Eye

Eyes physiology. The Intricate Physiology of the Human Eye: From Light Reception to Visual Processing

How does the human eye function to process light and create visual perception. What are the key structures involved in focusing light onto the retina. How do photoreceptor cells in the retina convert light into electrical signals. What is the difference between rod and cone cells in the retina. How does the brain interpret signals from the optic nerve to form images.

The Fundamental Structures of the Eye and Their Functions

The human eye is a marvel of biological engineering, capable of receiving and processing light to create our visual perception of the world. To understand its physiology, we must first examine its key structures:

  • Cornea: The clear, dome-shaped surface that covers the front of the eye
  • Iris: The colored part of the eye that controls the amount of light entering
  • Pupil: The dark center of the iris that allows light to pass through
  • Lens: The transparent structure behind the iris that focuses light rays
  • Retina: The light-sensitive layer at the back of the eye
  • Optic nerve: The nerve that carries visual information from the retina to the brain

Each of these components plays a crucial role in the visual process. But how do they work together to create vision?

The Light’s Journey Through the Eye

When light enters the eye, it first passes through the cornea, which begins the process of focusing the light. The light then travels through the aqueous humor, a clear fluid in the front part of the eye, before reaching the pupil. The iris controls the size of the pupil, adjusting how much light enters the eye.

After passing through the pupil, the light reaches the lens. The lens further focuses the light, adjusting its shape to accommodate for viewing objects at different distances. This process, known as accommodation, is controlled by the ciliary muscles.

Finally, the focused light passes through the vitreous humor, a gel-like substance filling the back of the eye, before reaching the retina. But what happens when the light hits the retina?

The Retina: Where Light Becomes Electrical Signals

The retina is a complex layer of neural tissue lining the back of the eye. It contains two types of photoreceptor cells: rods and cones. These cells are responsible for converting light into electrical signals that can be interpreted by the brain.

Rods: Masters of Low-Light Vision

Rods are the more numerous of the two types of photoreceptors, with approximately 90 million in each human retina. They are primarily responsible for:

  • Scotopic vision (vision in low light conditions)
  • Peripheral vision
  • Detection of motion

Rods are incredibly sensitive and can detect even a single photon of light. However, they do not provide color vision and have lower spatial resolution compared to cones.

Cones: Color Vision and High Acuity

Cones, on the other hand, are less numerous, with about 6 million in each human retina. They are responsible for:

  • Photopic vision (vision in well-lit conditions)
  • Color vision
  • High visual acuity

There are three types of cones, each sensitive to different wavelengths of light: S-cones (short wavelength), M-cones (medium wavelength), and L-cones (long wavelength). This trichromatic system allows us to perceive a wide range of colors.

The Molecular Mechanism of Phototransduction

How exactly do photoreceptor cells convert light into electrical signals? This process, known as phototransduction, is a complex cascade of molecular events.

Rhodopsin: The Light-Sensitive Protein

In rod cells, the key player in this process is a protein called rhodopsin. Rhodopsin consists of two parts:

  1. Scotopsin: A protein that forms the structure of rhodopsin
  2. Retinal: A vitamin A derivative that acts as the light-sensitive component

When a photon of light hits rhodopsin, it causes a conformational change in the retinal molecule. This change triggers a cascade of events that ultimately leads to the hyperpolarization of the rod cell and the release of neurotransmitters.

The Phototransduction Cascade

The phototransduction cascade involves several steps:

  1. Light causes retinal to change from 11-cis-retinal to all-trans-retinal
  2. This change activates the G protein transducin
  3. Activated transducin stimulates cGMP phosphodiesterase
  4. cGMP phosphodiesterase breaks down cGMP
  5. Reduced cGMP levels cause cGMP-dependent ion channels to close
  6. The closure of these channels leads to hyperpolarization of the rod cell

This process is remarkably sensitive and efficient, allowing our eyes to detect even very low levels of light.

Visual Acuity and Refraction

Visual acuity, or the sharpness of vision, depends on the proper refraction of light as it passes through the eye. But what factors influence refraction in the eye?

The Refractive Components of the Eye

Several structures in the eye contribute to refraction:

  • Cornea: Provides about two-thirds of the eye’s refractive power
  • Aqueous humor: Helps maintain the shape of the cornea
  • Lens: Provides the remaining one-third of refractive power and allows for accommodation
  • Vitreous humor: Helps maintain the shape of the eye

The ability to focus on objects at different distances is crucial for clear vision. How does the eye achieve this?

Accommodation: Focusing Near and Far

Accommodation is the process by which the eye changes optical power to maintain a clear image of an object as its distance varies. This is primarily achieved through changes in the shape of the lens:

  • For distant objects: The ciliary muscles relax, causing the lens to flatten
  • For near objects: The ciliary muscles contract, allowing the lens to become more convex

This ability to adjust focus allows us to maintain clear vision across a range of distances.

The Visual Pathway: From Retina to Brain

Once photoreceptors have converted light into electrical signals, how does this information reach the brain? The visual pathway is a complex network of neurons that carries visual information from the eye to the visual cortex of the brain.

