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An eyelid is a thin fold of skin that covers and protects an eye. With the exception of the prepuce and the labia minora, it has the thinnest skin of the whole body. The levator palpebrae superioris muscle retracts the eyelid to "open" the eye. This can be either voluntarily or involuntarily. The human eyelid features a row of eyelashes which serve to heighten the protection of the eye from dust and foreign debris, as well as from perspiration. "Palpebral" (and "blepharo") means relating to the eyelids. Its key function is to regularly spread the tears and other secretions on the eye surface to keep it moist, since the cornea must be continuously moist. They keep the eyes from drying out when asleep. Moreover, the blink reflex protects the eye from foreign bodies.
The eyelid is made up of several layers; from superficial to deep, these are: skin, subcutaneous tissue, orbicularis oculi, orbital septum & tarsal plates, and palpebral conjunctiva. The meibomian glands lie within the eyelid and secrete the lipid part of the tearfilm.
The skin is similar to areas elsewhere, but has more pigment cells. In diseased persons these may wander and cause a discoloration of the lids. It contains sweat glands and hairs, the latter becoming eyelashes as the border of the eyelid is met.
In humans, the sensory nerve supply to the upper eyelids is from the infratrochlear, supratrochlear, supraorbital and the lacrimal nerves from the ophthalmic branch (V1) of the trigeminal nerve (CN V). The skin of the lower eyelid is supplied by branches of the infratrochlear at the medial angle, the rest is supplied by branches of the infraorbital nerve of the maxillary branch (V2) of the trigeminal nerve.
 Blood supply
In humans, the eyelids are supplied with blood by two arches on each upper and lower lid. The arches are formed by anastamoses of the lateral palpebral arteries and medial palpebral arteries, branching off from the lacrimal artery and ophthalmic artery, respectively.
red and swollen eyelids. excessive tearing.  Eyelid disorders Any condition that affects the eyelid is called eyelid disorder. or a scar on the inside of the lid that could be from surgery. injury. dry eye and sometimes crusting of the eyelashes on awakening. Treatment normally consists in maintaining a good hygiene of the eye and holding warm compresses on the affected eyelid to remove the crusts. redness of the eye. • Ectropion is another aging-related eyelid condition that causes chronic eye irritation and scarring. blurred vision. but sometimes can be due to a congenital defect. Death After death. This condition is mainly caused by staphylococcus infection and scalp dandruff. The main symptoms of styes include pain. light sensitivity. • Entropion usually results from aging. their causes. • Chalazion is caused by the obstruction of the oil glands and can occur in both upper and lower eyelids. Otherwise. It mostly affects the lower lid and it is characterized by the turning inward of the lid. Styes usually disappear within a week without treatment. Chalazia may be mistaken as styes due to the similar symptoms. or disease. it is common in many cultures to pull the eyelids of the deceased down to close the eyes. • Eyelid edema is a condition in which the eyelids are swollen and contain excessive fluid. symptoms and treatments are the following: • Styes are infections of the sebaceous glands of Zein usually caused by Staphylococcus Aureus bacteria. The most common eyelid disorders. Blepharitis symptoms include burning sensation. Gently scrubbing the eyelid with the warm compress is recommended as it eases the healing process. In more serious cases. It may also be the result of allergies and its main symptoms are excessive tearing and hardening of the eyelid conjunctiva. They are characterized by an acute onset of symptoms and they look like a red bump that is placed underneath the eyelid. Chalazia heals within few months if treatment is administered and otherwise it can resorb within two years. a spastic eyelid muscle. antibiotics may be prescribed and home remedies such as warm water compresses may be used to promote faster healing. redness of the eyelid and sometimes swollen eyelids. This is a typical part of the last offices. • Blepharitis is a common condition that causes inflammation of the eyelids and which is quite difficult to manage because it tends to recur. antibiotics may be prescribed. Eyelid edema is caused by an allergic . Chalazia that do not respond to topical medication is usually treated with surgery as a last resort. It may be serious when it increases the intraocular pressure. Styes are normally harmless and do not cause long lasting damage. toward globe. This condition is however less painful and it tends to be chronic. the feeling that there is something in the eye. It is an asymptomatic condition that can rarely lead to trichiasis which requires surgery.
