ANGLE OF ANTERIOR

CHAMBER
ANGLE OF ANTERIOR
CHAMBER

PRESENTER-
DR.VIDYA.R.E
1ST YEAR PG SCHOLAR
DEPARTMENT OF SHALAKYA TANTRA
SDMIAH,BENGALURU
CONTENTS
• Anterior chamber
• Angle of anterior chamber
• Aqueous outflow system
• Importance of angle of anterior chamber
• Diagnostic modalities
 ANGLE OF ANTERIOR
CHAMBER
Anterior chamber is an angular space

It is the space formed

o Anteriorly- posterior surface of cornea

o Posteriorly- lens within the pupillary aperture

o Anterior surface of iris and a part of ciliary body
 ANGLE OF ANTERIOR CHAMBER

 Anterior chamber is 3mm deep and it

contains 0.25 ml of aqueous humour

 AC is depth is shallower in the hypermetropic eye

than in myopic eye

 Also shallow in children and old people

 Chamber depth decreases by 0.01mm/year of life

 ANGLE OF ANTERIOR CHAMBER
 Chamber depth is slightly diminished during accommodation
partly by increased lens curvature and and partly but forward
translocation of lens

 Chamber deepens by 0.06mm for each diopter of myopia

 Structures of AC angle
 Schwalbe’s line

 Trabecular mesh work

 Scleral spur

 Anterior border of the ciliary body

(where its longitudinal fibers insert into the scleral spur)

 Iris root
 Development of AC angle
Neural crest:

 Descemet membrane 4th month

 Schlemm canal 4th month
 Trabecular mesh work 5th month
 Sclera

Mesoderm :

Iris & Sclera

DEVELOPMENT OF AAC
32ND WEEK- the angle is
closed by mesodermal tissue

36-37th WEEK- mesodermal

tissue dissolves

38th WEEK- the angle is

completely formed

Infants born by 38th week have

incomplete angle and high risk
of congenital Glaucoma
 Schwalbe’s line
Just anterior to the apical portion of the trabecular meshwork is a smooth
area called as S zone of width 50 to 150 µm

Anterior border of this zone marks transition from

1. Trabecular to cornea endothelium

2. Termination of the Descemet’s membrane
3. Insertion of trabecular meshwork into corneal stroma
 The posterior border is demarcated by a discontinuous elevation
called Schwalbe’s line, formed by the oblique insertion of uveal
trabeculae into limbal stroma

 Clusters of secretory cells, called Schwalbe’s line cells produce a

phospholipids material that facilitates aqueous humor flow through
the canalicular system
TRABECULAR MESHWORK
 Anterior to scleral spur and forms inner aspects of Schlemm’s canal

 Pigmentation acquired with age

 SCLERAL SPUR
 Wedge shaped circular ridge

 Pale, translucent narrow strip of scleral tissue

 Lies posterior to trabecular meshwork

 Gives attachment to anteriorly to corneoscleral meshwork and

posteriorly to ciliary muscle
 CILIARY BAND
 It marks posterior most part of the angle

 Represents the anterior face of the ciliary body between its attachment
to the scleral spur and insertion of iris

 Width depends on the level of iris insertion

 Wide in myopes and narrow in hypermetropes

 It appears as a grey/dark brown band

 OUTFLOW OF APPARATUS
 Internal scleral sulcus

Trabecular meshwork

Schlemm’s canal

Collector channels

Episcleral veins
 OUTFLOW OF APPARATUS
 Internal scleral sulcus • Sulcus
• Schwalbe’s ring
• Scleral spur
Trabecular meshwork

Schlemm’s canal

Collector channels

Episcleral veins
 Internal scleral sulcus

 Limbus is the transition zone between the cornea and sclera

On the inner surface of the limbus there is an indentation or groove,

which is known as SCLERAL SULCUS
 SCLERAL SULCUS

This scleral sulcus has a sharp posterior margin the scleral spur & a sloping
anterior wall which extends to the peripheral cornea

Bounded anteriorly by Schwalbe’s canal and corneoscleral meshwork

The portin of the spur which forms the post. boundary of the sulcus is
sometimes called scleral roll
 SCHWALBE’S RING
 Is the anterior border ring of the trabecular region

Contains circularly arranged collagen fibers intermixed with elastic

fibers

With age there are also patches of long spacing or curly collagen

This ring makes the transition between the corneal endothelium and the
trabecular cells and the termination of Descemet’s membrane
 SCLERAL SPUR
 Scleral spur is composed of a group of fibers known as scleral roll

Scleral roll is composed of 75-80% collagen + 5% elastic tissue

This circular structure prevents ciliary muscle from causing Schlemm’s

canal to collapse

Attachment:

