RANIA BIBI

4TH YEAR OPTOMETRY

STUDENT
ORBIT
CONTENTS
• Development of the orbit
• Anatomy
• Dimensions
• Walls & Contents of the orbit
• Surgical spaces and its importance
LEARNING OBJECTIVES

This session will enable students to

• Learn the anatomy of the orbit
• Structures passing through the orbit
• Surgical landmarks of the orbit
ORBITAL ANATOMY
• 2 eyes lie within the pear shaped bony orbit
• Bounded by
oSuperiorly- Anterior cranial fossa
oMedially- Nasal cavity and ethmoidal sinuses
oInferiorly- Maxillary Sinuses
oLaterally- Middle cranial fossa and temporal fossa
DIMENSIONS

Volume- 30 cm3
Rim- Horizontally 40mm & vertically 35mm
Intraorbital width- 2.5 cm
Extraorbital width- 10 cm
Depth- medially 4.2 cm & laterally 5.0 cm
BONY ORBIT

Seven bones make up the Ethmoidal bone

bony orbit Sphenoid bone
Frontal bone Lacrimal bone
Zygomatic bone Palatine bone
Maxillary bone
WALLS OF THE ORBIT

Medial
Lateral
Roof
Floor
MEDIAL ORBITAL WALL

Medial wall is formed from front to back by

 Frontal process of the maxilla
 Lacrimal bone
 Orbital plate of ethmoidal bone
 Body of sphenoid bone
CONT,,,

Clinical applications:
oThinnest wall of the orbit so frequently fragmented as a
result of blow out fractures & during orbitotomy operations
oFrequently eroded by chronic inflammatory lesions,
neoplasms, cysts
CONT,,,

oProvides alternate access route to the orbit through sinus

oHemorrhage can occur due to trauma to ethmoidal
vessels
oAccidental lateral displacement will result in traumatic
hypertelorism
LATERAL WALL

Formed by

 Zygomatic bone
 Greater wing of sphenoid
CONT,,,

Clinical Applications:
• Anterior half of the globe is not covered by bone on
lateral side, so palpation of retrobulbar traumas is easier
from lateral side
• Zygomatic-sphenoid suture is an important landmark in
creating the flap in lateral orbitotomy
CONT,,,

• Strongest portion of the orbit and needs to be sawed

open in lateral orbitotomy

• It is almost devoid of foramina, bleeding is less

ROOF OF THE ORBIT

• Underlies frontal sinuses and anterior cranial fossa

• Formed by
Orbital plate of frontal bone
Lesser wing of sphenoid bone
• Lacrimal gland residing within the orbital roof
• Medially, trochlear fossa is located on frontal bone
 CONT,,,

Clinical applications
• Thin and periorbita peels away easily
• Objects piercing upper eyelid penetrate roof and damage frontal lobe
• In old age, roof may be absorbed so that periorbital and dura matter
comes into contact
• Any trauma of dura matter and CSF escapes into orbit or nose or both
FLOOR OF THE ORBIT

• Shortest orbital wall

• Formed by:
Maxillary bone- medially
Zygomatic bone-laterally
Palatine bone- posteriorly
• Triangular in shape
CONT,,,

• Bordered laterally by inferior orbital fissure and

medially by maxillo-ethmoidal sinus

• Overlies maxillary sinuses

CONT,,,

Clinical applications
 Commonly involved in blow out fracture of the orbit
 Infra orbital vessels and nerves almost always involved
 Diplopia is the main symptom of blow out fracture
 Easily invaded by tumors of the maxillary antrum
BASE OF THE ORBIT

• The anterior open part bounded by 4 orbital margins

Superior
Inferior
Medial
Lateral orbital margin
• It gives attachment to the septum orbitale
APEX OF THE ORBIT

• It is the posterior end of the orbit

• 4 orbital walls converge
• Two orifices
Optic canal
Superior orbital fissure
OPTIC CANAL

• It connects the orbit to the middle cranial fossa

• It transmits:
Optic nerve
Ophthalmic artery
SUPERIOR ORBITAL FISSURE

• Structures passing through

Upper lateral part
• Lacrimal & frontal nerves
• Trochlear nerve
• Superior ophthalmic vein
• Recurrent branch of ophthalmic artery
CONT,,,

Middle part
• Superior & inferior division of oculomotor nerve
• Nasociliary branch of ophthalmic division of trigeminal nerve
• Abducent nerve
Lower part
• Inferior ophthalmic vein
PERIORBITA

• Refers to periosteum lining the orbital surface of the bones of orbit

• Loosely adherent to the bones
• Fixed firmly at
oOrbital margins
oSuture lines
oVarious fissures and foramina
oLacrimal fossa
CONT,,,

• Applied Anatomy
Surgery in the orbital roof in the areas of fissures and
suture lines may be complicated at cerebrospinal fluid
leakage
ORBITAL FASCIA

• It is a complex interwoven thin connective tissue

membrane joining the various intra-orbital contents
 Fascia bulbi
 Muscular sheaths
 Intermuscular septa
 Ligament of lockwood
SURGICAL SPACES OF THE ORBIT

Orbit is divided into 4 surgical spaces

Subperiosteal space
Peripheral orbital space/Extraconal space
Central orbital space/Intraconal space
Subtenon’s space
CONT,,,

Importance of these spaces

Most of the orbital tumors tends to remain within a space in

which they are formed unless they are large and malignant or
represent an infiltrative process such as pseudotumor
 ORBITAL FORAMINA, DUCTS,
CANALS & FISSURES
• Optic Foramen: optic nerve
• Nasolacrimal duct: travels inferiorly from lacrimal fossa
• Infraorbital canal: Infraorbtal nerve (V2)
• Superior orbital fissure: Lacrimal nerve & frontal nerve of V1,
CN IV, superior ophthalmic vein
• Inferior orbital fissure: Infraorbital & zygomatic of V2, inferior
ophthalmic vein
CONTENTS OF THE ORBIT

Eyeball
Fascia
Extraocular muscles
Vessels & lymphatics
Nerves & Ciliary ganglion
Lacrimal gland and lacrimal sac
REFERENCES

• Fundamentals & principles of ophthalmology by

American Academy of Ophthalmology
• Google
LEARNING OUTCOMES

Students have learnt

• Anatomy of the orbital
• Vascular supply of the orbit
• Various structures passing through the orbit