Chronic bouts of eyelid edema can lead to blepharochalasis. stress. The main symptoms are swollen red eyelids. In rare cases. plan allergens. The tumors may be benign or malignant. allergic edemas treatments consists in staying away from the allergen. • Eyelid dermatitis is the inflammation of the eyelid skin. making up 85% to 95% of all malignant eyelid tumors. The most common factors that make the muscle in the eyelid twitch are fatigue. pain. Eyelid surgeries are overall safe procedures but they carry certain risks since the area on which the operation is performed is so close to the eye. and caffeine. • Eyelid tumors may also occur.  Eyelid surgeries The eyelid surgeries are called blepharoplasties and are performed either out of medical reasons or to improve one's facial appearance. Basal cell carcinomas are the most frequently encountered kind of cancer affecting the eyelid. Most of the cosmetic eyelid surgeries are aimed to enhance the look of the face and to boost one's self-confidence by restoring a youthful eyelid appearance. They are intended to remove fat and excess skin that may be found on the eyelids after a certain age. trichiasis. . Usually benign tumors are localized and removed before becoming a cancerous threat and before they become large enough to impair one's vision. ptosis. Treatment may vary depending on what is causing the condition. The affected eyelid may itch. Treatment consists in proper eye hygiene and avoiding the allergens that trigger the condition. Cosmetic eyelid surgeries are mostly used to regain a younger and refreshed look but the costs are quite raised so not everyone affords them. trichinosis or infections. Malignant tumors on the other hand tend to spread to surrounding areas and tissues.reaction that one has to food. topical creams may be used but only under a doctor's supervision. It is mostly a result of allergies or it is triggered by contact dermatitis of the eyelid. Symptoms that one may experience are dry and flaky skin on the eyelids and swollen eyelids. drugs. Whereas infections are fought against with antibiotics. Eyelid surgeries are also performed to improve one's peripheral vision or to treat different eyelid related conditions such as chalazion. Patients are however advised to get more sleep and drink less caffeine. and itching. Eyelid twitching is not considered a harmful condition and therefore there is no treatment available. and other. • Eyelid twitching is an involuntary spasm of the eyelid muscle. eyelid tumors.
Eye makeup Bloodvessels of the eyelids. Right eye. front view . X 30 Sagittal section of right orbital cavity Sagittal section through the upper eyelid The tarsi and their ligaments. front view Horizontal section through the eye of an eighteen days' embryo rabbit.
com/Q/Function_of_eyelid Eyelid Muscles Function: The upper eyelid function is to protect the eye yet get out of the way for vision. Normally the eyelids of human eyes close by reflex action about every six seconds. The eyelids also protect our eyes from injuries caused by foreign bodies through the process of blinking. a set of small glands. And when we are sleeping.wikipedia. Levator Muscle Anatomy The levator muscle starts back above the eyeball. they cover our eyes help prevent evaporation. The eyelashes. act as a screen to keep dust particles and insects out of the eyes when the eyelids are partly closed. a fringe of short hairs growing on the edge of either eyelid.The lacrimal apparatus. the eyelids blink more often and more tears are produced. Right side Reference: http://en. Reference: http://wiki. the eyelids sweep the secretions of the lacrimal (tear gland) apparatus and other glands over the surface at regular intervals. When we are awake.answers. Certain muscles lift the eyelid up so that you can see through the pupil. produce a fatty secretion that lubricates the eyelids and the eyelashes. The Meibomian glands. Our eyelids perform this all-important task for us. located on the edges of the eyelids. descends in the eyelid. . courses over the top. but if dust reaches the surface of the eye and is not washed away. and the Orbicularis Occuli Muscles close the eye. eyelid tone.org/wiki/Eyelid Function of eyelid? It is extremely important that the front surface of the eyeball and cornea remain moist. • • • Levator Muscle Muller's Muscle Frontalis Muscle Gravity.
