Ciliary ganglion

Last revised by Assoc Prof Frank Gaillard on 19 Mar 2022

The ciliary ganglion is one of four parasympathetic ganglia of the head and neck. It receives preganglionic parasympathetic fibers from the Edinger-Westphal nucleus via the oculomotor nerve. It supplies the eye via short ciliary nerves not only with parasympathetic fibers, but also with sensory and sympathetic fibers that pass through the ganglion. 

Gross anatomy

Roots

Although the ciliary ganglion has parasympathetic, sensory and sympathetic roots, only the parasympathetic ones synapse within the ganglion. 

Branches
  • short ciliary nerves 
    • ~12 or more branches, termed 
    • each contains elements from all 3 roots (above), and pierce the back of the sclera around the attachment of the optic nerve to supply the globe
    • the vast majority of fibers from ganglionic cells supply the ciliary body (accommodation); only ~3% supply sphincter pupillae

Note: while both long ciliary nerves (branches of the nasociliary nerve) and short ciliary nerves contain sensory/sympathetic supply to the cornea, iris, and ciliary body, only the short ciliary nerves 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

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Cases and figures

  • Figure 1
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  • Figure 2: oculomotor nerve
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