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Aqueous humour

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Fluid in the anterior segment of the eye
Aqueous humour
Schematic diagram of the human eye.
Details
Identifiers
Latinhumor aquosus
MeSHD001082
TA98A15.2.06.002
TA26791
FMA58819
Anatomical terminology[edit on Wikidata]

The aqueous humour is a transparent water-like fluid similar to blood plasma, but containing low protein concentrations. It is secreted from the ciliary body, a structure supporting the lens of the eyeball. It fills both the anterior and the posterior chambers of the eye, and is not to be confused with the vitreous humour, which is located in the space between the lens and the retina, also known as the posterior cavity or vitreous chamber. Blood cannot normally enter the eyeball.

Structure

Composition

Function

  • Maintains the intraocular pressure and inflates the globe of the eye. It is this hydrostatic pressure that keeps the eyeball in a roughly spherical shape and keeps the walls of the eyeball taut.
  • Provides nutrition (e.g. amino acids and glucose) for the avascular ocular tissues; posterior cornea, trabecular meshwork, lens, and anterior vitreous.
  • May serve to transport ascorbate in the anterior segment to act as an antioxidant agent.
  • Presence of immunoglobulins indicates a role in immune response to defend against pathogens.
  • Provides inflation for expansion of the cornea and thus increased protection against dust, wind, pollen grains, and some pathogens.
  • Contributes refraction, with a refractive index of 1.3335
  • Prevents eye dryness.

Production

Aqueous humour is secreted into the posterior chamber by the ciliary body, specifically the non-pigmented epithelium of the ciliary body (pars plicata). 5 alpha-dihydrocortisol, an enzyme inhibited by 5-alpha reductase inhibitors, may be involved in production of aqueous humour.

Drainage

Aqueous humor is continually produced by the ciliary processes and this rate of production must be balanced by an equal rate of aqueous humor drainage. Small variations in the production or outflow of aqueous humor will have a large influence on the intraocular pressure.

The drainage route for aqueous humor flow is first through the posterior chamber, then the narrow space between the anterior iris and the posterior lens (contributes to small resistance), through the pupil to enter the anterior chamber. From there, the aqueous humor exits the eye through the trabecular meshwork into Schlemm's canal (a channel at the limbus, i.e., the joining point of the cornea and sclera, which encircles the cornea). It flows through 25–30 collector canals into the episcleral veins. The greatest resistance to aqueous flow is provided by the trabecular meshwork (esp. the juxtacanalicular part), and this is where most of the aqueous outflow occurs. The internal wall of the canal is very delicate and allows the fluid to filter due to the high pressure of the fluid within the eye. The secondary route is the uveoscleral drainage, and is independent of the intraocular pressure, the aqueous flows through here, but to a lesser extent than through the trabecular meshwork (approx. 10% of the total drainage whereas by trabecular meshwork 90% of the total drainage).

The fluid is normally 15 mmHg (0.6 inHg) above atmospheric pressure, so when a syringe is injected the fluid flows easily. If the fluid is leaking, the hardness of the normal eye is compromised, leading to collapse and wilting of the cornea.

Clinical significance

Main article: Glaucoma

Glaucoma is a progressive optic neuropathy where retinal ganglion cells and their axons die causing a corresponding visual field defect. An important risk factor is increased intraocular pressure (pressure within the eye) either through increased production or decreased outflow of aqueous humour. Increased resistance to outflow of aqueous humour may occur due to an abnormal trabecular meshwork or due to obliteration of the meshwork resulting from injury or disease of the iris. However, increased interocular pressure is neither sufficient nor necessary for development of primary open angle glaucoma, although it is a major risk factor. Uncontrolled glaucoma typically leads to visual field loss and ultimately blindness.

Uveoscleral outflow of aqueous humour can be increased with prostaglandin agonists, while trabecular outflow is increased by M3 agonists. Fluid production can be decreased by beta blockers, alpha2-agonists, and carbonic anhydrase inhibitors.

