Lecture 03

Anatomy of the
ORBIT- I

By:

A. Prof. Dr Farooq A. Khan

PMC

26th Nov. 2018

1
 The bony orbits (or eye sockets) are
bilateral and symmetrical cavities in
the head.

 They enclose the eyeball and its

associated structures.

 In the adult human, the volume of the

orbit is 30 ml, of which the eye
occupies 6.5 ml.

 The orbits are conical or four-sided

pyramidal cavities, which opens into
the midline of the face and point back
into the head.
Bones
Seven bones make up the bony orbit:
1. Frontal bone
2. Lacrimal bone
3. Ethmoid bone
4. Zygomatic bone (Orbital process of the
zygomatic bone)

5. Maxillary bone (Orbital surface of the body of the

maxilla)

6. Palatine bone (Orbital process of palatine

bone)
7. Sphenoid bone (Greater and lesser wings)
•The lacrimal bone is a small and
fragile bone of the facial skeleton.

•It is roughly the size of the little fingernail.

•It is situated at the front part of the

medial wall of the orbit.

•It has two surfaces and four borders.

•A depression on the anterior inferior

portion of the bone, the lacrimal fossa,
houses the membranous lacrimal sac.

Articulations:
The lacrimal bone articulates with four bones:
Two of the cranium, the frontal and ethmoid,
and
Two of the face, the maxilla and the
inferior nasal concha.
 Each orbit consists of a base, an apex and four walls.
 They protect the eye from mechanical injury.

 The base, or the orbital margin which opens in the face, has four borders.
 The following bones take part in the formation of the orbital margin:

 Superior margin: frontal bone

 Inferior margin: maxilla and zygomatic

 Medial margin: frontal, lacrimal and maxilla

 Lateral margin: zygomatic and frontal

 The apex lies near the medial end
of superior orbital fissure and contains
the optic canal which communicates
with middle cranial fossa.

 The roof (superior wall) is formed by the

orbital plate frontal bone and the lesser wing
of sphenoid.

 The orbital surface presents medially by

trochlear fovea and laterally by lacrimal fossa

Near the nasal part of the interior surface of the frontal

bone is a depression, the trochlear fovea, or occasionally a
small trochlear spine, for the attachment of the cartilaginous
pulley of the Oblique oculi superior.
 The floor (inferior wall) is
formed by the orbital surface of maxilla,
the orbital surface of zygomatic
bone and the orbital process of palatine
bone.

 Medially near the orbital margin is

located the groove for nasolacrimal
duct.

 The floor is separated from the lateral

wall by inferior orbital fissure, which
connects the orbit to
pterygopalatine and infratemporal fossa.
 The medial wall is formed by the frontal process of maxilla, lacrimal bone,
orbital plate of ethmoid and a small part of the body of the sphenoid.

 The Lateral wall is formed by the orbital process of zygomatic and the orbital
plate of greater wing of sphenoid.
 The bones meet at the zygomaticosphenoid suture.
 The lateral wall is the thickest wall of the orbit.
 The optic foramen, which contains the optic nerve and the large ophthalmic artery, is
at the nasal side of the apex.
 Contents

 Eyeball
 Fascias: (i)Orbital, (ii)Bulbar

 Extra ocular muscles:

 (Levator Palpebrae Superioris,
Superior, Inferior, Lateral and
Medial Rectus muscles, Superior
and Inferior Oblique Muscles)

 Nerves:
 Cranial nerves II, III, IV,V,
andVI.
 Blood vessels
 Extra ocular Fat.
 Content …..Con’t
 Lacrimal gland, Lacrimal
sac, Nasolacrimal duct

 Eyelids.

 Ligaments
 Medial palpebral ligament and Lateral
palpebral ligament
 Suspensory ligament of the eyeball

 Conjunctiva.
 Trochlea of superior oblique.
 Orbital septum.
 Ciliary ganglion and short ciliary
nerves.
 Openings
 There are two important foramina, or windows,
two important fissures, or grooves, and one canal
surrounding the globe in the orbit.
 These are the:

 Supraorbital foramen
 An Infraorbital foramen
 Superior orbital fissure
 Inferior orbital fissure and
 Optic canal.