Its function is to lift the eyelid out of the line of vision. congenitally weak. or separated by age. They have a resting tone and can close the eyes to various degrees. Bermant's web site. It can lift the eyelid in a secondary fashion and can compensate for eyelid muscles to a certain degree. it is relaxed letting the eyelid sag and droop. the medial palpebral ligament. from the frontal process of the maxilla in front of the lacrimal groove. 2 The Orbicularis oculi (Orbicularis palpebrarum) (Fig. There are several subgroups in this muscle that act to close the eyelids. When tired or asleep.com/procedure_folder/eyelid_recon_folder/eyelid_muscl e_function. forms a series of concentric curves. It generally is contracted while you are awake so that it lifts the eyelid. There is one for each brow. Corrugator. it arises from the bifurcation of the medial palpebral ligament. surrounds the circumference of the orbit. It works with facial expression. and is inserted into the lateral palpebral raphé. its fibers form a complete ellipse without interruption at the lateral palpebral commissure. Orbicularis oculi. and spreads over the temple.see below). Correction of this process is covered in Brow Lift sections of Dr.html The Muscles of the EyelidThe muscles of the eyelids are: 1 Levator palpebræ superioris.plasticsurgery4u. the upper eyelid: • • • rests just under the iris (colored part of the eye) moves more than 16 mm. Obicularis Occuli Muscle Anatomy These muscles circle the eyes. The palpebral portion of the muscle is thin and pale. can close all of the way (when the levator is relaxed) Muller's Muscle Anatomy This is a short muscle controlled by the sympathetic nerves of your body. the brow can descend with gravity. The orbital portion is thicker and of a reddish color. the fibers are directed lateralward. The obicularis occuli muscles are important muscles of facial expression. It starts on the top of the head and attaches to the eyebrow skin. and from the anterior surface and borders of a short fibrous band. It can be weakened by disease. If it is working the eyelid (with the brow blocked . which occupies the eyelids or palpebræ. From this origin. Frontalis Muscle Anatomy Is the brow's muscle. Notice the prominent extra folds of skin showing the compensation happening. They are located just under the skin.The aging and sagging of these muscles are addressed during blepharoplasty eyelid rejuvination surgery. Reference: http://www. With the aging face. the upper . forming a broad and thin layer. 379) arises from the nasal part of the frontal bone. It lifts the eyebrow out of the way and is a muscle of facial animation. Below you can see examples of the frontalis muscle compensation in ptosis. This pair of muscles may have to work "overtime" to keep the redundant skin and tissues off the eyelid.and attaches to the eyelid margin. The eyelids can now close with minimal orbicularis tone. ripped by trauma. and downward on the cheek. You can see examples of the aged sagging skin problems on Paul Revere and President Adams. The Levator palpebræ superioris is described with the Anatomy of the Eye.
it raises the upper eyelid and exposes the front of the bulb of the eye. temple. in breadth and 12 mm. is attached to the frontal process of the maxilla in front of the lacrimal groove. thin muscle. and passes medialward to the lateral commissure of the eyelids. and may be regarded as the principal muscle in the expression of suffering. situated behind the medial palpebral ligament and lacrimal sac (Fig. The Corrugator draws the eyebrow downward and medialward. Each time the eyelids are closed through the action of the Orbicularis. it also compresses the lacrimal sac. beneath the Frontalis and Orbicularis oculi. (See enlarged image) The Corrugator 79 (Corrugator supercilii) is a small. and is attached to the posterior lacrimal crest. upper and lower. Crossing the lacrimal sac. It arises from the medial end of the superciliary arch. these folds become permanent in old age. which are attached to the margins of the respective tarsi. 