1. Visual apparatus Oculus et structurae pertinentes Morfology and embryology

2. Odilo Redon

3. Orbita  Shape of 4-sided pyramid falled backside  Bony margins  aditus x apex  10 openings  m. orbitalis Mülleri – smooth muscle in fissura orbitalis inferior  content: eye ball, muscles, adipose tissue and accessory organs

4. Orbita – bony walls

5. Surrounding structures:  medially: cellulae ethmoidales (behind thin lamina orbitalis o.e.)  caudally: sinus maxillaris  cranially: fossa cerebri anterior  dorsally: sinus cavernosus + fossa pterygopalatina

6. Visual apparatus  Eye ball = Bulbus oculi  Accessory apparatus = Structurae accessoriae/pertinentes oculi  Topography - regio orbitalis  Development of eye apparatus

7. Eye ball  tunica fibrosa (externa)  tunica vasculosa (media)  tunica interna (nervosa)  Vitreous body + lens cristallina

8. Eye ball  polus anterior, posterior  equator x meriadiani  axis bulbi externus, internus  axis opticus (= „linea visus“)

9. Tunica fibrosa (externa)  sclera  cornea

10. Tunica fibrosa (externa) Sclera  Thick tissue (= reticulum trabeculare), colagenous fibers, fibroblasts, basic substance  lamina episcleralis, substantia propria, lamina fusca  lamina cribrosa (entrance of n. II.)  5/6 of surface, ø 2,2 cm  sinus venosus sclerae (canalis Schlemmi s. Lauthi)  sulcus sclerae – sclerocorneal junction = limbus corneae (angulus sclerocornealis)

11. Tunica fibrosa (externa) Cornea  Totally translucent, w/o vessels  limbus, vertex  5 layers –epithelium anterius cornae (multi l. cuboid) –lamina limitans anterior (Bowmann membrane) –substantia propria corneae –lamina limitans posterior (Descement membrane) –epithelium posterius corneae („endotelium“)  11 x 12 mm – fyziological astigmatismus

12. Tunica vasculosa (media) = Uvea  choroid (choroidea)  Ciliary body (corpus ciliare)  iris (iris)

13. Tunica vasculosa (media) Choroidea  lamina suprachoroidea (= lamina fusca sclerae)  spatium perichoroideum  lamina vasculosa (choroideal stroma) –Big vessels, tissue, smooth muscle cells, nerves  lamina choroidocapillaris –capillaries  lamina basalis = Bruch membrane –BM pigment epitelium and capillaries + tissue

14. Tunica vasculosa (media) ciliary body = Corpus ciliare  Shape of annulus, section of triangle  processus + plicae ciliares  orbiculus (outer part), corona (inner part)  smooth musculus ciliaris –fibrae meridionales, radiales, circulares, longitudinales

15. Tunica vasculosa (media) ciliary body = Corpus ciliare  stroma –m. ciliaris: parasympaticus  akomodation  look close (look remote maintains plasticity of uvea) –Capillaries and nerves supplying muscle  Epitelial cover – production of humor aquosus –BL – continuation of Bruchs membrane –pigment epitelium – (from pigment epitelium of retina) –Cilliary canal –Non pigmented epithelium (from sensory epithelium of retina) –BL –fibrae zonulares – fixate lens

16. Tunica vasculosa (media) Iris  Shape of annulus, flat  Function of shutter  margo ciliaris (outer), m. pupillaris (inner)  pupilla (= pupil)  anulus iridis major + minor (contain circulus arteriosus iridis major + minor)  m. sphincter pupillae (parasymp.) – miosis (circular)  m. dilatator pupillae (symp.) – mydriasis (fanwise)

17. Tunica vasculosa (media) Iris  plicae iridis, stroma iridis  Anterior pole –Does not have epithelial lining (stratum limitans anterius) –fibroblasts and melanocytes (color) –plica radians = serrated line – remnant of membrana pupillaris Wachendorfi  Posterior pole –Two layers of pigment epithelium –Inner pigment –Outer myoepitelial m. sphincter pupillae m. dilatator pupillae

18. Lens crystallina = Lens  polus anterior, posterior  axis, equator, radii (sutures in Y shape and reversed Y)  capsula lentis  substantia lentis – cortex, nucleus  zonula ciliaris Zinni –fibrae zonulares –spatia zonularia Gray cataracta - prosthesis

