veryyoungchildren

6. Angle of the anterior 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. 50 -150 μm

9. 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

10. 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

12. Blood in Schlemm’s canal

13. Applied anatomyApplied Anatomy
Main function is drainage of aqueous humour.

14. 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

15. Applied Anatomy
•Only constant landmark in UBM.
•Location : trabecular meshwork meets
the interface line between the sclera
and ciliary body

16. 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

17. 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 .

18. • 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

19. Applied Anatomy
Angle recession

20. THANK YOU