The Optic Nerve and Beyond

The journey of visual information involves several key steps:

  1. Photoreceptors synapse with bipolar cells in the retina
  2. Bipolar cells synapse with ganglion cells
  3. Axons of ganglion cells form the optic nerve
  4. The optic nerves from both eyes meet at the optic chiasm
  5. Visual information continues through the optic tract to the lateral geniculate nucleus
  6. From there, signals are sent to the primary visual cortex in the occipital lobe

This pathway ensures that visual information from both eyes is integrated and processed to form a cohesive visual perception.

Color Vision: The Trichromatic Theory

The ability to perceive color adds richness and depth to our visual experience. But how does color vision work?

The Three Types of Cone Cells

Color vision in humans is based on the presence of three types of cone cells, each sensitive to different wavelengths of light:

  • S-cones: Sensitive to short wavelengths (blue light)
  • M-cones: Sensitive to medium wavelengths (green light)
  • L-cones: Sensitive to long wavelengths (red light)

The combination of signals from these three types of cones allows us to perceive a wide spectrum of colors. This is known as the trichromatic theory of color vision.

Color Processing in the Brain

The perception of color isn’t just about the initial detection of wavelengths by cone cells. The brain plays a crucial role in processing and interpreting color information:

  • Opponent process theory: Explains how the brain processes contrasting color pairs
  • Color constancy: The ability to perceive colors consistently under different lighting conditions
  • Color memory: The brain’s ability to remember and recognize colors

These processes work together to create our rich perception of color in the world around us.

Maintaining Eye Health: Supportive Structures and Systems

While the process of vision is fascinating, it’s equally important to understand the structures and systems that maintain eye health and function.

The Choroid: Nourishing the Eye

The choroid is a layer of blood vessels between the retina and the sclera (the white of the eye). It plays several crucial roles:

  • Provides oxygen and nutrients to the outer layers of the retina
  • Helps regulate eye temperature
  • Absorbs light to prevent internal reflection within the eye

Without the choroid, the retina would not be able to function properly.

The Lacrimal System: More Than Just Tears

The lacrimal system, responsible for tear production and drainage, is essential for eye health:

  • Keeps the cornea moist and nourished
  • Washes away debris and foreign particles
  • Contains antimicrobial compounds to protect against infection
  • Provides a smooth optical surface for clear vision

Proper function of the lacrimal system is crucial for maintaining clear vision and eye comfort.

Intraocular Pressure: A Delicate Balance

Maintaining the correct pressure within the eye is vital for its proper function. This intraocular pressure (IOP) is regulated by the production and drainage of aqueous humor:

  • Produced by the ciliary body
  • Flows through the pupil into the anterior chamber
  • Drains through the trabecular meshwork and Schlemm’s canal

Imbalances in IOP can lead to conditions such as glaucoma, highlighting the importance of this often-overlooked aspect of eye physiology.

The physiology of the eye is a testament to the incredible complexity and efficiency of biological systems. From the initial capture of light to the final perception of a visual image, each step involves intricate processes and specialized structures. Understanding these processes not only satisfies our curiosity about how we see the world but also provides crucial insights for maintaining eye health and treating visual disorders. As research continues, we may uncover even more fascinating aspects of eye physiology, potentially leading to new treatments and technologies to enhance and protect our vision.

Physiology, Eye – StatPearls – NCBI Bookshelf

Parker E. Ludwig; Rishita Jessu; Craig N. Czyz.

Author Information and Affiliations

Last Update: October 7, 2022.

Introduction

The proper function of the eye depends on its ability to receive and process energy from light in the environment, produce action potentials in specialized nerve cells, and relay those potentials through the optic nerve (cranial nerve II) to the brain. The cornea, iris, ciliary body, and lens all play a role in transmitting and focusing light onto the sensory component of the eye, the retina. Structures such as the choroid, aqueous and vitreous humor, and the lacrimal system are important for physiological balance, appropriate pressure maintenance, and nourishment of ocular tissues.[1]

Issues of Concern

Visual acuity relies on proper refraction or bending of light passing through structures of varying densities as the light is transmitted through the cornea, aqueous humor, lens, and vitreous humor before striking the retina. The lens is the adjustable component of the refractive system: its shape is altered by the contraction or relaxation of the ciliary muscle to focus on objects that are near or far.

Cellular Level

The retina is comprised of two types of photoreceptor cells: rods and cones. Rods are the cells primarily responsible for scotopic vision, or low-light vision. Rods are the more abundant cell-type of the retina and reach their maximum density approximately 15 to 20 degrees from the fovea, a small depression in the retina of the eye where visual acuity is highest. There are approximately 90 million rod cells in the human retina. The cones confer color vision and high spatial acuity and are the cell-type most activated at higher light levels when photopic vision predominates. The fovea has the highest density of cones and is free of rods. The human retina contains approximately 6 million cone cells. It should be noted that there is a visual field “blind spot” at the site of the optic nerve where photoreceptor cells are absent.

