1. Sclera and Cornea cornea Sclera

2. Sclera It forms the posterior portion of the globe It forms the posterior portion of the globe It is perforated posteriorly by the optic nerve. It is perforated posteriorly by the optic nerve.

3. Parts of sclera Episclera -fibrous tissue containing fine capillaries Episclera -fibrous tissue containing fine capillaries Sclera proper-collagen fibres of the stroma Sclera proper-collagen fibres of the stroma Lamina fusca-located adjacent of the stroma Lamina fusca-located adjacent of the stroma

4. Blood and nerve supply Choroidal vessels is supplying blood to Episcleral part Anterior insertion of Recti muscles, the anterior ciliary arteries form a dense episcleral plexes. These vessels becomes congestion of ciliary congestion. Nerve supply Short ciliary nerves posteriorly, Long ciliary nerves anteriorly provide sensory innervation.

5.   Inflammation of episclera Simple Simple Nodular Nodular Diffuse Diffuse Necrotizing with inflammation Necrotizing with inflammation without inflammation without inflammation Types of scleritis Types of scleritis Anterior scleritis Anterior scleritis Posterior scleritis Posterior scleritis

6. Cornea It is transparent part of the eye with circular wrist watch shape It is transparent part of the eye with circular wrist watch shape It is 10-11mm diameter It is 10-11mm diameter It is the most important refractive state of the eye It is the most important refractive state of the eye The junction of cornea and sclera is called limbus and also important angle structure of the eye. The junction of cornea and sclera is called limbus and also important angle structure of the eye.

7. Part of cornea It has 5 layers in the anatomic structure It has 5 layers in the anatomic structure Epithelium- Epithelium-corneal epithelium rests on a basement of membrane secreted by the basal cells. Bowman’s membrane - Bowman’s membrane - condensation of substania propria. Stroma - collagen fibrils arranged inset of lamellae, lying parallel to the surface. Decemet’s membrane -homogenous, very resistant membrane Endothelium -single layer of flattened polygonal endothelial cells

8. Blood supply and nerve supply Blood supply :Cornea is avascular structure. Blood supply :Cornea is avascular structure. Nerve Supply :The cornea nerve, are derived from the long and short ciliary nerves of the ophthalmic division of trigeminal nerve. Nerve Supply :The cornea nerve, are derived from the long and short ciliary nerves of the ophthalmic division of trigeminal nerve.

9. Types of ulcers Bacterial ulcer Bacterial ulcer Fungal ulcer Fungal ulcer Viral ulcer Viral ulcer Parasitic ulcer Parasitic ulcer Degenerative condition Degenerative condition Corneal dystrophies Corneal dystrophies

10. Bacterial ulcer It is defined as a break in the corneal epithelium with added infection It is defined as a break in the corneal epithelium with added infection

11. Investigations Lacrimal sac syringing Lacrimal sac syringing Diabetic status Diabetic status Corneal scrapping Corneal scrapping Gram and Giemsa stains for bacteria Gram and Giemsa stains for bacteria Culture on blood agar for aerobic organisms Culture on blood agar for aerobic organisms 10% KOH wet preparation for fungus 10% KOH wet preparation for fungus Culture on Sabouraud’s dextrose agar for fungus Culture on Sabouraud’s dextrose agar for fungus

12. Viral Ulcer with a branched appearance caused by herpies simplex virus. Ulcer with a branched appearance caused by herpies simplex virus.

13. Investigations Sensation of cornea Sensation of cornea Fluorescent stain Fluorescent stain Enlarged and tender pre auricular lymph nodes Enlarged and tender pre auricular lymph nodes

14. Keratoconus Bilateral conical protrusion of central part of the cornea due to thinning is called Keratoconus Bilateral conical protrusion of central part of the cornea due to thinning is called Keratoconus In this condition we have to check keratometry to know the astigmatism In this condition we have to check keratometry to know the astigmatism

15. Corneal dystrophies Cornea loses its clarity due to deposition of materials in various layers of the cornea it can be seen by Childhood Cornea loses its clarity due to deposition of materials in various layers of the cornea it can be seen by Childhood

16. Types of dystrophies Epithelial dystrophy-Map dot finger print Epithelial dystrophy-Map dot finger print Stromal dystrophy-Granular or macular or lattice Stromal dystrophy-Granular or macular or lattice Endothelial dystrophy-Fuch’s Endothelial dystrophy-Fuch’s

17. Don’ts in a case of corneal ulcer No Bandage No Bandage No steroid drop ( except viral) No steroid drop ( except viral) No schiotz tonometer No schiotz tonometer