ORBIT

&
CONTENTS
ORBIT
Pair of bony cavities
Four sided pyramid
Apex – Directed behind at
the Optic canal
Base – Represented by
Orbital margin
Medial wall – parallel &
seperated by nasal cavities
Lateral wall – slope
backwards & medially
Boundaries
 Roof :
 Orbital plate of Frontal bone Infront
 Lesser Wing of Sphenoid behind

 Features:
 Anterolateral part presents Lacrimal fossa
 Ant. Med. Angle has Trochlear notch or Spine – gives
attachment to the pulley for Superior oblique muscle of
Eyeball
 Post. Part b/w the two roots of Lesser wing & body of
sphenoid presents Optic canal – Transmits Optic nerve
Floor
a. Orbital surface of the Body of Maxilla
b. Zygomatic bone Anterolaterally
c. Orbital process of Palatine bone Posteromedially

Features:
Infraorbital groove & canal – Transmit nerve & vessels
from Inferior Orbital fissure to Infraorbital foramen
Ant. Med. Angle – Origin to Inf. Oblique muscle
Lateral Wall
 Orbital surface of Zygomatic bone Infront
 Orbital surface of Greater Wing of Sphenoid, behind

Features:
 Zygomatic Foramina for passage of Zygomatico-facial &
Zygomatico-temporal nerves.

 Behind lateral Margin of Orbit – Whitnall’s Tubercle -

gives attachment to : Lateral Palpebral lig. / Check lig. Of
Lat. Rectus / Suspensory lig. Of eyeball / Levator
palpebrae superioris
Superior Orbital fissure
Gap b/w Post. Part of Lat. Wall & Roof of Orbit
 Communicates with the Middle cranial fossa

Above : Lesser Wing

Below : Greater Wing
Med. End – Body of Sphenoid

Lower border – has tubercle – gives attachment to

Lat. Part of Common Tendinous Ring
It provides common origin to the Four Recti Muscles
Superior Orbital fissure
Superior Orbital fissure
It is divided into 3 compartments by tendinous ring

Superolateral – (LFTS)
Transmits Lacrimal
Frontal Nerves
Trochlear
Superior Ophthalmic vein
Recurrent meningeal branch
of Lacrimal artery
Superior Orbital fissure
Intermediate – (SANI)
SUPERIOR&
INFERIOR divisions
of Occulomotor nerve
Nasociliary nerve
Abducens nerve
Inferomedial – Inferior
Ophthalmic vein
Inferior Orbital Fissure
At junction of Posterior part of Lateral Wall & floor of
the Orbit - communicates with Infratemporal &
Pterygopalatine fossa

Below & Medially – Maxilla

Above & Laterally – Greater Wing of sphenoid
Lateral End – by Zygomatic bone
Inferior Orbital Fissure
Infraorbital vessels & nerve
Zygomatic nerve
Orbital branch of
Pterygopalatine ganglion
Communication between
Inferior Ophthalmic veins
& Pterygoid venous plexus
CONTENTS OF ORBIT
1. Eyeball 5. Ophthalmic artery
2. Muscles 6. Ophthalmic veins
3. Fascia bulbi 7. Lacrimal gland
4. Nerves 8. Orbital fat.
a. Optic
b. Oculomotor
c. Trochlear
d. Abducent
e. Ophthalmic
f. Ciliary ganglion

 All these structures lie within the orbital periosteum that

lines the bony walls of the orbit.
 Orbital Periosteum / Orbital Fascia or
Periorbita
 It lines the bones that form the boundaries of the orbit and forms
a funnel-shaped fascial sheath that encloses the orbital contents.

 It is loosely attached to the bones.

 At the optic canal and superior orbital fissure, it becomes

continuous with the periosteum lining the interior of the skull
(endocranium).

 At the infraorbital fissure and orbital margins it becomes

continuous with the periosteum covering the external surface of
the skull (periosteum).
Periorbita
The Fascia bulbi
The fascia bulbi or Tenon’s capsule forms a
membranous envelope of the eyeball and extends from
the optic nerve to the sclero-corneal junction.

It separates the eyeball from the orbital fat, and is

separated from the sclera by the episcleral space which
is traversed by delicate bands of connective tissue.

It forms a socket for the eyeball to facilitate free ocular

movements.
 The fascia bulbi is pierced
by……
a. Ciliary vessels and nerve;
b. The tendons of four recti
and two oblique muscles
of the eyeball.