3 The medial palpebral ligament (tendo oculi). between the palpebral and orbital portions of the Orbicularis oculi. as in sleep or in blinking. a strong aponeurotic lamina is given off from its posterior surface. placed at the medial end of the eyebrow.” The Levator palpebræ superioris is the direct antagonist of this muscle. divides into two slips. When the entire muscle is brought into action. The skin thus drawn upon is thrown into folds.—The Orbicularis oculi is the sphincter muscle of the eyelids. producing the vertical wrinkles of the forehead. the medial palpebral ligament is tightened. closing the lids gently. It is the “frowning” muscle. The lacrimal part of the Orbicularis oculi draws the eyelids and the ends of the lacrimal canals medialward and compresses them against the surface of the globe of the eye. 379– Left orbicularis oculi.com/reference/gray/subjects/subject/106 . thus placing them in the most favorable situation for receiving the tears. which are inserted into the superior and inferior tarsi medial to the puncta lacrimalia. and its fibers pass upward and lateralward.fibers of this portion blend with the Frontalis and Corrugator. and the eyelids are firmly closed. As the ligament crosses the lacrimal sac. 379). this expands over the sac. narrow. the skin of the forehead. 8 Reference: http://education. The lacrimal part (Tensor tarsi) is a small. 6 Nerves. so that a vacuum is made in it and the tears are sucked along the lacrimal canals into it. and cheek is drawn toward the medial angle of the orbit. It arises from the posterior crest and adjacent part of the orbital surface of the lacrimal bone. and are inserted into the deep surface of the skin. where it divides into two slips. it divides into two parts. pyramidal muscle. about 6 mm. and passing behind the lacrimal sac. about 4 mm. above the middle of the orbital arch. the wall of the lacrimal sac is thus drawn lateralward and forward. in length. It is attached to the margin of the frontosphenoidal process of the zygomatic bone. as in photophobia. and form the so-called “crows’ feet. The palpebral portion acts involuntarily. occasionally it is very indistinct. upper and lower. 4 The lateral palpebral raphé is a much weaker structure than the medial palpebral ligament.yahoo. the orbital portion is subject to the will.—The Orbicularis oculi and Corrugator are supplied by the facial nerve. 7 Actions. especially radiating from the lateral angle of the eyelids. 5 FIG. seen from behind. in breadth. in length and 2 mm. each attached to the medial end of the corresponding tarsus.
Sagittal Section of the Eyelids and Anterior Orbital Structures The conjunctiva The conjunctiva is a mucous membrane that performs the task of attaching the eyeball to the orbit and lids. When our eyes are open. Its chief parts are the tarsal plates. and the other is the outer canthus. If you’ve been to an ophthalmologist or had the . The last is the innermost layer of the lid. One layer is the skin that contains glands. and the eyelashes. which is responsible for the closing of the lids. It permits a certain degree of rotation of the eyeball in the orbit (the hole in the skull intended for the eyeball). It also contains a muscular layer that comprises the orbicularis oculi muscle. which is a portion of the conjuctiva. The one nearest to the nose is called the inner canthus. The other parts of the conjuctiva include two loose recesses. The points of the almond are called canthi. The conjunctiva lines the lids and also covers the surface of the eyeball. known as the upper and lower fornices. they leave an almond-shaped aperture. The third is a fibrous layer that gives the lid its mechanical stability. The part of the conjuctiva that lines the lids is called the palpebral portion and the part that covers the white of the eyeball is called the bulbar conjunctiva. It is possible for the eyelids and eyeballs to move only because of the looseness of the conjunctiva at these points. The layers of the eyelid The eyelid comprises four layers. which open onto the surface of the lid margin. They are also known as conjunctival sacs and are located between the bulbar and the palpebral conjunctiva.Our Eyelids Our eyelids are actually two folds of skin and tissue that can be closed by means of muscles to form a protective covering over the eyeball against excessive light and injury.
