SCLERA

ANATOMY

PRESENTED BY:
MARGARET MWANGI
HND/OPHT/21001/001
NAIROBI CAMPUS
17/12/2020
 OBJECTIVES

• At the end of this presentation we should be able to:-

• Describe the appearance, location and size of the sclera.
• Describe the embryology of the sclera.
• Describe histology, blood and nerve supply of sclera.
• State the functions of the sclera.
• Outline the clinical application of sclera.
 INTRODUCTION

➢ Sclera forms posterior 5/6 th opaque external

fibrous tunic of the eyeball.
➢ Outer surface is covered by Tenon's capsule.
➢ Anteriorly begins at the limbus.
➢ Posteriorly terminates at the optic nerve canal.
➢ Anterior surface is covered by bulbar conjunctiva.
➢ Inner surface lies in contact with choroid with
a potential suprachoroidal space in between.
 THICKNESS OF SCLERA

➢ Thickness varies with individuals and age.

➢ Thinner in children than adults.
➢ Thicker in males than females.
➢ Thickest posteriorly (1mm) and thins anteriorly.
➢ Thinnest at the insertion of extraocular muscles(0.3mm).
➢ Measures 0.83mm at the limbus.
 EMBRYOLOGY OF THE SCLERA

• Develops from neural crest mesenchyme.

• Starts to develop at the 5 th week gestation.
• Begins to develop at the limbus
and continues posteriorly up to the optic nerve.
• 3rd month developing choroid surrounds it.
• 4th month lamina cribrosa begins to form.
• 5th month sclera is well differentiated.
HISTOLOGY OF THE SCLERA
 MICROSCOPIC STRUCTURE

EPISCLERA

• It is a thin, dense vascularized layer of connective tissue.

• Forms outermost layer of the sclera.
• Covers sclera proper.
• Consist of bundles of collagen fibers
arranged circumferentially.
• Also contains fibroblasts, macrophages and lymphocytes.
• Thickest anteriorly at insertion of rectus muscle
and thins towards the posterior part.
 SCLERA PROPER

• Its the middle layer of the sclera.

• Its avascular and consist of dense bundles
of collagen fibers criss- crossing each other.
• That arrangement makes the sclera opaque.
• Also contains proteoglycans and glycoproteins.
• Few fibroblasts are also present.
• Deficiency in water binding substance accounts
for sclera dull white colour.
 LAMINA FUSICA

• It is the innermost layer of the sclera.

• Blends with the suprachoroidal and supraciliary
lamina of uveal tract.
• Presence of pigmented cells (melanocytes)
gives it the brownish colour.
SPECIAL REGIONS OF THE SCLERA

Scleral sulcus
• It is a furrow on the inner surface
of the limbus.
• Provides attachment for ciliary body.
Scleral spur
• It is a protrusion of the inner surface
of the sclera near the limbus.
• Prevents ciliary muscles from causing schlemms
canal to collapse.
Lamina cribrosa
• Thin sieve like sclera where fibers
of optic nerves pass.
Canal of schlemm
• Circular canal found at the posterior
part of the limbus. Drains aqueous humour
 SCLERAL APERTURES

Sclera pierced by 3 types of apertures:-

• Posterior aperture-situated around optic nerve.
- Transmit long and short ciliary vessels.
• Middle aperture-situated 4mm posterior to
the equator, four in number.
- Transmit four vortex veins.

• Anterior aperture-situated 4mm posterior to

the equator near insertion of recti muscles.
- Transmit anterior ciliary vessels.
 BLOOD SUPPLY & VENOUS DRAINAGE

• Episclera- anterior and posterior ciliary arteries.

Sclera proper - relatively avascular structure.
• Venous drainage by episcleral collecting veins
that drain into anterior ciliary veins.
 NERVE SUPPLY

-Sclera is rich in nerve supply.

-Anterior sclera-long posterior ciliary nerves.
-Posterior sclera-short posterior ciliary nerves.
 FUNCTIONS OF THE SCLERA

• Protects intraocular components from trauma, light

and mechanical displacement.
• Maintain the shape of the globe
along with the intraocular pressure of the eye.
• Provide attachment site for extraocular muscles.
 CLINICAL SIGNIFICANCE

• Scleral icterus-yellowing of the sclera

associated with liver disease.
• Blue sclera-diseases of the connective tissue
e.g. osteogenesis imperfecta and Marfans syndrome.
Iron deficiency-blue tint on sclera.
• Episcleritis-inflammation of episclera,sclera appears red.
• Scleritis- inflammation of sclera.
 REFERENCES

• http:/www.slideshare.net/sushmarsudhakar2/
anatomy-of-sclera-88620363.
• www.eophtha.com
• www.kenhub.com.
• Eyewiki.AAO.December 2015-scleritis
 SUMMARY

Sclera anatomy
➢ Forms posterior 5/6th of external fibrous
tunic of eyeball.
➢ Continues with dura matter and cornea.
➢ Whole surface covered by Tenon's capsule.
➢ Covered by bulbar conjunctiva anteriorly.
➢ Inner surface lies in contact with choroid with
a potential suprachoroidal space in between.
 SCLERA THICKNESS

➢ Varies with individuals and age.

➢ Thinner in children than adults.
➢ Thicker in males than females.
➢ Thickest posteriorly, thins anteriorly and at insertion
of extraocular muscles.
➢ Posteriorly 1mm,0.83mm at limbus,0.3mm
at insertion of extraocular muscles.
 Layers of the sclera
➢ Episclera
➢ Sclera proper
➢ Lamina tunica
Scleral apertures
➢ Posterior aperture
➢ Middle aperture
➢ Anterior aperture
 Blood and nerve supply/venous drainage

➢ Blood supply -Episclera by anterior and posterior

ciliary arteries. Sclera proper is relatively avascular.
➢ Venous drainage- Episcleral collecting veins
➢ Nerve supply-Anterior sclera by long posterior ciliary nerves.
-Posterior sclera by short posterior ciliary nerves.
➢ Functions-Protection of intraocular contents.
-Maintain shape of eyeball together with intraocular pressure.
-Site for extraocular muscles attachment.
THANK YOU