 A tubular sheath is
prolonged proximally
around each tendon
towards the muscle belly.
LIGAMENTS OF EYE BALL
From the sheath of lateral rectus a triangular
expansion known as the lateral check ligament
extends for attachment to the Whitnall’s tubercle of
zygomatic bone.

Another triangular expansion, the medial check

ligament, extends from the sheath of medial rectus
and is attached to the posterior lacrimal crest of the
lacrimal bone.
LIGAMENTS OF EYE BALL
Both the check ligaments are connected below the
eyeball by a fascial hammock which supports the
eyeball; hence called the suspensory ligament of
Lockwood.

The suspensory ligametn is expanded in the middle

where it blends with the sheaths of inferior rectus and
inferior oblique.
LIGAMENTS OF EYE BALL
Extra ocular
muscles
Muscles (Extraocular Muscles)
There are seven voluntary muscles in the orbit.

Of these, six muscles move the eyeball and one muscle
moves the upper eyelid.

The muscles moving the eyeball are four recti and two
oblique muscles.

The one which moves the upper eyelid is called levator

palpebrae superioris.
Recti Muscles
Origin –
All the recti arise from the corresponding margins of
the common tendinous ring.
The lateral rectus arises by two heads.
Common tendinous ring is attached medially to apex
of the orbit and laterally to a small tubercle on the
lower border of superior orbital fissure.
Insertion –
All the recti are inserted into sclera little posterior to
the limbus (corneo-scleral junction) in front of the
equator of the eyeball.
Average distance from limbus is..
Medial rectus - 5mm
Inferior rectus - 6mm
Lateral rectus - 7mm
Superior rectus - 8mm
Oblique muscles
 The oblique muscles of the orbit are: Superior and Inferior.

 Superior oblique –
 Origin – from body of sphenoid superomedial to the optic
canal.
 Insertion: into sclera behind the equator in posterior
superior quadrant of the eyeball, between the superior
rectus and lateral rectus.

 The tendon of superior oblique passes through a

fibrocartilaginous pulley attached to the trochlear notch in
the anteromedial part of the roof of the orbit.
Inferior oblique
 Origin – from rough impression in the anteromedial angle of the
floor of orbit.

 Insertion – into sclera behind the equator in the postero-

superior quadrant of the eyeball a little below and posterior to the
insertion of superior oblique.
 Nerve Supply ( SO 4 LR6 - 3)
 All the extraocular muscles that move the eyeball are supplied by
oculomotor nerve (CN3) except lateral rectus and superior
oblique

 Abducent nerve – Lateral rectus

 Trochlear nerve – Superior oblique
Axis of Movements of the Eyeball
Elevation and depression: around, the transverse axis
passing through the equator.
Adduction and abduction: around, the vertical axis
passing through the equator.
Rotation (torsion): around the anteroposterior axis
extending from anterior pole to posterior pole of the
eyeball.
When 12 o’clock position of cornea rotates medially, it
is called intorsion and when it rotates laterally, it
called extorsion.
Actions of Individual Muscles
 Superior rectus (SR) – elevation,
adduction, and intorsion.
 Medial rectus (MR) – adduction.
 Inferior rectus (IR) – depression,
adduction, and extorsion.
 Lateral rectus (LR) – abduction.
 Superior oblique (SO) –
depression, abduction, and
intorsion.
 Inferior oblique (IO) – elevation,
abduction, and extorsion.
Associated Movements of the Eyeball
1. Conjugate movements – when both the eyes move
in the same direction with visual axes being parallel.

2. Disconjugate movements – when the axes of both

eyes converge or diverge.
Clinical correlation
Unilateral paralysis of an individual muscle due to
involvement of nerves produces strabismus or squint
and may result in diplopia (double vision).
In diplopia, the light from an object is not focused on
the identical areas of both retinae.
MUSCLE PARALYSED NERVE INVOLVED EFFECTS

Lateral rectus Abducent Medial squint

Medial rectus Oculomotor Lateral squint

 Levator palpebrae superioris (LPS)
muscle
Origin – from undersurface of the lesser wing of
sphenoid at the apex of the orbit, above the common
tendinous ring by a narrow tendon.

Insertion – the muscle broadens as it passes forwards

from its origin and divides into three lamellae.
1. Upper lamella consisting of skeletal muscle
penetrates the orbital septum passes through the
fibers of orbicularis oculi to be inserted into the skin
of upper eyelid.