In comparing the photoreceptor cell types, rods have more photopigment and exhibit high amplification, highly convergent retinal pathways, and high sensitivity, while cones have a faster response with short integration times, are directionally selective, and exhibit high acuity. The term “bleaching” refers to the absorption of a photon by a pigment molecule. Rods are achromatic, meaning they contain one type of pigment, while cones are arranged in a chromatic organization of three different pigments. In the fovea, this arrangement takes on the form of what is referred to as the “cone mosaic.” Photopigment molecules are embedded in the membranes of photoreceptors.[1][2][3]

Mechanism

The photopigment in rods is called rhodopsin. Human rhodopsin is a G-protein-coupled receptor made up of 348 amino acids arranged in seven transmembrane domains, and its gene is located on chromosome 3. Rhodopsin consists of a protein called scotopsin and its covalently-bound cofactor, retinal. The chromophore retinal lies in a pocket formed by the transmembrane domains of scotopsin. Retinal is a vitamin A derivative produced from dietary beta-carotene. Inactive, retinal exists in the 11-cis-retinal conformation. Upon exposure to light, retinal is isomerized to all-trans-retinal leading to a series of changes in conformation to the form metarhodopsin II (Meta II). Meta II activates the G protein transducin, after which its alpha subunit is released. The transducin alpha subunit, bound to guanosine triphosphate (GTP), then activates cyclic guanosine monophosphate (cGMP) phosphodiesterase.  cGMP is hydrolyzed by cGMP phosphodiesterase which inhibits its activation of cGMP-dependent cation channels and causes hyperpolarization of the rod cell and consequent release of glutamate which depolarizes some neurons and hyperpolarizes others. Reversion of rods to their resting state involves rhodopsin kinase (RK), arrestin, a regulator of G protein signaling (RGS) protein, and closure of cGMP channels. The activity of transducin is partially inhibited by the phosphorylation of the rhodopsin cytosolic tail by RK. Arrestin then binds the phosphorylated rhodopsin to inactivate it further. The RGS protein increases the rate of GTP to GDP hydrolysis to convert transducin into its “off” state. cGMP-sensitive channel closure decreases the concentration of calcium ions, which stimulates calcium ion-sensitive proteins to activate guanylyl cyclase causing restoration of cGMP levels and plasma membrane depolarization.

In contrast to rods, there are three different types of cones: S-cones (short wavelength-sensitive), M-cones (medium wavelength-sensitive), and L-cones (long wavelength-sensitive). The S-cone photopigment gene is encoded on chromosome 7, while those of the M-cones and L-cones are on the X chromosome. All cone receptors contain the protein photopsin in modified conformations to enable activation by different wavelengths of light. The different types of photopsin, which are also opsins combined with retinal, are the cone equivalent of rhodopsin in rods. The absorption maxima for photopsin I, photopsin II, and photopsin III are for yellowish-green, green, and bluish-violet light respectively. The increased visual acuity associated with cones is due to their individual connections to the optic nerve, which enables improved distinction between isolated signals. As compared to rods, each step in the generation of a response to light in cones is less effective, and the reactions responsible for termination of such a light response are faster. Melanopsin is located in some ganglion cells of the retina and is responsible for non-visual responses to light such as the regulation of circadian rhythms and the pupillary reflex. The function of melanopsin is similar to that of invertebrate opsins, it absorbs light and triggers a cascade that allows the brain to generate and modify the body’s circadian rhythm. The absorption of blue light by melanopsin can disrupt the body’s circadian rhythm and can lead to insomnia. 

Signals from photoreceptor cells are transmitted through bipolar cells to the retinal ganglion cells (RGCs) in the innermost layer of the retina, which carry the signals through the optic nerve (composed of bundled RGC axons) to the brain. Retinal horizontal cells are responsible for providing inhibitory feedback to photoreceptor cells. It is interesting to note that light exposure has an inhibitory effect on photoreceptor neurotransmitter release; glutamate is released in states of darkness, causing depolarization of the membrane at rest, and its release is inhibited by photon absorption.[4][5][6][7][8]

Clinical Significance

Astigmatism refers to a blurring of vision due to the irregular curvature of the cornea or the lens. Compensation for such abnormalities is generally made through the use of extraocular lenses such as glasses or contact lenses, or refractive surgery. Myopia or nearsightedness is the result of an excessively long eyeball or thick lens. Hyperopia or farsightedness typically is due to an abnormally short globe or thin lens. Both types of visual disturbance are corrected using intra- or extraocular lenses and/or refractive surgery.

Glaucoma refers to a group of diseases that cause optic nerve damage due to increased intraocular pressure. Open-angle glaucoma is the most common type and is characterized by a normal angle between the iris and cornea (iridocorneal angle). Other types of glaucoma include closed-angle and normal-tension glaucoma. While some cases of glaucoma result from mutations of certain genes, the cause of primary glaucoma remain largely unknown. Glaucoma is usually associated with either an overproduction of aqueous humor or impairment in the drainage of aqueous.

