AC to Lens
Angle
- Schwalbe’s line
- Termination of DM and anterior border of trabecular meshwork
- Can be seen at corneal wedge
- Corresponds with the anatomical limbus
- Trabecular meshwork
- Non-pigmented portion (anterior)
- Pigmented portion (posterior): this part overlies Schlemm’s canal
- Corresponds with the corneoscleral limbus on the globe surface
Clinical Correlate
The anterior trabecular meshwork is where treatment is applied during laser trabeculoplasty
- Scleral spur: appears as a white line anterior to the ciliary body.
- A fibrous protrusion of the sclera
- The longitudinal ciliary muscle (see below) inserts on the posterior scleral spur
- Ciliary body
- Visible as a concavity anterior to the iris root
- Comprises ciliary muscle and epithelium
- Iris
Trabecular meshwork
- Uveal meshwork innermost: first layer for aqueous to cross
- Large intercellular spaces (70 microns)
- Low resistance to flow
- Corneoscleral meshwork middlemost
- Lamellar in structure
- Connective tissue covered by endothelium
- 35 microns (therefore medium resistance to flow)
- Cribiform (juxtacanalicular) meshwork outermost
Loose extracellular matrix of collagen (type I mostly), elastic fibres and proteoglycans and trabecular cells within and lining passageways (these have phagocytic abilities to collect debris)
- Highest resistance to aqueous outflow (7 microns)
Note: the TM comprises branching laminae with progressively decreasing pore size (hence resistance increases as you go deeper)
Schlemm’s canal
- Canal running in a continuous circle
- Lined by a single layer of non-fenestrated endothelium joined by tight junctions
Aqueous drains from the TM to Schlemm’s canal via transcellular giant vacuoles (ie. they are not directly connected)
- Vacuoles are pressure-sensitive
Drained by 25-30 collector channels that join the deep scleral plexus then the intrascleral plexus and 2-8 veins of Ascher
- Drain into intra/episcleral veins or directly into conjunctival veins
- Scleral spur sits posteriorly
Described as the conventional outflow pathway: 70-90% of outflow
Hot Topic
10-30% of aqueous drains via the so-called non-conventional route: through ciliary body muscle fibres into the suprachoroidal space and from there into sclera and venous system.