19. Lens crystallina (lens)  transparent biconvex w/o vessels  capsula – similar to basal lamina  Lens epithelium – single layer cuboid –Only on anterior side of lens  Lens matter –cortical – contains elongated cells (fibers) with organels and nucleus –nuclear – cellular fibers w/o organles and nucleus –Cells contain specific proteins (filensin, crystallins)

20. Acommodation  Focusing on close distance –Contraction of m. ciliaris –fibrae zonulares relaxing –Lens forms ball –Together with contraction of m. sphincter pupillae (= miosis)  Focusing on remote distance –Tonus of vessels maintains fibrae zonulares extended –Lens is flattened –Contraction of m. dilatator pupillae (= mydriasis)

21. Vitreous body = Corpus vitreum  membrana, stroma, humor vitreus  Composed of 99% water  Hyaluronic acid, kolagen fibers  cells – hyalocytes – only during development !  Does not regenerate ! – in case of injury it flows out – exchanged by chamber fluid  canalis hyaloideus Cloqueti – remnant of fetal arteria hylaloidea  fossa hyaloidea  Maintains inner eyeball pressure, pushes retina

22. Chamber fluid = Humor aquosus  Produced by ciliary body  Reabsorbed in angulus iridocornealis  0,2-0,3 ml translucent, watery fluid  Daily produced cca 3 ml  composition: 0,7-1,2 % NaCl, traces of urea and glucose (0,1%), no proteins  Serves as lymph  Intraocular pressure 14-17 mmHg  Intraocular pressure  pressure on retina  glaucoma (= glaukom)

23. Eyeball chambers = Camerae bulbi  Vitreal chamber (camera postrema s. vitrea) –Between ciliary body, lens and retina –Contains vitreous body –spatium retrozonulare  posterior chamber (camera posterior) –Between iris, lens and ciliary body –Contains and produces humor aquosus  Anterior chamber (camera anterior) –Between cornea and iris –angulus iridocornealis –Contains and reabsorps humor aquosus

24. Iridocorneal angle = angulus iridocornealis  At the sclerocorneal junction  Trabecular frame of the back side = spatia anguli i.c. = Fontana spaces  Not connected with Schlemm canal  Resorption of humor aquosus  Maintenance of intraocular pressure  !!! No parasympaticolytics in glaucoma !!!

25. OCT Optical coherent tomograp h measurement of light reflection

26. Tunica interna (nervosa) = Retina  pars caeca –pars iridica –pars ciliaris  ora serrata  pars optica – 11 layers –pigment part –Sensory part

27. Tunica interna (nervosa) Retina – pigment part  stratum pigmentosum  Single layer cuboid epithelium  cells (pigmentocytus) connected by tight junction  Apical part contains melanin granules  Surrounds external segments of sensory cells  interfotoreceptor matrix Cell nutrition, fotopigment rejuvenation, degradation of membranous discs

28. Tunica interna (nervosa) R etina – sensory part  Light recepting neurons –Rods and cones  Conduction neurons –Bipolar and ganglionic cells  Association neurons –Horizontal and amacrine cells  Supportive cells (glia) –Müllers cells

29. Tunica interna (nervosa) Retina – sensory part  discus n. optici (= blind spot) –No light perceiving elements  excavatio disci  macula lutea (= yellow spot) – higher layers to the side –Sharpest vision –fovea centralis (100.000 cones)  foveola (2500 cones)

30. Tunica sensoria (interna) Rods = Neuron bacilliferum  rod = bacillum retinae  synaptic disc (discus membranaceus)  axon  nucleus  Inner segment –GA, ER, MIT; synthesis of ATP and rhodopsin  Outer segment (segmentum externum) –Membranous discs with fotopigment –migrate externally till separation black-white vision

31. Tunica sensoria (interna) Cones = Neuron coniferum  rod = conus retinae  synaptic pod (pes terminalis)  fotopigment is iodopsin  External segment –Membranous discs with fotopigment Communicate with around  Color vision – three types of rods – according to wave length –„blue“ – 420 nm – type S –„green“ – 535 nm – type M –„red“ – 565 nm – type L

