OS 204: Eye and Orbit
Lecturer: Jose V. Tecson III, MD, DHPEd, DPBO
I. SURFACE ANATOMY
 Lacrimal Lake
 Shallow reservoir of tears observed in median angle of eye
 Contains lacrimal caruncle, mound of moist modified skin
 Semilunar Conjunctival Fold
 Lateral to the caruncle which slightly overlaps the eyeball
II. BONY ORBIT AND FORAMINA
 Foramina and Fissures
 Optic Canal: optic nerve, ophthalmic artery
 Superior Orbital Fissure: CN III, IV, VI, nasociliary n.,
lacrimal n., frontal n., ophthalmic v.
 Inferior Orbital Fissure: infraorbital n. (V2), zygomatic n.
 Supraorbital Foramen: supraorbital n.
 Infraorbital Foramen: infraorbital n.
 Fossa of Lacrimal Sac: lacrimal sac
III. EYELIDS AND EXTRAOCULAR MUSCLES
A. EYELIDS
 Muscles of the Eyelid
 Protractors: orbicularis oculi
 Retractors: levator superioris, frontalis, superior tarsal
B. EXTRAOCULAR MUSCLES
 Muscles that move the eyeball
 Superior Rectus: elevation, adduction and intorsion of
eye
 Lateral Rectus: abduction of eye
 Medial Rectus: adduction of eye
 Inferior Rectus: depression and extorsion of eye
 Superior Oblique: depression, abduction and intorsion
eye
 Inferior Oblique: elevation, abduction and extorsion of
eye
 Muscles the Innervate the Extraocular Muscles
 CN III: superior rectus, medial rectus, inferior rectus,
inferior oblique
Notes by Carlo Miguel B. Barrios, UPCM 2025
Topic 8
1 Mar 2021
 CN IV: superior oblique
 CN VI: lateral rectus
 Axis of the Eyeball: axes of orbit and axis of eyeball
IV. LAYERS AND CHAMBERS OF THE EYE
A. COMPARTMENTS OF THE EYEBALL
 Anterior: between cornea (A) and iris/pupil (P); contains
aqueous humor
 Posterior: between the iris/pupil anteriorly and the lens and
ciliary body posteriorly
 Vitreous: between the lens and retina; with vitreous humor
B. LAYERS OF THE EYE
 Fibrous (Outer) Layer
 Sclera: provides attachment for both extrinsic
(extraocular) and intrinsic muscles of the eye
 Cornea: primary refractory medium of the eyeball that is
highly sensitive to touch
 Lens: technically not part of the fibrous layer
 Vascular (Middle) Layer
 Choroid: engorged with blood in life and is responsible for
the “red eye” reflection that occurs in flash photography
 Ciliary body: ring-like thickening of the vascular layer
posterior to the corneoscleral junction that is muscular and
vascular
 Iris: thin contractile diaphragm with a central aperture, the
pupil, for light transmission
 Inner Layer
 Retina: thin, semi-transparent multilayered sheet of neural
tissue that lines the inner wall of the posterior 2/3 of the
eye and functions as its sensory neural layer
V. INNERVATION OF EYE
 CN II (Optic Nerve)
 Sensory-only nerve
 Transmits visual information to the brain
 CN III (Oculomotor Nerve)
 Innervates rectus (except lateral) and inferior oblique eye
muscles
 Innervates the levator palpebrae superioris
 Parasympathetic fibers synapse in ciliary ganglion
 CN IV (Trochlear Nerve)
 Innervates superior oblique eye muscles
 CN V (Trigeminal Nerve)
 Ophthalmic (V1), maxillary (V2), mandibular (V3)
 V1: carries sensory information from the upper eyelid,
cornea, conjunctiva, forehead, scalp, etc.
 CN VI (Abducens Nerve)
 Innervates lateral rectus muscles
VI. TEAR PRODUCTION
 Innervation of the Lacrimal System
 Both sympathetic and parasympathetic
 Facial nerve, greater petrosal nerve, nerve of pterygoid
canal → presynaptic parasympathetic fibers to the
pterygopalatine ganglion
 Maxillary, infra-orbital, zygomatic, and lacrimal nerves →
postsynaptic fibers to the gland
 Pathway of Tears
OS 204: Eye and Orbit Topic 8
Lecturer: Jose V. Tecson III, MD, DHPEd, DPBO 1 Mar 2021
 Produced in the lacrimal glands → lacrimal ducts →
superior conjunctival fornix → anterior eyeball → lacus
lacrimalis → lacrimal canaliculi (at the inner canthus) →
lacrimal sac → nasolacrimal duct → inferior nasal meatus

Notes by Carlo Miguel B. Barrios, UPCM 2025