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Review
. 2022 Jan 14;6(1):6.
doi: 10.3390/vision6010006.

Ocular Autonomic Nervous System: An Update from Anatomy to Physiological Functions

Feipeng Wu  1 , Yin Zhao  1 , Hong Zhang  1
Affiliations
Review

Ocular Autonomic Nervous System: An Update from Anatomy to Physiological Functions

Feipeng Wu et al. Vision (Basel). .

Abstract

The autonomic nervous system (ANS) confers neural control of the entire body, mainly through the sympathetic and parasympathetic nerves. Several studies have observed that the physiological functions of the eye (pupil size, lens accommodation, ocular circulation, and intraocular pressure regulation) are precisely regulated by the ANS. Almost all parts of the eye have autonomic innervation for the regulation of local homeostasis through synergy and antagonism. With the advent of new research methods, novel anatomical characteristics and numerous physiological processes have been elucidated. Herein, we summarize the anatomical and physiological functions of the ANS in the eye within the context of its intrinsic connections. This review provides novel insights into ocular studies.

Keywords: anatomy; aqueous humor; autonomic nervous system; choroidal blood flow; eye; pupil light reflex.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Autonomic pathways in mammals and avian. The encircled areas represent nuclei and ganglia. There are three autonomic pathways: (1) EW→CG→targets (parasympathetic pathway); (2) SSN→PPG→targets (parasympathetic pathway); (3) IML→SCG→targets (sympathetic pathway). Trigeminal nerve branches are also present. CG—ciliary ganglion; ChBF—choroidal blood flow; EWpg—nucleus of Edinger-Westphal; preganglionic division; IML—intermediolateral column; PPG—pterygopalatine ganglion; SCG—superior cervical ganglion; SSN—superior salivatory nucleus; TG—trigeminal ganglion.
Figure 2
Figure 2
Autonomic pathway of PLR. The encircled areas represent nuclei and ganglia. There are four light-modulated autonomic pathways: (1) parasympathetic (light-stimulated): PON→EW→CG →pupil constriction; (2) sympathetic (light-inhibited): SCN→PVN→IML→SCG→pupil dilation; (3) sympathetic (light-stimulated), SCN→DMH→LC→IML→SCG→pupil dilation; (4) sympathetic (light-inhibited): pretectum→PAG→sympathetic premotor nuclei (PVN, LC, DR)→IML→SCG→pupil dilation; CG—ciliary ganglion; DMH—dorsomedial hypothalamus; DRN—dorsal raphe nucleus; EWpg—Edinger-Westphal nucleus; IML—intermediolateral column; LC—locus coeruleus; oc—optic chiasm; PAG—periaqueductal gray autonomic ganglia; PON—pretectal olivary nucleus; PVN—paraventricular nucleus; SCG—superior cervical ganglion; SCN—suprachiasmatic nucleus.
Figure 3
Figure 3
The aqueous humor outflow pathway. The red words represent parasympathetic innervation, the blue words represent sympathetic innervation, and the yellow words represent trigeminal innervation, respectively. There are two pathways of AH outflow: (1) conventional outflow pathway: non-pigmented epithelial cells→posterior chamber→anterior chamber→TM→Schlemm canal→collection tube, aqueous vein→episcleral vasculature→general venous circulation; (2) unconventional outflow pathway: non-pigmented epithelial cells→posterior chamber→anterior chamber→ciliary body clefts→interstitial spaces of the ciliary muscle→suprachoroidal space, vortex veins, and sclera. The uveolymphatic pathway remains controversial.
See this image and copyright information in PMC

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