32. Tunica sensoria (interna) conduction neurons  Bipolar cells (Neuron bipolare) –Staminate bipolare cells (n.b. bacillotopicum) –Cony bipolar cells (n.b. conotopicum) Dwarfy cells (n.b.c. nanum) x diffuse cells (n.b.c. diffusum) –contact with ganglionic cells  Ganglionic cells (N. ganglionare multipolare) –Diffuse type (n.g.m. umbelliforme) – connects more bipolar cells –Dwarfy type (n.g.m. nanum) – connects to dwarfy bipolar cell –Their axons form nervus opticus

33. Tunica sensoria (interna) Association neurons Have only axonal extensions – both direction  Horizontal cells (N. horizontale) –Connection with rods and cones  Amacrine cells (N. amacrinum) –Connection with bipolar and ganglionic cells Modification and synchro of signal

34. Tunica sensoria (interna) supporting cells  Müllers cells (Gliocytus radialis) –macroglia –processus radiales –Have their own BL = membrana limitans interna –zonulae adherentes with rods and cones = membrana limitans externa

35. Tunica sensoria (interna) Vrstvy zrakové části sítnice  celkem 11 vrstev !!! neděste se !!!

36. Tunica sensoria (interna) layers of visual part of retina  stratum pigmentosum (1.)  stratum nervosum (2.-10.) –stratum segmentorum externorum et internorum(2.) –stratum limitans externum (3.) –stratum nucleare externum (4.) –stratum plexiforme externum (5.) –stratum nucleare internum (6.) –stratum plexiforme internum (7.) –stratum ganglionicum (8.) –stratum neurofibrarum (9.) –stratum limitans internum (10.)

37. Tunica sensoria (interna) Specific places of retina  ora serrata – termination of sensory epithelium  pars optica – 10 layers –discus n. optici /formerly papilla/ (= blind spot) – place of nerve separation No light detecting elements excavatio disci –macula lutea (= yellow spot) – higher layers bent to the side, sharpest vision fovea centralis (100.000 cones) – only cones –Higher layers bent side –Sharpest vision  foveola (2500 cones)

38. OCT Optical coherent tomograph measurement of light reflextion

39. OCT

40. Retinal dystopia

41. Arterial supply of eye a. carotis interna  a. ophthalmica   aa. ciliares posteriores breves  choroid  aa. ciliares posteriores longae (2  4)  corpus ciliare + iris  aa. musculares  aa. ciliares ant., aa. episclerales, aa. conjuctivales lat.  a. centralis retinae  retina  a. lacrimalis  aa. palpebrales lat.  aa. palpebrales med.  aa. conjuctivales med.

43. Vasa sanguinea retinae – eye backside (fundus oculi) a. centralis retinae  arterioles  a. temporalis sup.+ inf.  a. nasalis sup.+ inf.  a. macularis sup.+ inf. (+ media) Veins corresponding to arteries, often crossing

44. Arteria cilioretinalis  appearance: 10-33 %  Branch from a. ciliaris posterior brevis  Enters via discus n.II independently on a. centralis retinae  Acessory arterial supply of macula lutea from choroid circuit  Only source of blood for retina during closure of a. centralis retinae  90 % temporally - 10 % nasally  closure of a. cilioretinalis → central scotoma  Closure of a. centralis retinae → spared central vision of macula lutea

45. A. cilioretinalis

46. Venous supply of eye – 3 directions  vv. episclerales  vv. ciliares ant.  vv. sclerales  sinus venosus sclerae Schlemmi s. Lauthi  vv. vorticosae (4 in quadrants of eye ball)  v. centralis retinae  v. ophthalmica sup.  sinus cavernosus  v. ophthalmica inf.  plexus pterygoideus  v. angularis  v. facialis  v. jugularis int. ! Danger of inflammation spreading !

47. Nervous supply of eye  n. opticus – sensory –pars intraocularis, canalis, intracranialis –vagina interna, externa  n. ophthalmicus  nn. ciliares longi – sensory  n. lacrimalis, n. frontalis, n. nasociliaris – for surrounding  nn. ciliares breves  ganglion ciliare - autonomous (sympaticus does not connect, parasympaticus yes)  n.III., n. IV., n.VI – motoric

49. Nervus opticus  Exvagination of diencephalon (thalamus opticus)  Axons separated by endoneurium  On the surface are analogs of cerebral coverings  Inside nervus running a. et v. centralis retinea