Anteriorly – trabecular meshwork

Posteriorly-sclera and longitudinal fibers of ciliary muscle
 TRABECULAR MESHWORK

Trabecular meshwork is a spongy , sieve like tissue

It is roughly a triangular

Anteriorly by periphery of the cornea and posteriorly scleral spur and

anterior surface of ciliary body

Trabecular meshwork is pale tan to dark brown in color, varying with

pigmentation of the tissue, which is darker posteriorly
It is divided into three portions

 Uveal meshwork

 Corneoscleral meshwork

 Juxtacanalicular tissue
 UVEAL MESHWORK

 Innermost portion is adjacent to the aqueous humor in the anterior

chamber

 It is arranged in cord or rope like trabeculae that that extends from the
iris root to the Schwalbe’s line

 The arrangement of the trabecular bands creates irregular openings

that vary in size from 25 to 75µm
 CORNEOSCLERAL MESHWORK

this portion extends from

scleral spur to the anterior wall
of the scleral sulcus

It consists of 8-14 sheets of

trabeculae that are
interconnected via cytoplasmic
processes
 .
 They are perforated by elliptical openings
which become progressively smaller as the
trabecular sheets approach Schlemm’s
canal

 These perforations are not aligned and

have a diameter ranging from 5 to 50µm
 ULTRASTRUCTURE OF MESHWORK
Both the uveal and corneoscleral trabecular meshwork bands or
sheets are composed of 4 concentric layers

1. An inner connective tissue core is composed of collagen fibres

with 64 nm periodicity. The central core contains collagen
types 1 and 3 and elastin

2. Elastin fibers are arranged in a spirally pattern with

periodicity of 100nm

3. Cortical zone also called as glassy membrane

4. An outer endothelial layer provides a continuous covering

over the trabeculae
 TRABECULAR ENDOTHELIAL CELLS

 Larger , more irregular and have less prominent than corneal

endothelium

 Joined by gap junction and desmosomes ,which provide stability

 2types of microfilaments:
active and intermediate filament
 JUXTACANALICULAR TISSUE

 The outermost portion of the

meshwork adjacent to
Schlemms canal

 This structure has three layers

of connective tissuelined on
either side by endothelium

 The inner trabecular

endothelium layer is continuous
with the endothelium of the
corneoscleral meshwork
 JUXTACANALICULAR TISSUE

 The central connective tissue layer has variable

thickness and is unfenestrated with several layers of
parallel, spindle shaped cells loosely arranged in a
connective tissue ground substance

 The outermost portion of the trabecular meshwork is

the inner wall endothelium of Schlemm’s canal

 Endothelial layer has significant morphologic

characteristics which distinguish it from the rest of
the endothelium in both the trabecular meshwork
and in Schlemm’s canal
 SCHLEMM’S CANAL
This 360 degree endothelial channel

It is a single channel but occasionally branches into a plexus like system
 SCHLEMM’S CANAL
 The endothelium of the outer wall is a
single cell layer that is continuous with the
inner wall endothelium but has a smoother
surface with larger less numerous cells
and no pores

 The outer wall also differs in having

numerous , large outlet channels

 Lip like thickening are present around the

openings of the outlet channels and septa
are noted to extend from these openings to
the inner wall of the Schlemm’s canal
which keep the canal open
 COLLECTER CHANNELS
Schlemm’s canal is connected to episcleral and conjunctival veins by
complex system of intrascleral channels

Two systems of intrascleral channels has been identified

a. An indirect system of numerous , finer channels which forms an

intrascleral plexux

b. A direct system of large caliber vessels which run a short intrascleral

course and drain into the episcleral venous system
 EPISCLERAL AND CONJUNCTIVAL CHANNELS
The aqueous vessels join the episcleral and conjunctival venous systems
by several routes

Most aqueous vessels are directed posteriorly with most of these

draining into episcleral veins whereas a few cross the subconjunctival
tissue and drain into conjunctival veins

Episcleral veins drain into the cavernous sinus via the anterior ciliary
and superior ophthalmic veins

While the conjunctival veins drain into superior ophthalmic or facial

veins via palpebral and angular veins
 EPISCLERAL AND CONJUNCTIVAL CHANNELS
The aqueous vessels join the episcleral and conjunctival venous systems
by several routes

Most aqueous vessels are directed posteriorly with most of these

draining into episcleral veins whereas a few cross the subconjunctival
tissue and drain into conjunctival veins

Episcleral veins drain into the cavernous sinus via the anterior ciliary
and superior ophthalmic veins

While the conjunctival veins drain into superior ophthalmic or facial

veins via palpebral and angular veins