RADIOLOGICAL

ANATOMY OF ORBIT
-Dr. Nipun Gupta
Introduction
The orbit has a volume of approximately
30ml, of which theglobe occupies 6.5ml.
It has a roof, floor, medial and lateral wall.
The central axis of the orbit lies approx. 25
degree to the sagittal plane
Normal eye ball.
Muscles
Blood supply
The orbit's bony margins are made
up of seven bones:
1. pars orbitalis of thefrontal bone
2. lacrimal bone
3. lamina papyraceaof theethmoid bone
4. orbital process of thezygomatic bone
5. orbital surface of themaxillary bone
6. orbital process of thepalatine bone
7. greater and lesser wings of thesphenoid
bone
Pathological classification
orbital pathology is presented based on division of the
orbit into the following compartments:
Ocular space
Intraconal space
Conal space
Extraconal space

The ocular muscles within the orbit form a muscle-cone.

These ocular muscles are connected via the annulus of
Zin, which is a fibrous connective tissue sheet and
together they form the conal space.
The intraconal space
is marked by arrows
and is located within
the muscle cone It
contains the optic
nerve, vessels and
cranial nerves III, IV
and VI
Conal space formed by the extra occular
muscles and the facia covering them
Extraconal space
includes the sinuses
and bony lesions.
CT Anatomy
CT is most versatile
bony detail or calcifications easily detectable
Temporal / spatial resolution is obtained
Drawbacks
- radiation-induced cataracts
- beam hardening artifacts from dental fillings
MRI
Better for optic nerve and tumors
no radiation
Drawbacks
- poor temporal resolution
- must screen for metallic foreign bodies in orbit
before MRI
MRI Orbit coronal section.
T1W axial image
T1 W axial image.
T2W axial Image.
ULTRASOUND
An eye and orbit ultrasound is a test that uses
high-frequency sound waves to get
measurements and produce detailed images
of the eye .
Ultrasound can show details about the cornea
and the structures like iris, anterior chamber
and posterior chamber.
Uses of Eye USG
Identifying tumors,neoplasms.
foreign substances in penetrating eye
injuries.
detachment of the retina
glaucoma
cataracts
lens implants
PROCEDURE
Use of a high resolution, small footprint probe
(10-15MHZ) is essential when assessing the
internal structures of the globe.
colour / power / Doppler for assessing
vessels or vascularity of a structure.
Explain the procedure.
Position supine with closed eyes.
If possible, use sterile gel. Apply a small amount of gel to the
probe.

ANTERIOR CHAMBER
Reduce the depth to include the posterior aspect of the lens
and zoom to fill the screen.
minimal to no pressure because the anterior chamber is
easily compressed.
Sweep in both saggital and transverse checking for
symmetry.
Look for sharp margins where the cornea meets the lateral
margins of the iris & ciliary bodies.
Ensure the lens is intact, anechoic and normally located. A
cataract will be seen as echogenic heterogeneity of the lens.
POSTERIOR CHAMBER
Increase the depth to include the entire globe and
proximal optic nerve.
TRANSVERSE -ask the patient to look left and right to
facilitate maximum scan range.
SAGITTAL- ask the patient to look up/down.
Look for a smooth inner wall of uniform thickness and
echogenicity. Check for homogeneity of the vitreous
humour.
Commonly in elderly people there will be some echogenic
'debris' within the vitreous due to degenerative changes.
A vitreous haemorrhage will be seen as mobile, fibrinous,
complex material possible tethered.
The optic nerve is uniform and symmetrical in size
bilaterally with no retro-occular masses.
Include measurements and vascularity if indicated.
An eye series should include the
following minimum images

Anterior chamber - longitudinal and

transverse.
Entire globe: Longitudinal-eyes up/down
Entire globe: Transverse-eyes left/right
Power doppler of retina
Macula/Fovea longitudinal and transverse
Comparison Right V's Left
THANKYOU!!!