Aqueous humour
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Aqueous humourThe aqueous humor is a thick watery substance that is between the lens and the cornea.
LocationsThe anterior segment is the front third of the eye that includes the structures in front of the vitreous humor: the cornea, iris, ciliary body, and lens.[1] Within the anterior segment are two fluid-filled spaces divided by the iris plane:
Aqueous humor fills these spaces within the anterior segment to provide nutrients to the lens and corneal endothelium, and its pressure maintains the convex shape of the cornea.[2][3] In a healthy eye, the aqueous humor does not mix with the firm, gel-like vitreous humor because of the lens and its Zonule of Zinn between the two. Functions
Its main function is to provide diopteric power to the cornea. CompositionThe fluid is essentially the same as blood plasma although with less protein.
Production and drainageAqueous humor is secreted into the posterior chamber by the ciliary body, specifically the non-pigmented epithelium of the ciliary body. It flows through the narrow cleft between the front of the lens and the back of the iris, to escape through the pupil into the anterior chamber, and then to drain out of the eye via the trabecular meshwork. From here, it drains into Schlemm's canal by one of two ways: directly, via aqueous vein to the episcleral vein, or indirectly, via collector channels to the episcleral vein by intrascleral plexus and eventually into the veins of the orbit. Production
DrainageAqueous humor is continually produced by the ciliary processes and this rate of production must be balanced by an equal rate of aqueous humour drainage. Small variations in the changes in production or outflow of aqueous humour will have a large influence on the intraocular pressure. The drainage route for aqueous humor flow is first through the posterior chamber, then the narrow space between the posterior iris and the anterior lens (contributes to small resistance), through the pupil to enter the anterior chamber. From there, the aqueous humour exits the eye through the trabecular meshwork into Schlemm's canal, it flows through 25 - 30 collector canals into the episcleral veins. The greatest resistance to aqueous flow is provided by the trabecular meshwork, and this is where most of the aqueous outflow occurs. The secondary route is the uveoscleral drainage, and is independent of the intraocular pressure, the aqueous flows through here, but to a lesser extent than through the trabecular meshwork. The fluid is 15 mm Hg above atmospheric pressure, so when a syringe in injected the fluid flows easily. If the fluid is deficient, the cornea will wilt and collapse. Diseases and disordersGlaucoma is a condition characterised by increased intraocular pressure (pressure within the eye) either through increased production or decreased outflow of aqueous humor.[5] Increased resistance to outflow of aqueous humour may occur due to an abnormal trabecular meshwork or to obliteration of the meshwork due to injury or disease of the iris. However, increased intraocular pressure is neither sufficient nor necessary for development of primary open angle glaucoma, although it is a major risk factor. Uncontrolled glaucoma typically leads to visual field loss and ultimately blindness. References
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