Anatomy Of Sclera

Anatomy Of Sclera


SCLERA     

  • Commonly k/a “the white of the eye“.
  • Outer & fibrous coat of EYEBALL.
  • Opaque, posterior  5/6th segment of eyeball.
  • Thinnest portion of sclera→ Posterior to insertions of rectus muscle.
  • Thickest portion of sclera→ Posterior pole.
  • Sclero-corneal  Junction is c/d LIMBUS.
  • This limbus contains stem cells (limbal stem cells).
  •  Sclera is weakest at  – 
  1. Apex
  2. Limbus
  3. Anteriorly
  4. Behind rectus insertion or (at level of extraocular muscle).
  •  Lamina cribrosa is a sieve like perforation in the posterior part of sclera, which allows passage of axons of retinal ganglion cells and central retinal vessels.  It is the weakest part of sclera.
  • Absence of lamina cribrosa is feature of Morning glory syndrome.
  •  Bluish sclerae associated with –
  1. HALLERMANN-STREIFF SYNDROME
  2. EHLER DANLOS SYNDROME
  3. ROBERT’S SYNDROME
  4. MARFAN’S SYNDROME
  5. RUSSELL SILVER SYNDROME
  6. MARSHALL SMITH SYNDROME
  7. Van der HOEVE’S SYNDROME
  8. OSTEOGENESIS IMPERFECTA
  9. GLAUCOMA
  10. ALKAPTONURIA
  11. HYPOPHOSPHATASIA
  12. JUVENILE PAGET’S DISEASE
  13. NEWBORNS
  • Retrobulbar cellulitis is present late after trauma to eye.
  • Pneumo-orbit, Retrobulbar hematoma & carotico-cavernous fistula – all present early after trauma.
  • Rupture of sclera m/c seen in Superonasal quadrant.

SCLERA BUCKLING 

  • used for the treatment of Retinal detachment.
  • Retinal detachment surgery consists of three components : sealing retinal tears, reducing the vitreous traction on retina and flattening of retina.
  • It is important to find all retinal tears (holes) and seal them by laser, photocoagulation, diathermy or cryoapplication.
  • Scleral buckling or external plombage or encirclage is a procedure to push the wall of sclera inwards to close the tear, reduce the traction & flatten the retina.
Exam Question
 
  • Thinnest portion of sclera→ Posterior to insertions of rectus muscle.
  • Thickest portion of sclera→ Posterior pole
  • Retrobulbar cellulitis is the only option which can present late after trauma to eye.
  • Pneumo-orbit, Retrobulbar hematoma & carotico-cavernous fistula – all present early after trauma.
  • Rupture of sclera m/c seen in Superonasal quadrant.
  • Lamina cribrosa is the  weakest part of sclera.
  • Absence of lamina cribrosa is feature of Morning glory syndrome.
  • SCLERA BUCKLING used for the treatment of Retinal detachment.
  • Blue coloured sclera is frequently associated with Osteogenesis imperfecta.
  • Non necrotising anterior scleritis is the most common types of scleritis.
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