PHYSIOLOGY OF CORNEA

PRAJWAL
3RD BSC OPTOMETRY
NJC UDUPI
FUNCTION OF CORNEA
There are two primary physiological functions of cornea:
To act as a powerful refracting lens.
1. To protect intraocular contents.
2. The cornea also plays an important role in,
• Absorption of topically applied drugs.
•wound repair after anterior segment surgery or trauma.
Cornea performs these functions by maintaining its transparency and replacement
of its tissues.
 Biochemical and physiological processes concerned with functioning of
cornea are,

• Biochemical composition of cornea

• Metabolism of cornea
• Corneal transparency
• Drug permeability through the cornea
• Corneal wound healing
BIOCHEMICAL COMPOSITION OF CORNEA

• Under normal conditions, biochemically cornea consists of approximately 80%

water and 20% solid
Epithelium
•Water 70%, lipids 5% and contain glycogen, glutathione, ascorbic acid,
acetylcholine and cholinesterase.
Stroma
•Main bulk of cornea
• 70-80% water, 20% solid
•solids include extracellular collagen, mucopolysaccharides and salts.
Pre-descemet’s membrane and Descemet’s membrane
• Made up of collagen and glycoprotein
• GAG’s are absent
• Descemet’s collagen is insoluble and resistant to chemical and enzymatic
action.
Endothelium
Histochemical examination of endothelium, presence of enzymes for glycolysis
and Krebs’s cycle.
METABOLISM OF CORNEA
• Metabolism for maintenance of transparency and dehydration
• Energy generated by glucose breakdown
• Major nutrients for metabolism: oxygen, glucose and amino acid
• Oxygen derived from tear film and aqueous humour
• Glucose, amino acid and vitamins enter from aqueous through endothelium
• Glycolysis – 2 ATP molecules, Krebs cycle 36 ATP molecules produced
• Glucose metabolised through HMP shunt for NADPH production
CORNEAL TRANSPARENCY
Normal corneal transparency is due to anatomical and physical factors
Anatomical
Uniform and regular arrangements of Corneal epithelium
• Maurice theory: fibrils regularly arranged in lattice, lesser diameter and
septation less than wavelength of light
•Goldman theory: fibrils are smaller in relation to light , don’t interfere with light
transmission
•Corneal Vascularization
Physical
• Relative state of Corneal dehydration
CORNEAL HYDRATION

Normal cornea maintain itself in a state of relative dehydration

Corneal hydration is maintained by
1. Barrier function of epithelium and endothelium
2. Stromal swelling pressure
3. Hydration control by active pump mechanism
4. Evaporation of water from Corneal surface
5. Intraocular pressure
DRUG PERMEABILITY ACROSS THE CORNEA

Topically instilled medication largely penetrate intraocularly through the cornea

Factors which affects the Drug permeability through cornea are
1. Lipid and water solubility of drug
2. Molecular size, weight and concentration of the drug
3. Ionic form of the drug
4. pH of the solution
5. Tonicity of the solution
6. Surface active agents
7. Pro drug form
EFFECT OF CONTACT LENS WEAR ON CORNEAL
PHYSIOLOGY
Contact lens reduce direct availability of oxygen to epithelium
Hard contact lens
•Made from PMMA and have greatest effect on Corneal function
• It effects the Corneal transparency induced by disturbed metabolism
Soft contact lens
• Made from polymer of HEMA, silicon, other similar material
• Prolonged use affects the function of the endothelium.
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