Achromatopsia describes a partial or total absence of color vision. Usually, it is inherited in an autosomal recessive manner. Genetic mutations, most commonly in CNGA3, CNGB3, GNAT2, PDE6C, or PDE6H, cause inappropriate responses of cones to light exposure. This can mean a complete lack of functionality or a significant deficit.

Some of the most common retinal diseases include diabetic retinopathy (DR), and age-related macular degeneration (AMD). AMD exits in two forms: dry (atrophic) and wet (exudative or neovascular). In the majority of people, AMD starts as the dry form and in some individuals, it progresses to the wet type (15% to 20%). AMD is always bilateral, but not always the same form in both eyes. Also, the disease does not necessarily progress at the same rate in both eyes. Both AMD and DR involve degeneration of retinal structure which leads to disruption of the phototransduction pathway discussed. In diabetic retinopathy, blood vessels and neurons are damaged by an overaccumulation of glucose, and in severe disease, the proliferation of new blood vessels can further exacerbate visual impairments. In AMD, there is a buildup of damaged cellular components such as lipofuscin (intracellular) and drusen (extracellular). This leads to damage to the macula which causes dysfunctional central vision and can ultimately lead to complete blindness. Choroidal neovascularization can also exacerbate AMD. Many different genes have been implicated in the development and progression of AMD.

In contrast to achromatopsia, retinitis pigmentosa (RP) affects the rod cells of the retina. Rods are progressively lost as the disease advances, leading to difficulty seeing at night, and decreased peripheral vision which has been described as “tunnel vision”. Symptoms often begin in childhood and progressively worsen with age. Mutations in many genes have been shown to cause RP, with possible inheritance patterns including autosomal dominant, autosomal recessive, X-linked, and mitochondrial inheritance.[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]

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Figure

Schematic diagram of the human eye. Contributed by the Public Domain

References

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Kawamura S, Tachibanaki S. Rod and cone photoreceptors: molecular basis of the difference in their physiology. Comp Biochem Physiol A Mol Integr Physiol. 2008 Aug;150(4):369-77. [PubMed: 18514002]

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Mendez A, Burns ME, Roca A, Lem J, Wu LW, Simon MI, Baylor DA, Chen J. Rapid and reproducible deactivation of rhodopsin requires multiple phosphorylation sites. Neuron. 2000 Oct;28(1):153-64. [PubMed: 11086991]

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Zhang TZ, Fan B, Chen X, Wang WJ, Jiao YY, Su GF, Li GY. Suppressing autophagy protects photoreceptor cells from light-induced injury. Biochem Biophys Res Commun. 2014 Jul 25;450(2):966-72. [PubMed: 24971547]

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Lamb TD, Hunt DM. Evolution of the vertebrate phototransduction cascade activation steps. Dev Biol. 2017 Nov 01;431(1):77-92. [PubMed: 28347645]

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Astakhova L, Firsov M, Govardovskii V. Activation and quenching of the phototransduction cascade in retinal cones as inferred from electrophysiology and mathematical modeling. Mol Vis. 2015;21:244-63. [PMC free article: PMC4392649] [PubMed: 25866462]

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Chen CK. RGS Protein Regulation of Phototransduction. Prog Mol Biol Transl Sci. 2015;133:31-45. [PMC free article: PMC4664578] [PubMed: 26123301]

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Zhou Z, Doggett TA, Sene A, Apte RS, Ferguson TA. Autophagy supports survival and phototransduction protein levels in rod photoreceptors. Cell Death Differ. 2015 Mar;22(3):488-98. [PMC free article: PMC4326583] [PubMed: 25571975]

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Emanuel AJ, Do MT. Melanopsin tristability for sustained and broadband phototransduction. Neuron. 2015 Mar 04;85(5):1043-55. [PMC free article: PMC4351474] [PubMed: 25741728]

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Schön C, Sothilingam V, Mühlfriedel R, Garcia Garrido M, Beck SC, Tanimoto N, Wissinger B, Paquet-Durand F, Biel M, Michalakis S, Seeliger MW. Gene Therapy Successfully Delays Degeneration in a Mouse Model of PDE6A-Linked Retinitis Pigmentosa (RP43). Hum Gene Ther. 2017 Dec;28(12):1180-1188. [PubMed: 29212391]

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Occelli LM, Schön C, Seeliger MW, Biel M, Michalakis S, Petersen-Jones SM. Gene Supplementation Rescues Rod Function and Preserves Photoreceptor and Retinal Morphology in Dogs, Leading the Way Toward Treating Human PDE6A-Retinitis Pigmentosa. Hum Gene Ther. 2017 Dec;28(12):1189-1201. [PubMed: 29212382]

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Eblimit A, Agrawal SA, Thomas K, Anastassov IA, Abulikemu T, Moayedi Y, Mardon G, Chen R. Conditional loss of Spata7 in photoreceptors causes progressive retinal degeneration in mice. Exp Eye Res. 2018 Jan;166:120-130. [PMC free article: PMC5756513] [PubMed: 29100828]