Detail of the eyelid structures 1.experience of having eye drops put in your eyes. The functions of the eyelids It is extremely important that the front surface of the eyeball and cornea remain moist. Be able to suggest a diagnostic and therapeutic strategy for neoplasms affecting the eyelid. The eye drops are put inside the lower fornice. they cover our eyes help prevent evaporation. Paul E.wisedude. This is done by pulling the outer lid away from the globe. BASIC ANATOMY AND PHYSIOLOGY A. Know that eyelid lacerations should be treated atraumatically. a.longer. Normally the eyelids of human eyes close by reflex action about every six seconds. Be able to describe the normal anatomy and functions of the eyelids. 2. Miller. Be able to list and identify the inflammatory conditions affecting the eyelids and suggest an appropriate diagnostic and therapeutic strategy for these conditions. and be able to suggest a prognosis for the most common eyelid neoplasms in each species.htm EYELIDS Paul E. Our eyelids perform this all-important task for us. quickly and closed in two layers following minimal debridement. act as a screen to keep dust particles and insects out of the eyes when the eyelids are partly closed. which is enough for the liquid to diffuse through the cornea and act on the internal structure of the eye. cilia (eyelashes) protect the globe. but if dust reaches the surface of the eye and is not washed away. And when we are sleeping. c. Diplomate ACVO Reading Assignments Required: This handout. the eyelids blink more often and more tears are produced. When we are awake. 6. 3. a fringe of short hairs growing on the edge of either eyelid. skin is covered with hair for external protection.to-lid conformation or palpebral fissure motility disorder. Miller and Ron Ofri OBJECTIVES 1. The Meibomian glands.Protects the eye. 5. DVM. stiffer periocular hairs that warn of potential unseen hazards. a set of small glands. Maggs. The eyelashes. . 4. produce a fatty secretion that lubricates the eyelids and the eyelashes. ded: Eyelids in Slatter’s Fundamentals of Veterinary Ophthalmology by David J.com/health_medicine/eyelids. Reference: http://www. Be able to identify diseases resulting in an abnormal globe. and suggest appropriate therapies and prognoses for these conditions. Overlying Skin . The drops are retained in this cavity for a short while. b. Vibrissae . The eyelids also protect our eyes from injuries caused by foreign bodies through the process of blinking. located on the edges of the eyelids. the eyelids sweep the secretions of the lacrimal (tear gland) apparatus and other glands over the surface at regular intervals. and suggest appropriate treatments for these diseases. I. Be able to identify and differentiate the congenital and eyelash diseases discussed in this lecture.
Tarsus . Muscle which closes the eyelids/palpebral fissure . These muscles protect the eye and facilitate vision. e.sphincter-like skeletal muscle. Eyelid Muscles . The duct openings on the lid margin are important surgical landmarks. 4. 2) Lower eyelid . This is important clinically because a misdiagnosis of ocular inflammation can be made by . Meibomian glands . a) levator palpebrae superioris -. Vasculature a. and is important surgically. Glands of Zeis and Moll are two other glands of minor importance at the base of the lid cilia which. 2. b.Main skeletal muscle elevator of the upper lid. Muscles which open the eyelids/palpebral fissure 1) Upper eyelid . Glandular Structures a. Sensory innervation is via CN 5.All are innervated by CN 7 except the levator which is innervated by CN 3. They secrete lipid that stabilizes the precorneal tear film.Provides structural rigidity to the eyelids.Smooth muscle lifting the upper lid and causes the ptosis in Horner's syndrome. b. when inflamed. It's a poorly defined dense connective tissue structure between the orbicularis oculi muscle and the palpebral conjunctiva near the lid margin. b) 2 other less important skeletal muscles.sebaceous glands embedded in the tarsus near the lid margin. b. modified skin similar to eyebrows in man act like a shock absorber.d.A skeletal muscle of lesser importance depresses the lower lid. a.orbicularis oculi -. Palpebral conjunctiva normally is redder than the bulbar conjunctiva. Eyelids are very vascular making them heal rapidly and resistant to infection.most mobile. form hordeolum (stys). c) Muller's muscle-. 5. 3.
comparing the whiter bulbar conjunctiva to the redder palpebral conjunctiva. Check these in infectious/neoplastic disease. and is a site for immunological regulation.pdf . 6.vetmed. or by examining only the palpebral conjunctiva. Lymphatic drainage is via parotid and mandibular lymph nodes. Avoid when enucleating.wisc. foreign material and light. Conjunctiva . Spread the tear film. Reference: http://www. Protect the eye from trauma.edu/Data/CourseMaterial/Miller/eyelids. 3. Venous drainage is mainly via the angularis oculi vein in the medial canthus. 2. Function of the Eyelids 1. Immunological regulation of the ocular surface and resistance to external infection. 5. B. Pump tears to the nasolacrimal system. c. Produce portions of the precorneal tear film.Reduces the friction of the eyelids on the cornea. d. 4.