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BLOOD AND NERVE SUPPLY OF
EYE AND OPTIC NERVE

Presenter – Pushkar Dhir
Moderator – Dr .Samiksha Choudhary
INTERNAL CAROTID
CERVICAL

PETROUS

CAVERNOUS

•Caraticotympanic
•Pterygoid

CEREBRAL

•To Trigeminal Ganglion
•Sup.& Inf. Hypophyseal
•Meningeal

•Ant. & Middle
Cerebral
•Ant.& Post.
Communicating

•Ophthalmic

Lacrimal Artery
Central
Retinal
artery

Long & Short
Supra
Posterior ciliary
trochlear
Supra orbital arteries

Lacrimal &
Muscular Art
Ant.ciliary art.

1.
2.
3.
4.
5.

Ant. Ethmoidal
Post. Ethmoidal
Dorsal Nasal
External Nasal
Internal Nasal
Ophthalmic artery
 1st intracranial portion of the internal carotid
artery.

 It passes beneath the optic nerve and accompanies
it through the optic canal into the orbit.
 1st intraorbital branch is the central retinal artery,
which enters the optic nerve .
 Anterior branches of the ophthalmic artery forms
the arterial arcades of the eyelids.
 And further makes anastomosis with the external
carotid circulation via the facial artery.
Supratrochlear a. &
Supra-orbital
Ant. ethmoidal a.
Supra-orbital a
Post. ethmoidal a.
Muscular Branches.
(Ant.ciliary arteries
are derived from it)
Central Retinal Art.
Ophthalmic a.
(pierces the dural
sheath of optic
nerve at apex
& lie below &
then lateral to
optic nerve)

Lacrimal a.
(supply lacrimal
gland and upper
eyelid)

Post.Ciliary
(supply the
choroid and
parts of the
optic nerve)

Internal carotid a.
 LONG POSTERIOR CILIARY ARTERIES supply Ciliary body and anastomose with each other and with
the anterior ciliary arteries to form the major arterial circle of the iris.
 ANTERIOR CILIARY ARTERIES (7 in no.- (2 from each MR, SR, IR & 1 from LR) are derived from the
MUSCULAR BRANCHES to the rectus muscles. Pass anteriorly in episclera & supply the anterior
SCLERA, EPISCLERA, LIMBUS, AND CONJUNCTIVA

 Finally penetrate sclera near Limbus

Ciliary Muscle

Anastomose with Long Post.Ciliary
MAJOR ARTERIAL CIRCLE OF THE IRIS.
Supratrochlear a.
Supra-orbital a
Supratrochlear a. &
Supra-orbital
Ant. ethmoidal a.
Supra-orbital a
Post. ethmoidal a.
Lacrimal a.
Muscular Branches.
(Ant.ciliary arteries
are derived from it)

(supply lacrimal
gland and upper
eyelid)

Post.Ciliary

Central
Retinal Art.
Supplies retina &
optic nerve

(supply the choroid
and parts of the optic
nerve)

Ophthalmic a.

Internal carotid a.
ARTERIAL CIRCLE OF ZINN /HALLER
(in lamina cribrosa)

CRA Course
•Runs a wavy course , adherent to the dural sheath of optic nerve .
•10-15mm behind eye ball it pierces Dura & Arachnoid of optic nerve.
•In sub-arachnoid space it bends forwards & after a short course bend at approx right angle &
invaginates piamater to enter centre of the nerve.
• In Optic nerve --- it runs a straight course & pierce the lamina cribrosa to appear on o.disc.

•In Optic nerve head --- it lies superficially in nasal part of optic cup & divides into Sup. & inf. Tempoal & nasal branche
NFL
IpL
INL
RPE, R&C,ELM,ONL
B/S:- Choriocapillaries

Outer-plexiform layer
B/S:- CRA + partially by Choriocapillaries

INL,IPL,Ganglion cell layer,NFL,ILM
B/S:- CRA

Macula Region
B/S:- Superior & Inferior temporal branches
**In 20% population Cilioretinal Artery supplies macula.(in case of CRA occlusion it helps to retain vision)
**Retinal art. are END ARTERIES.
B/S OF OPTIC NERVE

INTRAOCULAR
PART
1.Surface NFL:Supplied by capillaries
from retinal arterioles.
2.Pre-laminar region:Supplied by vessels of
ciliary region i.e
peripapillary choroidal
vessels.
3.Lamina Cribrosa :Supplied by ciliary
vessels derived from
short Post Ciliary &
arterial circle of zinn.
4.Retrolaminar Region:Supplied by both
retinal & ciliary
circulation

INTRAORBITAL
PART
•Periaxial System
(derived 4m
Ophthalmic art, Long
& short ciliary art,
lacrimal art ,CRA
)supplies periaxial part
of optic nerve.

