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.

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