 Each of which contains structures that are crucial

to normal eye functioning.

 The Supraorbital foramen contains the

supraorbital nerve, the first division of the
trigeminal nerve or V1 and lies just lateral to the
frontal sinus.
• The infraorbital foramen contains the
second division of the trigeminal nerve, the
infraorbital nerve or V2, and sits on the anterior
wall of the maxillary sinus.

• Both foramina are crucial as potential pathways

for cancer and infections of the orbit to spread
into the brain or other deep facial structures.

• The Optic canal contains the optic nerve

(cranial nerve II) and the ophthalmic artery, and
sits at the junction of the sphenoid sinus with
the ethmoid air cells, superomedial and
posterior to structures at the orbital apex.

• It provides a pathway between the orbital

contents and the middle cranial fossa.
• The superior orbital fissure lies just lateral and
inferior to the optic canal, and is formed at the
junction of the lesser and greater wing of the
sphenoid bone.

• It is a major pathway for intracranial

communication, containing cranial nerves III, IV, VI
which control eye movement via the extraocular
muscles, and the ophthalmic branches of cranial
nerve V, or V1.
• The second division of the trigeminal nerve enters
the skull base at the foramen rotundum, or V2.
• The inferior orbital fissure lies inferior and
lateral to the ocular globe at the lateral wall of
the maxillary sinus.

• It is not as important in function, though it

does contain a few branches of the maxillary
nerve and the infraorbital artery and vein.

• Other minor structures in the orbit include the

anterior and posterior ethmoidal foramen and
zygomatic orbital foramen.
Anterior and posterior ethmoidal foramen
• The anterior ethmoidal foramen is a small
opening in the ethmoid bone in the skull.

• The posterior ethmoidal foramen opens at

the back part of this margin under cover of the
projecting lamina of the sphenoid, and transmits
the posterior ethmoidal vessels and nerve.

• Lateral to either olfactory groove are the internal

openings of the anterior and posterior ethmoidal
foramina (or canals).

• The anterior ethmoidal foramen, situated about

the middle of the lateral margin of the olfactory
groove, transmits the anterior ethmoidal artery,
vein and nerve.
 Foramina and openings
 Optic canal. Optic Nerve And Ophthalmic artery

 Superior orbital fissure. CN .V1, Iv, VI, Ophthalmic

Vein, sup and inf branch of oculomotor nerve.
 Inferior orbital fissure. Inferior Ophthalmic Vein.
 Anterior ethmoidal foramen. Ethmoidal nerve and vessels.
 Posterior ethmoidal foramen. Ethmoidal nerve and vessels.
 Infraorbital foramen. Infraorbital nerve and vessel
 Supraorbital foramen. Supraorbital nerve and vessel
 Naso-lacrimal canal opening. Nasolacrimal duct.
 Zygomatic orbital foramen. Zygomaticofascial nerve
 Clinical Relevance:

Fractures of the Bony Orbit

There are two major types of orbital
fractures:

1. Orbital rim fracture –

This is a fracture of the bones forming the

outer rim of the bony orbit.

It usually occurs at the sutures joining the

three bones of the orbital rim – the
maxilla, zygomatic and frontal.
 2. Blowout fracture
•This refers to partial herniation ogf
the orbital contents through one of
its walls.

•This usually occurs via blunt force

trauma to the eye.

•The medial and inferior walls are the

weekest, with the contents herniating
into the ethmoid and maxillary
sinuses respectively.
 Blowout fraCture…..Con’t

•Any fracture of the orbit will result in

intraocular pressure, raising the pressure in
the orbit, causing Exopthalmos (protrusion
of the eye).

•There may also be involvement of

surrounding structures,

•e.g:
Haemorrhage into one of the neighbouring
sinuses.
Thank You……