2. Intermediate lamella consisting of smooth muscle

(superior tarsal muscle) is inserted on to the upper
border of the superior tarsal plates.

3. Lower lamella consisting of connective tissue is

inserted on to the superior fornix of the conjunctiva.
Nerve Supply
1. Striped (skeletal muscle) part is supplied by upper
division of oculomotor nerve.

2. Unstriped (smooth muscle) part is supplied by

postganglionic sympathetic fibers from superior
cervical ganglion.

 Actions – elevation of upper eyelid to open the eye.

Clinical correlation
Paralysis of levator palpebrae superioris due to
involvement of oculomotor nerve leads to ptosis
(drooping of upper eyelid).

The lesion of cervical sympathetic chain (as in

Horner’s syndrome) leads to partial ptosis (partial
drooping of upper eyelid) as it affects only smooth
muscle part of LPS.
TUNICS OF EYE BALL
The eyeball consists of three
concentric coats
1. An outer fibrous coat
consisting of sclera and
cornea.
2. A middle vascular coat
consisting of choroid, ciliary
body, and iris.
3. An inner nervous coat
consisting of the retina.
TUNICS - SCLERA
Functions of sclera :
1. Helps to maintain the shape of the eyeball.
2. Protects internal structures.
3. Provides attachment to muscles that move the
eyeball.
Structure Piercing the Sclera : 1. Optic nerve, 2.
Posterior ciliary vessels and nerves, 3. Anterior ciliary
arteries & 4. Four choroidal veins.
CORNEA
It is transparent and more convex
It is avascular
It permits the light to enter the eye & also
reflects.
It is highly sensitive and supplied by the ophthalmic
division of trigeminal nerve.
The nerves of cornea form the afferent limb of the corneal
reflex.
Structure : consists of five layers - 1. Corneal epithelium, 2.
Anterior limiting membrane, 3. Substantia propria, 4.
Posterior limiting membrane, & 5. Endothelium.
HISTOLOGY
MIDDLE VASCULAR COAT OF THE
EYEBALL
It is also known as uveal tract & contains a large
number of melanin-containing cells.
It consists of three parts; from behind forwards these
are: choroid, ciliary body, and iris.
Choroid : Anteriorly- it is connected to the iris by the
ciliary body and posteriorly- it is pierced by the optic
nerve.
Arteries : short ciliary arteries.
Veins : arranged in the form of whorls, which converge
to form the 4 or 5 venae vorticosae
 Ciliary Body : It is continuous with the choroid behind and the
iris in front.
 The ciliary bodies suspend the lens via suspensory ligaments.
 Parts of the Ciliary Body : 1. Ciliary ring is an outer fibrous ring,
which is continuous with the choroid
 2. Ciliary processes are a group of 60–90 folds on the inner
aspect of the ciliary body. The ciliary processes are a complex of
capillaries and cuboidal epithelium, which secretes aqueous
humour
 3. The ciliary muscle is a small smooth muscle
 mass consisting of mainly two types of fibres, 1. Outer radial
fibres & 2. Inner circular fibres
 Functions : 1. focus the lens for near vision, 2. acts as a sphincter
& choroid is pulled towards the lens reducing the tension on
the suspensory ligaments.
 Iris : The iris is a contractile diaphragm between the cornea and
the lens.
 The iris is attached at its periphery to the middle of the anterior
surface of the ciliary body.
 Peripheral to this attachment the ciliary body and narrow rim of
sclera form the iridocorneal angle.
 Nerve supply: Constrictor pupillae is supplied by the
parasympathetic fibres and dilator pupillae by the sympathetic
fibres.
 Actions: The constrictor and dilator pupillae constricts and
dilates the pupil, respectively.
INNER NERVOUS COAT OF THE EYEBALL
RETINA
 The retina is present between the choroid and the
hyaloid membrane of the vitreous.
 Anteriorly, it presents an irregular edge called ora serrata.
 Blood Supply : The deeper part of the retina- up to the
bipolar neurons is supplied by the central artery of the
retina.
 While the superficial part of the retina up to the rods and
cones is nourished by diffusion from the capillaries of the
choroid.
 Venous Drainage : It is by central vein of the retina,
which drains into the cavernous sinus.
STRUCTURE
Clinical correlation
Retinal detachment: In retinal detachment there is
separation of two layers of the retina.
Fundoscopy : Macula lutea, a pale yellowish area near
the posterior pole.
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