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Wong WL, Su X, Li X, Cheung CM, Klein R, Cheng CY, Wong TY. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. 2014 Feb;2(2):e106-16. [PubMed: 25104651]

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Mehta S. Age-Related Macular Degeneration. Prim Care. 2015 Sep;42(3):377-91. [PubMed: 26319344]

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Gahlaut N, Suarez S, Uddin MI, Gordon AY, Evans SM, Jayagopal A. Nanoengineering of therapeutics for retinal vascular disease. Eur J Pharm Biopharm. 2015 Sep;95(Pt B):323-30. [PMC free article: PMC4604030] [PubMed: 26022642]

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Pershing S, Pal Chee C, Asch SM, Baker LC, Boothroyd D, Wagner TH, Bundorf MK. Treating age-related macular degeneration: comparing the use of two drugs among medicare and veterans affairs populations. Health Aff (Millwood). 2015 Feb;34(2):229-38. [PubMed: 25646102]

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Chiras D, Kitsos G, Petersen MB, Skalidakis I, Kroupis C. Oxidative stress in dry age-related macular degeneration and exfoliation syndrome. Crit Rev Clin Lab Sci. 2015 Feb;52(1):12-27. [PubMed: 25319011]

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van Lookeren Campagne M, LeCouter J, Yaspan BL, Ye W. Mechanisms of age-related macular degeneration and therapeutic opportunities. J Pathol. 2014 Jan;232(2):151-64. [PubMed: 24105633]

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Zhang K, Zhang L, Weinreb RN. Ophthalmic drug discovery: novel targets and mechanisms for retinal diseases and glaucoma. Nat Rev Drug Discov. 2012 Jun 15;11(7):541-59. [PubMed: 22699774]

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Jenkins AJ, Joglekar MV, Hardikar AA, Keech AC, O’Neal DN, Januszewski AS. Biomarkers in Diabetic Retinopathy. Rev Diabet Stud. 2015 Spring-Summer;12(1-2):159-95. [PMC free article: PMC5397989] [PubMed: 26676667]

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Sasongko MB, Wong TY, Jenkins AJ, Nguyen TT, Shaw JE, Wang JJ. Circulating markers of inflammation and endothelial function, and their relationship to diabetic retinopathy. Diabet Med. 2015 May;32(5):686-91. [PubMed: 25407692]

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Disclosure: Parker Ludwig declares no relevant financial relationships with ineligible companies.

Disclosure: Rishita Jessu declares no relevant financial relationships with ineligible companies.

Disclosure: Craig Czyz declares no relevant financial relationships with ineligible companies.

Physiology, Eye – StatPearls – NCBI Bookshelf

Parker E. Ludwig; Rishita Jessu; Craig N. Czyz.

Author Information and Affiliations

Last Update: October 7, 2022.

Introduction

The proper function of the eye depends on its ability to receive and process energy from light in the environment, produce action potentials in specialized nerve cells, and relay those potentials through the optic nerve (cranial nerve II) to the brain. The cornea, iris, ciliary body, and lens all play a role in transmitting and focusing light onto the sensory component of the eye, the retina. Structures such as the choroid, aqueous and vitreous humor, and the lacrimal system are important for physiological balance, appropriate pressure maintenance, and nourishment of ocular tissues. [1]

Issues of Concern

Visual acuity relies on proper refraction or bending of light passing through structures of varying densities as the light is transmitted through the cornea, aqueous humor, lens, and vitreous humor before striking the retina. The lens is the adjustable component of the refractive system: its shape is altered by the contraction or relaxation of the ciliary muscle to focus on objects that are near or far.

Cellular Level

The retina is comprised of two types of photoreceptor cells: rods and cones. Rods are the cells primarily responsible for scotopic vision, or low-light vision. Rods are the more abundant cell-type of the retina and reach their maximum density approximately 15 to 20 degrees from the fovea, a small depression in the retina of the eye where visual acuity is highest. There are approximately 90 million rod cells in the human retina. The cones confer color vision and high spatial acuity and are the cell-type most activated at higher light levels when photopic vision predominates. The fovea has the highest density of cones and is free of rods. The human retina contains approximately 6 million cone cells. It should be noted that there is a visual field “blind spot” at the site of the optic nerve where photoreceptor cells are absent.

