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When we think about ocular injury,

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we have to know a little bit about the anatomy of the globe.

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So, ocular injury, we're referring to the globe. And we like

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to think of the globe in terms of these various segments of the globe.

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We talked initially about the anterior

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segment, which includes the anterior, the anterior chamber,

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the lens and the uveal body.

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And we'll talk a little bit about

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the anatomy of the uveal body.

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Then we have the posterior chamber.

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Suffice it to say that this is such a small area of the globe that we actually

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don't see very much trauma to the posterior chamber.

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The large area behind the lens is actually the vitreous.

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And within the vitreous, we also look at the vitreous membranes

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of which the chloroid and the retina are most important.

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The sclera is the ocular membrane that is on the outermost portion of the globe.

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So here is a diagram of a globe, and I will

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point out what we talked about initially, which is the surface of the globe,

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in front of the lens, is the cornea. You see labeled here.

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You see that there is an anterior chamber,

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which is labeled here. Anterior chamber just behind the cornea

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and in front of the lens.

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The posterior chamber, which, as I said, is a very small area that we really are

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unable to discern pathology in, is labeled here.

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It's behind the anterior chamber, obviously, and in front of the vitreous,

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and it is in close approximation to the lens.

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I talked about the uveal tract, and the uveal tract includes the ciliary

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body with the ciliary muscle, as well as portions of the choroid.

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The choroid, as you can see here, is labeled in red.

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And it goes all the way up to communicate

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with that ciliary apparatus at the uveal tract.

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So if we follow the choroid all the way

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back, we can see it goes all the way back to the insertion site of the optic nerve.

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Let's look at the membrane that is

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superficial to the choroid, that is the retina.

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So the retina is seen as this yellowish material, which stops at this juncture.

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When we look at it on the axial scan, it's usually at 10 o'clock and 2 o'clock.

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This will be 2 o'clock, this would be 10 o'clock.

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And the area where it stops is known as the ora serrata.

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So the retina does not go up as far as

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the uveal tract, the ciliary apparatus, whereas the choroid does.

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And that's going to be helpful to us

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in separating choroidal detachments from retinal detachments.

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And then finally, we have the outermost

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covering of the globe, and that is the sclera.

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And we could sort of follow that all

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the way up until it communicates with the cornea.

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And again, here is the sclera over here.

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And we saw a little area of scleral injury on the first case that was shown.

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So here is the junction of the optic nerve

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with the posterior aspect of the globe and the communication with the retina.

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And this area here is usually referred to as the papilla.

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And we have this little hyaloid canal, which is obliterated with maturation.

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So looking at this diagrammatically. Again, we see the choroid as it continues

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into the ciliary body, and the retina, which stops beforehand.

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And I mentioned the uveal track

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which consists of the iris, which is the colored portion

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of the eyeball, the ciliary body and the choroid.

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This is another example of ocular injury.

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And once again on the right side this time, which might imply a left handed

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person who is hitting the person in the eye with the fist.

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Here we see the soft tissues lying superficially.

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We see the outline of the sclera leading to the cornea.

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We see that the anterior chamber on the affected eye is of higher density

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than the anterior chamber on the unaffected eye.

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We see that the depth of the anterior chamber on the left side is greater than

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the depth of the anterior chamber on the right side.

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So there is indeed anterior chamber globe rupture.

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And then we see this unusual appearance.

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It's almost a right angle here to the lens, which has also been traumatized.

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The lens is less dense than the lens on the left side.

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Again, a traumatic cataract with lens

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rupture, anterior chamber hyphema, anterior chamber rupture.

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And the vitreous looks just fine.

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So when we think about the location

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of blood, blood in the anterior chamber, you'll hear this quite frequently

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from the ophthalmologist, is called anterior hyphema.

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It'll be labeled on the ophthalmology note as A.H.

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Posterior chamber blood is not in the vitreous, it's in the posterior chamber.

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Let's go back to this. Here's this little area known as the posterior chamber.

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We usually don't discern blood

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in that location, but they may refer to a posterior hyphema.

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Hemorrhage in the vitreous is called vitreous hemorrhage, obviously,

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and that's in the big part of the globe behind the lens.

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And then we can talk about the various types of detachments of the membranes.

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And the two most common are coroidal detachment and retinal detachment.