50. OPTICAL PATH Projection → Ascending → Sensory path 4 - neuronal, partially crossed neuron: rods and cones of retina neuron: bipolar cells of retina neuron: ganglionic cells of retina  n. II  chiasma opticum  corpus geniculatum laterale neuron: cells of corpus geniculatum laterale  tractus geniculocorticalis (= radiatio optica Gratioleti)  lobus occipitalis, area 17 (around fissura calcarina)

51. Visual path sides from 3rd neuron  into hypothalamus (nucleus suprachiasmaticus) – transfers optical signals to highest vegetative centers (sight of food = salivation)  Tracts of pupillary reflex – via area pretectalis  to nucleus accessorius dorsalis n. III /Edinger-Westphal/ - parasympatic path vith n. III  ganglion ciliare  nn. ciliares breves  m. ciliaris et m. sphincter pupillae /miosis + acommodation/  into retikular formation  tractus reticulospinalis  centrum ciliospinale /Budge/ C8-Th1  sympathetic path in truncus symphaticus  ganglion cervicale superius  plexus caroticus internus et ophtalmicus  nn. ciliares breves  m. dilatator pupillae /mydriasis/  Path for convergence  nucleus interstitialis /Cajal/  fasciculus longitudinalis medialis  nuclei of all eyeball moving nerves  Tectal visual circuit - tractus tectospinalis (direction of eyeball synchro, head and neck towards visual inputs and for coordination of whole body movements)

54. Acessory apparatus = Structurae oculi pertinentes  Fibrous apparatus = Apparatus ligamentosus  Lids = Palpebrae  Conjunctiva = Conjunctiva  Lacrimal apparatus = Apparatus lacrimalis  Muscular apparatus = Apparatus muscularis  eyebrow = Supercilium

55. Fibrous apparatus  periorbita  vagina bulbi (= capsula Tenoni) –lig. suspensorium bulbi  spatium episclerale  corpus adiposum orbitae  fasciae musculares

56. Conjunctiva = Tunica conjunctiva  t.c.bulbi et palpebrarum  fornix superior, inferior  Continuation of corneal epithelium, continues from behind to eyelid, covers ventral side of eyeball  Multi layer cylindrical epithelium  Contains cup cells  Lacrimal film (irroratio lacrimarum)  glanduale conjuctivales Wolfringi  caruncula lacrimalis

57. Lids = Palpebrae  palpebra superior, inferior  tarsus superior (10 mm), inferior (5 mm)  lig. palpebrale med. (2 lines) + lat.  facies ant.+post., rima palpebrarum, commissura palp. med.+lat., limbus ant.+ post.  angulus oculi med.+ lat.  m. tarsalis sup.(Mülleri) + inf. – smooth muscles  pars palpebralis m. orbicularis oculi - n. VII  m. levator palpebrae superioris - n. III  eyelashes = cilia

58. Lids = Palpebrae  External skin part –Multi layered flat cuboid epithelium w exfoliation –gll. sebaceae Zeissi Ceruminous glands - hordeolum –eyelashes + gl. ciliares Molli Apocrine glands  m. orbicularis oculi  Tarsal plate –fibroelastic –gll. tarsales Meibomi Ceruminous glands - chalazion  Inner conjunctive part –Epithelial transition - sulcus

59. Lacrimal apparatus = Apparatus lacrimalis  glandula lacrimalis –pars orbitalis + palpebralis –12 – 15 individual ductuli excretorii  glandulae lacrimales accessoriae Krausei  rivus lacrimalis  lacus, papilla, caruncula lacrimalis  puctum, canaliculus lacrimalis  saccus lacrimalis  ductus nasolacrimalis (plica lacrimalis Hasneri)  meatus nasi inf.  In drainage lacrimal pathways more small villi

60. Glandula lacrimalis  tubuloacinous serous glands with myoepitelial cells

61. Svalové ústrojí  mm. recti bulbi: sup., inf., med., lat. (VI.)  mm. obliqui bulbi: inf., sup.(IV.) –/fovea trochlearis, spina trochlearis, trochlea, vagina m.o.b.s./  m. levator palpebrae sup. (pars spf.+prof.)  n. III – ostatních 5 svalů  hladké svaly: m. orbitalis Mülleri, m. tarsalis sup. Mülleri + inf.

