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Contents
Eyeball
Muscles of the orbit (extraocular muscles)
Orbital and bulbar fascia
Vessels: ophthalmic artery, superior and inferior
ophthalmic vein
Nerves: optic, oculomotor, trochlear and abducent,
branches of ophthalmic and maxillary nerves
Lacrimal gland
Orbital fat
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Orbital fascia
Also called periorbita
Makes the periosteum of the
bony orbit
Loosely attached with the bone
so that can be easily stripped
Anteriorly: continuous with
the periosteum lining the bones
around the orbital margin
Posteriorly: continuous with
the dural sheath of the optic
nerve
Over the inferior orbital fissure,
there is gap in the periorbita
which is bridged by connective
tissue with some smooth
muscle fibers called orbitalis
muscle
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Contd
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Bulbar fascia
Also known as fascia bulbi or
Tenons capsule
Forms a membranous sheath
around the eyeball extending
from optic nerve to the sclerocorneal junction
Separated from the sclera by the
episcleral space within which
the eyeball can freely rotate
Different structures pierce the
fascia:
Cilliary vessels and nerves around
the optic nerve
Tendons of the extraocular muscles
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Contd
Gives numerous extensions
Tubular sheath around each tendon
Medial check ligament: from the
sheath of the medial rectus muscle and
is attached to the lacrimal bone
Lateral check ligament: from the
sheath of the lateral rectus and is
attached to the zygomatic bone
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Extraocular muscles
Are involuntary and voluntary
Involuntary muscles are
Superior tarsal muscle: derived
from the intermediate fibers of the
levator palpabrae superioris and
assists in elevation of upper eye lid
Inferior tarsal muscle: extends
from the sheath of inferior rectus
and inferior oblique muscle to
inferior tarsal plate and possibly
assists in depression of lower eye
lid.
Orbitalis: bridges across the
inferior orbital fissure. Its functin is
unknown
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Voluntary muscles
Four recti:
Superior
Inferior
Medial
lateral
Two oblique
Superior
inferior
Levator palpabrae
superioris
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Recti muscles
Origin: from the common
tendinous ring
Common tendinous ring
encloses the optic canal and
the medial part of superior
orbital fissure
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10
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11
Oblique muscle
Superior oblique
Origin: sphenoid bone superomedial to the common
tendinous ring
Insertion:
1st passes forward
Forms rounded tendon which passes through the
fibro-cartilaginous pulley attached to the
depression of the frontal bone present on the
anteromedial angle of the roof
muscle then changes the direction, passes
backwards, downwards and laterally below the
superior rectus muscle
Inserted into the sclera behind the equator
between superior and lateral rectus
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12
Contd..
Inferior oblique:
Origin: orbital surface of the
maxilla in the floor of the
orbit slightly lateral to the
lacrimal groove
Insertion:
Passes backward, upwards and
laterally below the inferior
rectus and deep to the latearl
rectus
Inserted close to the superior
oblique little below and behind
the latter
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13
Nerve supply
All voluntary muscles are supplied by
oculomotor nerve (3rd cranial nerve)
except lateral rectus and superior rectus
Lateral rectus by abducent nerve (6th
cranial nerve)
Superior rectus by trochlear nerve (4th
cranial nerve)
LR:6, SO:4
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Action
The movements of the eyeball are
Around the transverse axis: elevation and
depression
Around the vertical axis: adduction and abduction
Around the anteroposterior axis: intortion and
extortion
Intortion: when the upper margin of the cornea (12
oclock position) rotates medially
Extortion: when the upper margin of the pupil rotates
laterally
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15
Contd
Inf.Oblique
12
Sup.Rectus
Med.Rectus
Lat.Rectus
Sup.Oblique
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Inf.Rectus
16
Contd
Combined movement:
Conjugate movement: when both eyes move
in same direction
Disjugate movement: when both eyes move in
opposite direction
convergence and divergence: when both eye move
in around vertical axis
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17
Contd
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18
Contd
Inf.Oblique
Med.Rectus
Lat.Rectus
Sup.Oblique
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Sup.Rectus
Inf.Rectus
19
20
Branches
Central artery of retina:
arise below the optic nerve within the
dural sheath
Runs forward within dural sheath, pierces
the optic nerve behind the eyeball to
enter the substance of the optic nerve
Runs forward within the substance of the
optic nerve and supplies the retina
This artery is an end artery and
obstruction of it leads to total blindness
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21
Contd.
Lacrimal artery:
arise after the ophthalmic artery
pierces the dural sheath
Runs along the lateral wall of the
orbit
Branches:
To lacrimal gland
Latearl palpebral branch to
supply the eyelid
Two zygomatic branch: which
appears on the face and temple
through zygomaticofacial and
zygomaticotemporal foramen of
the zygomatic bone
Recurrent memingeal artery:
runs backwards to enter the
middle cranial fossa through
superior orbital fissure and
anastomoses with the middle
meningeal arteries
Muscular branch to muscles of
the orbit
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22
Contd
23
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24
Contd
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Contd
Branches of ophthalmic
division of trigeminal
nerve
Lacrimal nerve: smallest
branch
Frontal nerve: largest
branch
Nasocilliary nerve
All these three branches enter
the orbit through superior
orbital fissure
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26
Contd
Lacrimal nerve:
Runs forwards along the
upper border of lateral
rectus
Receives communications
from the
zygomaticotemporal nerve
Ends in the lateral part of
the upper eyelid
Supplies the
lacrimal gland,
upper eyelid and
conjunctiva
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27
Contd.
Frontal nerve
Runs forward on the superior
surface of the levator
palpebrae superioris
beneathe the roof of the orbit
At the middle of the orbit, it
divides into
Supratrochlear nerve
Supraorbital nerve
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28
Contd.
Nasocilliary nerve
Within the orbit, it crosses
the optic nerve from
lateral to medial side
Runs along the medial wall
of the orbit between the
superior oblique and the
upper border of the medial
rectus
Ends by dividing into
anterior ethmoidal nerve and
infratrochlear nerve
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29
Contd.
Branches
Communicating branch to ciliary
ganglion
Long ciliary nerve: 2 or 3 number,
pierces the sclera and supply the
cornea, iris and the ciliary body.
it also provide sympathetic fibers to
supply the dilator pupillae
30
Ciliary ganglia
Peripheral parasympathetic
ganglia with multipolar neurons
Situated near the apex of the
orbit between optic nerve and
lateral rectus
Topographically connected with
the nasociliary nerve but
functionally with the oculomotor
nerve
It has motor, sensory and
sympathetic roots
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31
Contd..
Motor root:
from nerve to inferior oblique (branch
of oculomotor nerve)
carry preganglionic fibers from the
Edinger Westphal nucleus and relay
on the ganglion
postganglionic fibers pass through
short ciliary nerve to supply sphincter
pupillae and ciliaris muscle
32
Contd.
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