•Axial system derived
4m CRA, collateral
arteries , intraneural
branches supplies
axial part

INTRA
CANALICULAR
PART

Supplied by
periaxial system
of vessels formed
by ophthalmic &
collaterals
arteries.

INTRACRANIAL
PART
Supplied by
periaxial system
of vessels formed
by cerebral &
anterior
communicating
arteries.
Central
Retinal Art.

Intraocular + Intraorbital part

Intraorbital + intracanalicular part
Main B/S of
1.Optic Chiasma :- branches from Ant.cerebral & internal carotid.
2.Optic tract :-branches from Post.communicating art.,Ant.choroidal art. & MCA.
3.LGB:- Post.cerebral Artery -> supply postero-medial part of LGB &
therefore the Superior quadrents fibres.
Ant.choroidal artery -> supply antero-lateral part of LGB -> inferior quadrents fibres.
*Hilum region in LGB is supplied by both PCA and Ant.choroidal
4.Optic radiations :- Ant.choroidal art , Calcarine branches of PCA, branches of MCA.
5.Visual Cortex :- Post.cerebral artery via calcrine arteries + post.temporal & parieto-occipital arteries.
Venous Drainage

•

VENOUS DRAINAGE OF THE INNER RETINA
occurs via the central retinal vein  to the superior ophthalmic vein cavernous sinus 
internal jugular vein.

•

THE OUTER RETINA, CHORIOCAPILLARIS, AND CHOROID are drained through the vortex
veins join the central retinal vein  superior ophthalmic vein  cavernous sinus and
jugular vein circulation.

•

The vortex veins drain the choroidal circulation via superior and inferior ophthalmic veins.
Sup. Ophthalmic v.
Inf. Ophthalmic v.
Cavernous sinus

Facial v.

Retromandibular v.

Pterygoid plexus
NERVE SUPPLY
• Sensory N/S –

*Trigeminal nerve
(Mixed nerve) V
*Ophthalmic (V1) &
Maxillary(V2)
divison play main role of
eye sensation.

• Motor N/S --

*Cranial nerve 3rd ,4th,6th
for ocular movements.
*Cranial nerve 7th for
eyelid closure.

• Sympathetic N/s --* Nasociliary branch of
ophthalmic nerve
• Parasympathetic N/S:-- * Occulomotor (3rd).
TRIGEMINAL N.

OPHTHALMIC

MAXILLARY
(gives infraorbital nrv)

MANDIBULAR

NASOCILIARY N.
FRONTAL N.

LACRIMAL N.

•SUPRA-ORBITAL
•SUPRA-TROChLEAR

Supply
Forehead + Scalp
+ Conjunctiva +
upper & central
eyelid

•Ant.Ethmoidal –----- Supplies Ethmoidal Sinus ,
Internal & Ext.Nasal
•Post.Ethmoidal ------ Supplies Sphenoidal Sinus

Supplies to
lateral eyelid
+ lacrimal
gland +
conjunctiva

•Infratrochlear -------- Medial Eyelid
•Long Ciliary Nerves---Pierces Sclera & Supply
Cornea, Iris, Ciliary Body
•Sympathetic Fibres---Dilate Pupil
Abducens nrv.

Ophthalmic nrv.
•
•
•
•
•
•

The nerves of the orbit include those that enter through the superior orbital fissure and supply the
ocular muscles :
Oculomotor (CN III),
Trochlear (CN IV), and
Abducent (CN VI) nerves.
The trochlear and abducent nerves pass directly to the single muscle supplied by each nerve.
The oculomotor nerve divides into a
superior branch supplying superior rectus & LPS
inferior branch supplying the medial & inferior rectus and inferior oblique,
+ carry presynaptic parasympathetic fibers (miosis) to the ciliary ganglion.
B/S & N/S Of Various Structure of Eye
(Review)
Conjunctiva –
B/S:- Ant.Ciliary Artery.
N/S:Superiorly
Supraorbital nerve,
Supratrochlear nerve
Infratrochlear nerve
Inferior:-Infraorbital
nerve
Lateral:-Lacrimal nerve
Circumcorneal:-Long
ciliary nerves

IRIS B/S:- Ant .& Post. Ciliary
arteries
NS:Long ciliary nerves

Sclera:B/S:- Avascular
N/S:- long ciliary nerves anteriorly
& short ciliary nrv. Behind equator

