Ciliary ganglion
The ciliary ganglion is one of four parasympathetic ganglia of the head and neck. It receives parasympathetic fibers from the oculomotor nerve.
Gross anatomy
- smallest of the ganglia (2 mm in size)
- located posterolaterally in the intraconal space of the orbit (towards the orbital apex) between the optic nerve and the lateral rectus muscle
- just lateral to the ophthalmic artery as it crosses the optic nerve from lateral to medial
Roots
- parasympathetic root (fibers synapse in the ganglion)
- from the Edinger-Westphal nucleus of the oculomotor nerve (III)
- sympathetic root (fibers pass through the ganglion without synapsing)
- from the ICA (from the superior cervical ganglion) via the nasociliary nerve (V1)
- sensory root (fibers pass through the ganglion without synapsing)
- via the small communicating branch of the ciliary ganglion (from nasociliary - V1)
Branches
- ~12 or more branches, termed short ciliary nerves
- each contains elements from all 3 roots (above), and pierce back of sclera around attachment of optic nerve to supply the globe
- the vast marjority of fibers from ganglionic cells supply ciliary body (accommodation); only ~3% supply sphincter pupillae
- note; while both long and short ciliary nerves contain sensory/sympathetic supply to the cornea, iris, and ciliary body; only short ciliary are involved in pupillary constriction and accommodation
Related pathology
- pathology of the ciliary ganglion can produce a tonic pupil, where the pupil does not react to light and slowly accommodates
- Adie syndrome: when a non-reactive, slowly accomodating pupil is associated with absent deep tendon reflexes and diaphoresis