In comparing the photoreceptor cell types, rods have more photopigment and exhibit high amplification, highly convergent retinal pathways, and high sensitivity, while cones have a faster response with short integration times, are directionally selective, and exhibit high acuity. The term “bleaching” refers to the absorption of a photon by a pigment molecule. Rods are achromatic, meaning they contain one type of pigment, while cones are arranged in a chromatic organization of three different pigments. In the fovea, this arrangement takes on the form of what is referred to as the “cone mosaic.” Photopigment molecules are embedded in the membranes of photoreceptors.[1][2][3]

Mechanism

The photopigment in rods is called rhodopsin. Human rhodopsin is a G-protein-coupled receptor made up of 348 amino acids arranged in seven transmembrane domains, and its gene is located on chromosome 3. Rhodopsin consists of a protein called scotopsin and its covalently-bound cofactor, retinal. The chromophore retinal lies in a pocket formed by the transmembrane domains of scotopsin. Retinal is a vitamin A derivative produced from dietary beta-carotene. Inactive, retinal exists in the 11-cis-retinal conformation. Upon exposure to light, retinal is isomerized to all-trans-retinal leading to a series of changes in conformation to the form metarhodopsin II (Meta II). Meta II activates the G protein transducin, after which its alpha subunit is released. The transducin alpha subunit, bound to guanosine triphosphate (GTP), then activates cyclic guanosine monophosphate (cGMP) phosphodiesterase.  cGMP is hydrolyzed by cGMP phosphodiesterase which inhibits its activation of cGMP-dependent cation channels and causes hyperpolarization of the rod cell and consequent release of glutamate which depolarizes some neurons and hyperpolarizes others. Reversion of rods to their resting state involves rhodopsin kinase (RK), arrestin, a regulator of G protein signaling (RGS) protein, and closure of cGMP channels. The activity of transducin is partially inhibited by the phosphorylation of the rhodopsin cytosolic tail by RK. Arrestin then binds the phosphorylated rhodopsin to inactivate it further. The RGS protein increases the rate of GTP to GDP hydrolysis to convert transducin into its “off” state. cGMP-sensitive channel closure decreases the concentration of calcium ions, which stimulates calcium ion-sensitive proteins to activate guanylyl cyclase causing restoration of cGMP levels and plasma membrane depolarization.

In contrast to rods, there are three different types of cones: S-cones (short wavelength-sensitive), M-cones (medium wavelength-sensitive), and L-cones (long wavelength-sensitive). The S-cone photopigment gene is encoded on chromosome 7, while those of the M-cones and L-cones are on the X chromosome. All cone receptors contain the protein photopsin in modified conformations to enable activation by different wavelengths of light. The different types of photopsin, which are also opsins combined with retinal, are the cone equivalent of rhodopsin in rods. The absorption maxima for photopsin I, photopsin II, and photopsin III are for yellowish-green, green, and bluish-violet light respectively. The increased visual acuity associated with cones is due to their individual connections to the optic nerve, which enables improved distinction between isolated signals. As compared to rods, each step in the generation of a response to light in cones is less effective, and the reactions responsible for termination of such a light response are faster. Melanopsin is located in some ganglion cells of the retina and is responsible for non-visual responses to light such as the regulation of circadian rhythms and the pupillary reflex. The function of melanopsin is similar to that of invertebrate opsins, it absorbs light and triggers a cascade that allows the brain to generate and modify the body’s circadian rhythm. The absorption of blue light by melanopsin can disrupt the body’s circadian rhythm and can lead to insomnia.  

Signals from photoreceptor cells are transmitted through bipolar cells to the retinal ganglion cells (RGCs) in the innermost layer of the retina, which carry the signals through the optic nerve (composed of bundled RGC axons) to the brain. Retinal horizontal cells are responsible for providing inhibitory feedback to photoreceptor cells. It is interesting to note that light exposure has an inhibitory effect on photoreceptor neurotransmitter release; glutamate is released in states of darkness, causing depolarization of the membrane at rest, and its release is inhibited by photon absorption.[4][5][6][7][8]

Clinical Significance

Astigmatism refers to a blurring of vision due to the irregular curvature of the cornea or the lens. Compensation for such abnormalities is generally made through the use of extraocular lenses such as glasses or contact lenses, or refractive surgery. Myopia or nearsightedness is the result of an excessively long eyeball or thick lens. Hyperopia or farsightedness typically is due to an abnormally short globe or thin lens. Both types of visual disturbance are corrected using intra- or extraocular lenses and/or refractive surgery.

Glaucoma refers to a group of diseases that cause optic nerve damage due to increased intraocular pressure. Open-angle glaucoma is the most common type and is characterized by a normal angle between the iris and cornea (iridocorneal angle). Other types of glaucoma include closed-angle and normal-tension glaucoma. While some cases of glaucoma result from mutations of certain genes, the cause of primary glaucoma remain largely unknown. Glaucoma is usually associated with either an overproduction of aqueous humor or impairment in the drainage of aqueous.

Achromatopsia describes a partial or total absence of color vision. Usually, it is inherited in an autosomal recessive manner. Genetic mutations, most commonly in CNGA3, CNGB3, GNAT2, PDE6C, or PDE6H, cause inappropriate responses of cones to light exposure. This can mean a complete lack of functionality or a significant deficit.