Episclera :B/S:- long & short
ciliary arteries

Cornea –
B/S:- avascular
N/S:- long ciliary
nerves (nasociliary
nerves)
Thank You

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Blood supply n nerve supply of eye

  • 2.
  • 3. BLOOD AND NERVE SUPPLY OF EYE AND OPTIC NERVE Presenter – Pushkar Dhir Moderator – Dr .Samiksha Choudhary
  • 4. INTERNAL CAROTID CERVICAL PETROUS CAVERNOUS •Caraticotympanic •Pterygoid CEREBRAL •To Trigeminal Ganglion •Sup.& Inf. Hypophyseal •Meningeal •Ant. & Middle Cerebral •Ant.& Post. Communicating •Ophthalmic Lacrimal Artery Central Retinal artery Long & Short Supra Posterior ciliary trochlear Supra orbital arteries Lacrimal & Muscular Art Ant.ciliary art. 1. 2. 3. 4. 5. Ant. Ethmoidal Post. Ethmoidal Dorsal Nasal External Nasal Internal Nasal
  • 5. Ophthalmic artery  1st intracranial portion of the internal carotid artery.  It passes beneath the optic nerve and accompanies it through the optic canal into the orbit.  1st intraorbital branch is the central retinal artery, which enters the optic nerve .  Anterior branches of the ophthalmic artery forms the arterial arcades of the eyelids.  And further makes anastomosis with the external carotid circulation via the facial artery.
  • 6.
  • 7. Supratrochlear a. & Supra-orbital Ant. ethmoidal a. Supra-orbital a Post. ethmoidal a. Muscular Branches. (Ant.ciliary arteries are derived from it) Central Retinal Art. Ophthalmic a. (pierces the dural sheath of optic nerve at apex & lie below & then lateral to optic nerve) Lacrimal a. (supply lacrimal gland and upper eyelid) Post.Ciliary (supply the choroid and parts of the optic nerve) Internal carotid a.
  • 8.  LONG POSTERIOR CILIARY ARTERIES supply Ciliary body and anastomose with each other and with the anterior ciliary arteries to form the major arterial circle of the iris.  ANTERIOR CILIARY ARTERIES (7 in no.- (2 from each MR, SR, IR & 1 from LR) are derived from the MUSCULAR BRANCHES to the rectus muscles. Pass anteriorly in episclera & supply the anterior SCLERA, EPISCLERA, LIMBUS, AND CONJUNCTIVA  Finally penetrate sclera near Limbus Ciliary Muscle Anastomose with Long Post.Ciliary
  • 9. MAJOR ARTERIAL CIRCLE OF THE IRIS.
  • 11. Supratrochlear a. & Supra-orbital Ant. ethmoidal a. Supra-orbital a Post. ethmoidal a. Lacrimal a. Muscular Branches. (Ant.ciliary arteries are derived from it) (supply lacrimal gland and upper eyelid) Post.Ciliary Central Retinal Art. Supplies retina & optic nerve (supply the choroid and parts of the optic nerve) Ophthalmic a. Internal carotid a.
  • 12. ARTERIAL CIRCLE OF ZINN /HALLER (in lamina cribrosa) CRA Course •Runs a wavy course , adherent to the dural sheath of optic nerve . •10-15mm behind eye ball it pierces Dura & Arachnoid of optic nerve. •In sub-arachnoid space it bends forwards & after a short course bend at approx right angle & invaginates piamater to enter centre of the nerve. • In Optic nerve --- it runs a straight course & pierce the lamina cribrosa to appear on o.disc. •In Optic nerve head --- it lies superficially in nasal part of optic cup & divides into Sup. & inf. Tempoal & nasal branche
  • 14. RPE, R&C,ELM,ONL B/S:- Choriocapillaries Outer-plexiform layer B/S:- CRA + partially by Choriocapillaries INL,IPL,Ganglion cell layer,NFL,ILM B/S:- CRA Macula Region B/S:- Superior & Inferior temporal branches **In 20% population Cilioretinal Artery supplies macula.(in case of CRA occlusion it helps to retain vision) **Retinal art. are END ARTERIES.