62. Movements of eyeball I. Movements around axes = duction  Around vertical axis –adduction (inside) –abduction (outside)  Around horizontal axis –elevation (sursumduction; supraduction): up –depression (deorsumduction; infraduction): down  Around sagittal axis (ventrodorsal) : –intorsion (incykloduction): flapping inside –extorsion (excykloduction): flapping outside

63. Movements of eyeball II. Movements paired (together with both eyeballs)  Same directed conjugated paired movements = version (conjugated movements) –dextroversion (right) + sinistroversion (left) –supraversion (sursumverza) + infra/deorsumverza (up + down) –dextro/sinistroelevation + dextro/sinistrodepression (up/down and to sides) –dextro/sinistrocycloversion (rotation right/left)  Counter directed non conjugated paired movements = vergence (non conjugated movements) –convergence = inside direction of axes from both eyeballs –divergence = outside direction of axes from both eyeballs  strabismus = heterotropie = cross eye: – one eye is persistently rotated inward or outward

64. Eyeball movements

65. Strabismus concomitans  esotropie (s. convergens)  exotropie (s. divergens)  hypertropie (s. sursumvergens)  hypotropie (s. deosumvergens)

66. Development of visual apparatus  neuroectoderm of ventral forebrain  Surface ectoderm of head  In between mesenchyme  Cells of neural crest

67. Development of visual apparatus  Development since 4th week  Origin of eye rims in ventral forebrain  Deepens into eye sacs  Formation of eye stalk  Induction of ectoderm = thickening  Origin of eye placode

69. Development of vision apparatus  Invagination of eye placode  Origin of hollow lentiform sac w/o connection with surface  Eye sacs invaginate = eye cup  Invagination of stalk and cup with entering of vascular mesenchyme = origin of vitreal vessels

73. Development of retina  Origin from eye cup  External layer – pigment epithelium  Inner layer – proliferates in pars nervosa  Intraretinal space – gradually disappears  Inversion of retina

74. Development of nervus opticus  Fibers from ganglionic cells growth through stalk  lumen of stalk ceases  Fissure (invagination) ceases

75. BRAIN 3 brain ‘vesicles’ are subdividing Cephalic flexure/bend 35 days pcDEVELOPMENT of the EYE I from CNS Telencephalon Diencephalon Mesencephalon now four, then Rhombencephalon divides into Met- & Mel-encephalons Cervical flexure Rhombencephalon start the folding Already before 35d pc, on each side of the ‘head’, interactions have started between surface ECTODERM, a bulge of the FOREBRAIN & the MESENCHYME Surface ECTODERM MESENCHYME RETINA Neural ECTODERM

76. CORNEAL EPITHELIUM EYE PARTS’ EMBRYONIC SOURCES UVEA LENS Connective tissue & muscle (& vessels) come from cranial mesenchyme Surface ECTODERM MESENCHYME RETINA Neural ECTODERM SCLERA LENS CORNEAL STROMA VITREOUS RETINA OPTIC NERVE Two ectoderms drive events and shaping

77. CORNEAL EPITHELIUM ANTERIOR EYE PARTS’ EMBRYONIC SOURCES Surface ECTODERM LENS How does a surface layer produce two separate structures? In much the same way as an endocrine gland is produced: by a downgrowth of cells that then break off the surface connection Here the downgrowth makes the lens vesicle, conferring a roundish shape from early on To have enough cells for the future cornea and for the lens vesicle, the surface ectoderm first thickens to form a lens placode over the brain-derived optic vesicle Mesenchyme

78. LENS & OPTIC CUP DEVELOPMENT I While still growing, both placode and end of the optic vesicle invaginate lens placode optic vesicle Double wall of optic cup is starting to form Intraretinal space Mesenchyme Optic vesicle precedes the lens vesicle and is a distinct structure

79. OPTIC CUP DEVELOPMENT II: Choroid fissure Together with the invagination centrally at the end of the optic cup, Mesenchyme Blood vessels have to be introduced early into the soon to be enclosed round eye an invagination along the cup & stalk’s inferior surface occurs, to create the choroid fissure in which runs the hyaloid artery

80. OPTIC CUP DEVELOPMENT II: Coloboma Together with the invagination centrally at the end of the optic cup, Blood vessels have to be introduced early into the soon to be enclosed round eye an invagination along the cup & stalk’s inferior surface occurs, to create the choroid fissure in which runs the hyaloid artery Also, an annular vessel runs around the outside of the optic cup Mesenchyme Imagine a penis in which the urethra near & into the glans is still open on its underside - the condition of hypospadias - (but now contains an artery) Defects in the eye from failure of the choroid fissure to close are colobomas