Some of the most common retinal diseases include diabetic retinopathy (DR), and age-related macular degeneration (AMD). AMD exits in two forms: dry (atrophic) and wet (exudative or neovascular). In the majority of people, AMD starts as the dry form and in some individuals, it progresses to the wet type (15% to 20%). AMD is always bilateral, but not always the same form in both eyes. Also, the disease does not necessarily progress at the same rate in both eyes. Both AMD and DR involve degeneration of retinal structure which leads to disruption of the phototransduction pathway discussed. In diabetic retinopathy, blood vessels and neurons are damaged by an overaccumulation of glucose, and in severe disease, the proliferation of new blood vessels can further exacerbate visual impairments. In AMD, there is a buildup of damaged cellular components such as lipofuscin (intracellular) and drusen (extracellular). This leads to damage to the macula which causes dysfunctional central vision and can ultimately lead to complete blindness.  Choroidal neovascularization can also exacerbate AMD. Many different genes have been implicated in the development and progression of AMD.

In contrast to achromatopsia, retinitis pigmentosa (RP) affects the rod cells of the retina. Rods are progressively lost as the disease advances, leading to difficulty seeing at night, and decreased peripheral vision which has been described as “tunnel vision”. Symptoms often begin in childhood and progressively worsen with age. Mutations in many genes have been shown to cause RP, with possible inheritance patterns including autosomal dominant, autosomal recessive, X-linked, and mitochondrial inheritance.[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]

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Figure

Schematic diagram of the human eye. Contributed by the Public Domain

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Disclosure: Parker Ludwig declares no relevant financial relationships with ineligible companies.

Disclosure: Rishita Jessu declares no relevant financial relationships with ineligible companies.

Disclosure: Craig Czyz declares no relevant financial relationships with ineligible companies.

The structure and functions of the eye, the anatomy of the eye

A person sees not through the eyes, but through the eyes, from where information is transmitted through the optic nerve, chiasm, visual tracts to certain areas of the occipital lobes of the cerebral cortex, where the picture of the external world that we see is formed. All these organs make up our visual analyzer or visual system.

The presence of two eyes allows us to make our vision stereoscopic (that is, to form a three-dimensional image). The right side of the retina of each eye transmits the “right side” of the image through the optic nerve to the right side of the brain, the left side of the retina does the same. Then the two parts of the image – the right and the left – the brain connects together.

Since each eye perceives “its own” picture, if the joint movement of the right and left eyes is disturbed, binocular vision may be disturbed. Simply put, you will start seeing double or you will see two completely different pictures at the same time.

Basic functions of the eye

  • optical system that projects an image;
  • system that perceives and “codes” the received information for the brain;
  • “service” life support system.

Structure of the eye

The eye can be called a complex optical device. Its main task is to “transmit” the correct image to the optic nerve.

Cornea is the transparent membrane covering the front of the eye. There are no blood vessels in it, it has a large refractive power. Enters the optical system of the eye. The cornea borders on the opaque outer shell of the eye – the sclera. See the structure of the cornea.

Anterior chamber is the space between the cornea and the iris. It is filled with intraocular fluid.

Iris – similar in shape to a circle with a hole inside (pupil). The iris consists of muscles, with the contraction and relaxation of which the size of the pupil changes. It enters the choroid of the eye. The iris is responsible for the color of the eyes (if it is blue, it means that there are few pigment cells in it, if it is brown, there are many). Performs the same function as the aperture in a camera, adjusting the light output.

Pupil – hole in the iris. Its dimensions usually depend on the level of illumination. The more light, the smaller the pupil.

Lens is the “natural lens” of the eye. It is transparent, elastic – it can change its shape, “focusing” almost instantly, due to which a person sees well both near and far. Encapsulated, held in place by eyelash band . The lens, like the cornea, is part of the optical system of the eye.

Vitreous body is a gel-like transparent substance located in the back of the eye. The vitreous body maintains the shape of the eyeball and is involved in intraocular metabolism. Enters the optical system of the eye.

Retina – consists of photoreceptors (they are sensitive to light) and nerve cells. Receptor cells located in the retina are divided into two types: cones and rods. In these cells, which produce the enzyme rhodopsin, the energy of light (photons) is converted into electrical energy of the nervous tissue, i. e., a photochemical reaction.

The sticks are highly light sensitive and allow you to see in poor light, they are also responsible for peripheral vision. Cones, on the contrary, require more light for their work, but it is they that allow you to see fine details (responsible for central vision), make it possible to distinguish colors. The largest accumulation of cones is in the fovea centralis (macula), which is responsible for the highest visual acuity. The retina is adjacent to the choroid, but loosely in many areas. This is where it tends to flake off in various retinal diseases.

Sclera is the opaque outer shell of the eyeball, which passes into the transparent cornea in the anterior part of the eyeball. 6 oculomotor muscles are attached to the sclera. It contains a small number of nerve endings and blood vessels.

Choroid – lines the posterior sclera, adjacent to the retina, with which it is closely connected. The choroid is responsible for the blood supply to the intraocular structures. In diseases of the retina, it is very often involved in the pathological process. There are no nerve endings in the choroid, therefore, when it is ill, pain does not occur, usually signaling some kind of malfunction.

Optic nerve – with the help of the optic nerve, signals from the nerve endings are transmitted to the brain.