  • 15. B/S OF OPTIC NERVE INTRAOCULAR PART 1.Surface NFL:Supplied by capillaries from retinal arterioles. 2.Pre-laminar region:Supplied by vessels of ciliary region i.e peripapillary choroidal vessels. 3.Lamina Cribrosa :Supplied by ciliary vessels derived from short Post Ciliary & arterial circle of zinn. 4.Retrolaminar Region:Supplied by both retinal & ciliary circulation INTRAORBITAL PART •Periaxial System (derived 4m Ophthalmic art, Long & short ciliary art, lacrimal art ,CRA )supplies periaxial part of optic nerve. •Axial system derived 4m CRA, collateral arteries , intraneural branches supplies axial part INTRA CANALICULAR PART Supplied by periaxial system of vessels formed by ophthalmic & collaterals arteries. INTRACRANIAL PART Supplied by periaxial system of vessels formed by cerebral & anterior communicating arteries.
  • 16. Central Retinal Art. Intraocular + Intraorbital part Intraorbital + intracanalicular part
  • 17. Main B/S of 1.Optic Chiasma :- branches from Ant.cerebral & internal carotid. 2.Optic tract :-branches from Post.communicating art.,Ant.choroidal art. & MCA. 3.LGB:- Post.cerebral Artery -> supply postero-medial part of LGB & therefore the Superior quadrents fibres. Ant.choroidal artery -> supply antero-lateral part of LGB -> inferior quadrents fibres. *Hilum region in LGB is supplied by both PCA and Ant.choroidal 4.Optic radiations :- Ant.choroidal art , Calcarine branches of PCA, branches of MCA. 5.Visual Cortex :- Post.cerebral artery via calcrine arteries + post.temporal & parieto-occipital arteries.
  • 18. Venous Drainage • VENOUS DRAINAGE OF THE INNER RETINA occurs via the central retinal vein  to the superior ophthalmic vein cavernous sinus  internal jugular vein. • THE OUTER RETINA, CHORIOCAPILLARIS, AND CHOROID are drained through the vortex veins join the central retinal vein  superior ophthalmic vein  cavernous sinus and jugular vein circulation. • The vortex veins drain the choroidal circulation via superior and inferior ophthalmic veins.
  • 19. Sup. Ophthalmic v. Inf. Ophthalmic v. Cavernous sinus Facial v. Retromandibular v. Pterygoid plexus
  • 20.
  • 21. NERVE SUPPLY • Sensory N/S – *Trigeminal nerve (Mixed nerve) V *Ophthalmic (V1) & Maxillary(V2) divison play main role of eye sensation. • Motor N/S -- *Cranial nerve 3rd ,4th,6th for ocular movements. *Cranial nerve 7th for eyelid closure. • Sympathetic N/s --* Nasociliary branch of ophthalmic nerve • Parasympathetic N/S:-- * Occulomotor (3rd).
  • 22. TRIGEMINAL N. OPHTHALMIC MAXILLARY (gives infraorbital nrv) MANDIBULAR NASOCILIARY N. FRONTAL N. LACRIMAL N. •SUPRA-ORBITAL •SUPRA-TROChLEAR Supply Forehead + Scalp + Conjunctiva + upper & central eyelid •Ant.Ethmoidal –----- Supplies Ethmoidal Sinus , Internal & Ext.Nasal •Post.Ethmoidal ------ Supplies Sphenoidal Sinus Supplies to lateral eyelid + lacrimal gland + conjunctiva •Infratrochlear -------- Medial Eyelid •Long Ciliary Nerves---Pierces Sclera & Supply Cornea, Iris, Ciliary Body •Sympathetic Fibres---Dilate Pupil
  • 24. • • • • • • The nerves of the orbit include those that enter through the superior orbital fissure and supply the ocular muscles : Oculomotor (CN III), Trochlear (CN IV), and Abducent (CN VI) nerves. The trochlear and abducent nerves pass directly to the single muscle supplied by each nerve. The oculomotor nerve divides into a superior branch supplying superior rectus & LPS inferior branch supplying the medial & inferior rectus and inferior oblique, + carry presynaptic parasympathetic fibers (miosis) to the ciliary ganglion.
  • 25. B/S & N/S Of Various Structure of Eye (Review) Conjunctiva – B/S:- Ant.Ciliary Artery. N/S:Superiorly Supraorbital nerve, Supratrochlear nerve Infratrochlear nerve Inferior:-Infraorbital nerve Lateral:-Lacrimal nerve Circumcorneal:-Long ciliary nerves IRIS B/S:- Ant .& Post. Ciliary arteries NS:Long ciliary nerves Sclera:B/S:- Avascular N/S:- long ciliary nerves anteriorly & short ciliary nrv. Behind equator Episclera :B/S:- long & short ciliary arteries Cornea – B/S:- avascular N/S:- long ciliary nerves (nasociliary nerves)