Eyelid

(***Important Short Note)

Introduction:
• An eyelid is a thin movable fold of skin covering and protecting an eye.
• Upper eyelid is larger and mobile than lower eyelid.
• Both eyelids meet at Medial and Lateral angles.
• Palpebral fissure is elliptical opening between eyelids and entrance to conjunctival sac.
• Eyelashes are short, curved hairs on free edges of eyelids in double or triple rows for
protection of the eye from dust and foreign debris, as well as from perspiration.
• Function is to regularly spread the tears on the eye surface to keep it moist.

Parts of Eyelid
• Each eyelid is divided by a horizontal furrow (sulcus) into an orbital and tarsal part.

Medial Lateral

(No need to draw this diagram- only for understanding)

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Position of lid:
• When eye is open, the upper lid covers about 1/6th of the cornea & the lower lid just
touches the limbus.
Canthi (Angles):
• The two lids meet each other at medial and lateral angles (or outer & inner canthi).
• The medial canthus is about 2mm higher than the lateral canthus.
Palpebral aperture:
• It is the elliptical space between the upper and the lower lid.
• When the eyes are opened, it measures about 10-11mm vertically in the centre and
about 28-30mm horizontallly.
Lid Margin:
• It is About 2mm broad and is divided into two parts by punctum.
• The medial, lacrimal portion is rounded and devoid of lashes or glands with following
features:
• Lacus lacrimalis: Small space at medial angle of eye.
• Caruncula lacrimalis: Small reddish yellow elevation in the lacus lacrimalis.
• Plica semilunaris: Reddish semilunar fold lateral to caruncle.
• Lacrimal punctum: opens to lacrimal canaliculi to drain lacrimal fliud.
• The lateral, ciliary portion (containing eyelashes and glands) consist of rounded
anterior border, a sharp posterior border and an inter-marginal strip.

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Structure: (From Anterior to Posterior)
1. SKIN: It is elastic having fine texture and is the thinnest of the body.
2. THE SUBCUTANEOUS AREOLAR TISSUE: It is very loose and contain no fat. It is thus readily
distended by oedema or blood.
3. The layer of striated muscle:- (ORBICULARIS OCULI MUSCLE)
• It consists of orbicularis oculi muscle which forms an oval sheet across the eyelids.
• It comprises three portions:-
i. The orbital
ii. The palpebral
iii. The lacrimal
 It closes the eyelids & is supplied by zygomatic branch of the facial nerve.
4. SUBMUSCULAR AREOLAR TISSUE:
The layer of loose connective tissue.
• The nerve and vessels lie in this layer.
• Therefore, to anaesthetize lid, injection is given in this plane.
5. FIBROUS LAYER:- It is the framework of the lids and consist of two parts: the central tarsal
plate and the peripheral septum orbitale (orbital septum)
a.) Tarsal plate: Thickened dense connective tissue part of orbital septum near the
margin of eyelids. Tarsal glands are embedded in the posterior part of tarsal plates.
Lateral palpebral ligament: Tarsal plates are attached to bony margin laterally by this
ligament.
Medial palpebral ligament: Tarsal plates are attached to bony margin medially by this
ligament.
Function: To give shape and firmness to the lids.
b.) Septum orbitale (palpebral fascia): Framework of eyelid formed by fibrous sheet,
attached to periosteum at the orbital margin.
6. LAYER OF NON-STRIATED MUSCLE FIBRES: it consist of the palpebral muscle of muller
which lies deep to the septum orbitale in both the lids. In the upper lid it arises from the
fibres of Levator palpebrae supeioris muscle and in the lower lid from prolongation of the
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inferior rectus muscle; and is inserted on the peripheral margins of the tarsal plate. It is
supplied by sympathetic fibres.
7. CONJUCTIVA: Thin mucus membrane lines eyelids.
• The part which lines the lids is called palpebral conjuctiva. It consists of three parts”
marginal, tarsal and orbital.
 Superior and Inferior fornix: Reflection of conjunctiva superiorly and inferiorly to
eyeball.
• Conjunctival sac: Potential space enclosed by conjunctiva.
• Subtarsal sulcus: Sulcus on deep surface parallel to margin of upper eyelid. Clinically
important as it can trap the small foreign particles.

(Draw this Diagram for the short note)

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Glands of Eyelid:
 Meibomian glands (Tarsal glands): long modified sebaceous glands that pour oily
secretion onto margin of the lid opening behind the eyelashes.
o Oily secretion prevent overflow of tears and make the eyelids airtight.
o present in stroma of tarsal plate arranged vertically
o About 30-40 in upper & 20-3- in lower lid.
o Chronic infection of this gland known as Chalazion
o Acute infection of this gland is known as Internal Hordeolum
• Glands of zeis: These are also sebaceous glands which open into the follicles of
eyelashes.
• Glands of Moll: Modified sweat gland situated near the hair follicles or into the duct’s
of Zeis glands. They do not open directly into the skin surface as elsewhere.
• Infection of Glands of Zeis and Moll is known as External Hordeolum.
• Accessory lacrimal glands of Wolfring:
• These are present near the upper border of tarsal plate.

(No need to draw this diagram- only for understanding)

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BLOOD SUPPLY
ARTERIAL SUPPLY:

Medial palpebral vessel from the terminal ophthalmic artery

Lateral palpebral vessel from the lacrimal artery.

VENOUS DRAINAGE:
These are arranged in two plexus:
Post-tarsal which drains into ophthalmic veins
Pre-tarsal opening into subcutaneous veins.

LYMPHATIC DRAINAGE:
Those from lateral half of the lids drain into preauricular lymph nodes
Those from the medial half of the eyelids drain into submandibular lymph nodes.

NERVE SUPPLY OF LIDS

• MOTOR NERVES are facial (which supplies orbicularis muscle), oculomotor (which
supplies Levator palpebrae superioris muscle) and sympathetic fibres (which supply
the muller’s muscle).
• SENSORY NERVE supply is derived from branches of the trigeminal nerve.

APPLIED ANATOMY OF EYELID:

 Trichiasis: Posterior misdirection of eyelashes
 Entropion-inverted eyelashes
 Chalazion: Chronic infection of Meibomian glands
 Internal Hordeolum (Stye): Acute infection of Meibomian glands.
 External Hordeolum (Stye): Common bacerial Infection of Glands of Zeis and Moll.
 Ptosis: drooping of eyelid due to paralysis or weakness of Muller muscle.

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 (Some Photos for Reference Only)

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