Useful reading

General questions about treatment in the clinic

The structure and functions of the human eye

The structure and functions of the human eye

The human eye is an organ with a complex structure that allows us to receive almost 90% of information about the world. Its main task is to “transmit” the correct image to the optic nerve. The eye has a special structure, unlike other organs: it consists of peripheral, conductive and central parts. Each of its parts, each layer has its own functions, properties and purpose.

Structure of the eye

The eyeballs are located in the sockets, which reliably protect them from various injuries. The movement of the “apples” occurs due to six external muscles, which are attached to the sclera and bone tissue. The surface of the organ is regularly moistened thanks to the tears that are produced by the lacrimal gland and form a special film that creates a barrier to protect against external factors. The front of the eye is also protected by the eyelids, which prevent large amounts of germs, dust and pollution from entering it.

Shells

The eyeball has several shells, each of which has a specific function:

  1. Conjunctiva. Completely transparent outer shell allowing normal eyeball movement.
  2. Fibrous. It mainly consists of the sclera – a dense layer that provides protection to the organ and performs a supporting function. The anterior part of the fibrous membrane is called the cornea – this is its most sensitive area, which is the optical refractive medium.
  3. Vascular. This shell provides normal blood supply to the organ of vision and trophism of the structures located inside the eye.
  4. Mesh. This is the inner sheath, which is a multi-layered tissue made up of nerves. The macula is located in the retina and is responsible for central vision.

The choroid, in turn, also consists of several elements:

  1. Choroid – performs a trophic function, closely contacts with the retina and sclera.
  2. Ciliary body is a neuromuscular element that contributes to the natural hydration of the organ.
  3. Iris is the element responsible for the color of the eyes. In the center of the iris is the pupil, which limits the amount of light rays perceived by a person.

Chambers

The eyeball has two fluid-filled chambers that are normally closely connected to each other through the pupil. Their main task is to bring the intraocular tissues to a normal state and participate in the conduction of light rays to the retina. The anterior chamber is located directly behind the cornea, while the posterior chamber is located behind the iris. Due to the regular formation and outflow of fluid, both chambers have the same volume. The formation of fluid occurs in the posterior chamber, and then it flows into the drainage system located in the anterior.

Optical structures

The eye perceives objects with the help of optical structures that react to the image and conduct light rays. The quality of vision depends on the state of these structures.

  1. The cornea is essentially a lens that is responsible for the transmission and refraction of light rays.
  2. Lens focuses light rays and is responsible for their transformation into a nerve impulse.
  3. Aqueous humor and vitreous body also have refractive properties. The quality of vision depends on their transparency (or vice versa, cloudiness), that is, how clear a person sees the outlines of objects.

Basic functions

  1. Central vision. The task of this function is to perceive small objects and details. It is by this indicator that ophthalmologists determine the overall visual acuity. For diagnostics, a special table with graphic elements of different sizes is used.
  2. Peripheral . Forms a field visible to the eye with a constant direction of view. With the help of this function, a person can navigate in space, as well as see objects that fall into the extreme coverage areas.
  3. Color . This is the ability of the organ of vision to perceive different colors and shades. Colors are divided according to the wavelength of radiation and are long-wave (shades of the red spectrum), medium-wave (green-yellow spectrum) and short-wave (violet, cyan, blue). If the eye normally perceives all three spectra, then it is able to perceive many intermediate shades that arise when the three primary colors are mixed.
  4. Light perception . This function allows you to perceive and distinguish the brightness of the rays of light. Violation of light perception is a pathology and can be an early sign of various diseases.
  5. Binocular . Binocular vision is responsible for the clear perception of one object with both eyes at once. This function works thanks to the cortical section of the analyzer.

Binocular function is fully developed by 6–15 years of age. In order for binocular vision to develop correctly, the following conditions must be met:

  • symmetrical arrangement of the organs of vision;
  • free movement of the oculomotor muscles – with normal muscle tone, a parallel arrangement of the visual axes should be ensured when the rays are projected onto the central region of the retina;
  • equal value of the object in question in both organs;
  • normal functioning of the retina, optic nerve and pathways.

To make sure that all visual functions develop correctly, it is important to see an ophthalmologist regularly from an early age. The doctor will monitor the development of visual functions and, if necessary, make timely corrections to avoid the development of pathologies.

Why the correct performance of visual functions is impaired

There are several factors that can have a negative impact on the work of visual functions:

  1. Lack of regular consultations with an ophthalmologist . Vision should be checked once a year in order to prevent the development of diseases in time or to evaluate the effectiveness of the treatment.
  2. Incorrect use or incorrect fitting of contact lenses. Do not sleep in the lenses, and do not walk in them for longer than indicated in the instructions for each model. Also, you can’t choose the means of correction on your own – this can only be done according to the prescription of an ophthalmologist. At least once a year, you need to undergo a re-diagnosis in order to change lenses in time if visual acuity has changed.
  3. Incorrect light distribution. High-quality lighting while reading, drawing and any other work is very important for eye health.
  4. No sunglasses.