Additional Images

  • Structures of the eye labeled Structures of the eye labeled
  • Another labeled view of the structures of the eye Another labeled view of the structures of the eye
  • Sectional Anatomy of the Eye in greater detail, showing Anterior and Posterior Chambers in Anterior Cavity, and Posterior Cavity; also Canal of Schlemm, Ciliary body, and Ora serrata Sectional Anatomy of the Eye in greater detail, showing Anterior and Posterior Chambers in Anterior Cavity, and Posterior Cavity; also Canal of Schlemm, Ciliary body, and Ora serrata

See also

References

  1. Human Physiology. An Integrate approach. 5th edition. Dee Unglaub Silverthorn
  2. "Eye Anatomy". WebMD. Retrieved 8 March 2016.
  3. Crump, Andy; Omura, Satoshi (2011). "Ivermectin, 'Wonder drug' from Japan: The human use perspective". Proceedings of the Japan Academy, Series B. 87 (2): 13–28. Bibcode:2011PJAB...87...13C. doi:10.2183/pjab.87.13. PMC 3043740. PMID 21321478.
  4. Veselovský J, Oláh Z, Veselá A, Gressnerová S (2001). "". Cesk Slov Oftalmol. 57 (5): 291–7. PMID 11764684.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. Palanker, Daniel. "Optical Properties of the Eye". American Academy of Ophthalmology. Retrieved 2023-11-20.
  6. Weinstein, B. I.; Kandalaft, N.; Ritch, R.; Camras, C. B.; Morris, D. J.; Latif, S. A.; Vecsei, P.; Vittek, J.; Gordon, G. G.; Southren, A. L. (1991). "5 alpha-dihydrocortisol in human aqueous humour and metabolism of cortisol by human lenses in vitro". Investigative Ophthalmology & Visual Science. 32 (7): 2130–35. PMID 2055703.
  7. ^ "eye, human" (see 'Cornea') Encyclopædia Britannica -from Encyclopædia Britannica 2006 Ultimate Reference Suite DVD 2009
  8. "Glaucoma Medications: Click for Facts About Side Effects". www.emedicinehealth.com. Retrieved 3 December 2019.
  9. Tao, Le (2017-11-13). First aid for the USMLE Step 2 CS. Bhushan, Vikas., Lee, Kachiu., Deol, Maniver. (Sixth ed.). New York. p. 505. ISBN 9781259862441. OCLC 1011506616.{{cite book}}: CS1 maint: location missing publisher (link)

External links

Anatomy of the globe of the human eye
Fibrous tunic
(outer)
Sclera
Cornea
1:posterior segment 2:ora serrata 3:ciliary muscle 4:ciliary zonules 5:Schlemm's canal 6:pupil 7:anterior chamber 8:cornea 9:iris 10:lens cortex 11:lens nucleus 12:ciliary process 13:conjunctiva 14:inferior oblique muscule 15:inferior rectus muscule 16:medial rectus muscle 17:retinal arteries and veins 18:optic disc 19:dura mater 20:central retinal artery 21:central retinal vein 22:optic nerve 23:vorticose vein 24:bulbar sheath 25:macula 26:fovea 27:sclera 28:choroid 29:superior rectus muscle 30:retina1: posterior segment2: ora serrata3: ciliary muscle4: ciliary zonules5: Schlemm's canal6: pupil7: anterior chamber8: cornea9: iris10: lens cortex11: lens nucleus12: ciliary process13: conjunctiva14: inferior oblique muscule15: inferior rectus muscule16: medial rectus muscle17: retinal arteries and veins18: optic disc19: dura mater20: central retinal artery21: central retinal vein22: optic nerve23: vorticose vein24: bulbar sheath25: macula26: fovea27: sclera28: choroid29: superior rectus muscle30: retina
1:posterior segment 2:ora serrata 3:ciliary muscle 4:ciliary zonules 5:Schlemm's canal 6:pupil 7:anterior chamber 8:cornea 9:iris 10:lens cortex 11:lens nucleus 12:ciliary process 13:conjunctiva 14:inferior oblique muscule 15:inferior rectus muscule 16:medial rectus muscle 17:retinal arteries and veins 18:optic disc 19:dura mater 20:central retinal artery 21:central retinal vein 22:optic nerve 23:vorticose vein 24:bulbar sheath 25:macula 26:fovea 27:sclera 28:choroid 29:superior rectus muscle 30:retina
Uvea / vascular
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Choroid
Ciliary body
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