Short ciliary nerves

Postganglionic · M3 ACh

Six to ten nerves from the ciliary ganglion pierce the sclera around the optic nerve and run forward in the suprachoroidal space to the ciliary muscle and sphincter pupillae. They are the efferent limb of the pupillary light reflex and of accommodation.

Traced from the start

  1. Parasympathetic (craniosacral) outflow
  2. Edinger–Westphal nucleus (oculomotor, CN III)
  3. Ciliary ganglion
  4. Short ciliary nerves

Detail

Light reflex efferent
Pretectal nucleus → both Edinger–Westphal nuclei → CN III → ciliary ganglion → short ciliary nerves → sphincter pupillae
Near response
Ciliary muscle contraction relaxes the zonule so the lens thickens; accompanied by convergence and miosis
Passengers
Also carry sympathetic fibres to dilator pupillae and sensory fibres from the cornea and iris

When it goes wrong

Neurosyphilis (or diabetes) damaging the pretectal light-reflex pathway while sparing the near pathway

Argyll Robertson pupils: small irregular pupils that accommodate but do not react to light, bilaterally

Topical antimuscarinic (tropicamide, cyclopentolate, atropine) or systemic anticholinergic load

Mydriasis with cycloplegia (blurred near vision); can precipitate acute angle-closure glaucoma in a shallow anterior chamber — treated with pilocarpine (M3 agonist)

Practise this structure

1 question in the bank tagged Reflexes.