81. Mesenchyme OPTIC DEVELOPMENT III: Lens vesicle Deeper part of Placode sinks into mesenchyme & makes a vesicle Attachment to surface ectoderm will be broken LENS VESICLE Optic cup becomes deeper Inner wall thickens lens placodelens placode so that surface ectoderm can become corneal epithelium & intervening mesenchyme can form the corneal stroma

82. OPTIC DEVELOPMENT IV: Lens differentiation Posterior vesicle cells become elongated lens cells Attachment to surface ectoderm lostMesenchyme Anterior vesicle cells become subcapsular epithelium Mesenchyme Basal lamina becomes lens capsule Posterior vesicle cells form the nucleus of the lens. Subsequent lens cells derive from the subcapsular epithelium

83. OPTIC DEVELOPMENT IV: Lens differentiation Posterior-vesicle cells elongate to lens cells Anterior-vesicle cells become subcapsular epithelium Mesenchyme Basal lamina becomes lens capsule Lumen obliterated LENS

84. OPTIC DEVELOPMENT V: Retina differentiation I Outer layer of cup stays thin and beomes pigment cell layer Intra-retinal space occluded Mesenchyme Inner layer of cup thickens and becomes Neural layer Hyaloid artery reaches inside cup After a while, the lens and vitreous no longer need it, and it atrophies. Only the neural retina continues to depend on it, but under another name - central artery of the retina

85. OPTIC DEVELOPMENT VI: Retina differentiation II Mesenchyme Inner layer of cup thickens and becomes Neural layer Where cells multiply, form layers and differentiate to the several cell types of the neural retina Outer layer of cup stays thin and beomes pigment cell layer

86. Development of ciliary body  Protrusion of both layers of eye cup  pigment epithelium – from external layer  Non pigmented epithelium – from inner layer  Cilliary canal – from cavity of cup  m. ciliaris and tissue – from mesenchyme

87. Iris development  Margin of eye cup  External layer changes into smooth muscles  Inner layer creates pigment epithelium

88. Lens development  Originates from lentiform sac –Anterior wall is not changing = anterior epithelium –Posterior wall – cells elongating till lumen extinction Origin of primary fibers Secondary fibers – from cells of anterior epithelium –capsula lentis – thickened basal lamina of anterior epithelium  Supplied by a. hyaloidea – ceases  Pupillary membrane – covers lens – ceases

91. Development of eye chambers  Anterior chamber –Rift between origin of lens and cornea  Posterior chamber –Rift inside eye cup alongside lens

92. Development of cornea, uvea and sclera  cornea –Surface mesoderm –mesenchyme –Cells of neural crest  Choroidea and sclera –Surrounding mesenchyme

93. Development of eye palpebras  6th week: skin folds over cornea  10th week: folds connectiong  28th week: again opening  During that time from inside attaches conjunctiva  Muscle from IInd branchial arch  Tarsal plate and glands from mesenchyme

94. Development of lacrimal glands  Invagination of surface ectoderm  Non functional till approx. 6th week after delivery –Newborn is not lacrimating

95. Developmental defects  Inborn retinal dystopia  coloboma retinae (usually bilateral – defect of fissura optica closure)  cyclopia (1 eye), synophthalmia (fused eyes)  microphthalmia – infection  anophthalmia  coloboma iridis (6th week – defect of fissura optica closure  aniridia, aphakia  membrana pupillaris persistens  a. hyloidea persistens  Inborn green cataracta; inborn cataracta (in galactosemia)  Inborn ptosis, coloboma palpebrale  cryptophthalmia (eyelids missing – eye covered by skin)

96. Examination  Slit-lamp  Examination of the eye ground – oedema of discus/papilla n. optici = increased intracranial pressure  perimetria = examination of the width of the eye field  optometria = examination of the quality of vision  OCT (optical coherence tomography)

97. Goldmann applanation tonometry OCT Slit lamp OCT

98. Symptomes and malfunctions  epiphora (excesive lacrimation)  myopia – hypermetropie (short – long vision)  hypermetria (overshooting – lesion of cerebellum!)  presbyopia (elder eye)  hemeralopia (anopsia in twilight)  amblyopia (blunt-sighted) – functional lesion (ce when strabismus)  daltonismus (colorless vision)