Orbital Anatomy

Dr Abikarim Goodman.
 Anatomy Of Orbit
 Quadrangular truncated
pyramidal in shape.

 Bounded by-
• Superiorly- Anterior cranial
fossa
• Medially- Nasal cavity and
ethmoidal air sinuses
• Inferiorly- Maxillary sinus
• Laterally- Middle cranial fossa
and Temporal fossa.
 Dimensions
 Volume: 30cm2

 Rim: Horizontally- 4cm

Vertically- 3.5cm

 Intra orbital width: 2.5cm

 Extra orbital width: 10cm

 Depth: Medially- 4.2cm

Laterally- 5.0cm

 Ratio of vol. of orbit : vol. of

globe: 4.5:1
 Bony Orbit

 Seven bones make

up the bony orbit :

 Frontal bone
 Zygomatic Bone
 Maxillary bone
 Ethmoid bone
 Sphenoid bone
 Lacrimal bone
 Palatine bone
 Walls Of The Orbit

 The bony orbit has four

walls:

 Medial wall
 Lateral wall
 Roof
 Floor
 Medial Orbital Wall
 The medial wall is
formed from front to
back by the:

 Frontal process of maxilla

 Lacrimal bone
 Orbital plate of the ethmoid
bone
 Body of the sphenoid bone.
 Medial Orbital Wall
Clinical applications:

• It is the thinnest wall of the orbit, so it is frequently fragmented as a

result of indirect blow out fractures and during orbitotomy operations.

• Frequently eroded by chronic inflammatory lesions, neoplasms, cysts.

• Medial wall provide alternate access route to the orbit through sinus.

• Haemorrhage can occur due to trauma to ethmoidal vessels.

• Accidental lateral displacemet of medial wall causes traumatic

hypertelorism.
 Lateral Orbital Wall
 Thickest and strongest.

 Formed by two bones:

• Zygomatic
• Greater wing of sphenoid.
 Lateral Orbital Wall
Clinical applications:

• The anterior half of globe is not covered by bone on lateral side.

Hence, palpation of retrobulbar tumours is easier from the lateral
side.

• The zygomatico-sphenoid suture is an important landmark in creating

the flap in lateral orbitotomy.

• It is the strongest portion of the orbit and needs to be sawed open in

lateral orbitotomy.

• Since lateral wall is almost devoid of foramina, bleeding is less.

 Roof Of Orbit
 Underlies frontal sinus and
anterior cranial fossa.

 Formed by-
• Orbital plate of frontal bone
• Lesser wing of sphenoid.

 Triangular.

 Faces downwards and slightly

forwards.
 Roof Of Orbit
Clinical applications:
• Thin and periorbita peels away easily.

• Objects piercing upper eyelid penetrate roof and damage frontal

lobe.

• Any trauma of dura mater and CSF escapes into orbit or nose or
both.
 Floor Of Orbit
 Shortest orbital wall.

 Formed by:
• Maxillary bone- medially
• Zygomatic bone- laterally
• Palatine bone- posteriorly.

 Triangular in shape.

 Bordered laterallly by inferior

orbital fissure and medially by
maxilloethmoidal sinus.

 Overlies maxillary sinus.

 Floor Of Orbit
Clinical applications:
• Commonly involved in Blow
out fractures of the orbit.
Infra orbital vessels and
nerves almost always
involved.

• Diplopia is the main

symptoms of blow-out
fracture.

• Easily invaded by tumors of

the maxillary antrum.
Figure- Mechanism of blow-out fracture
from displacement of the globe itself into
the orbital walls. The globe is displaced
posteriorly, striking the orbital walls and
forcing them outward.
 Base Of Orbit
 The anterior open part.
 Bounded by four orbital
margins-
• Superior orbital margin
• Inferior orbital margin
• Medial orbital margin
• Lateral orbital margin.

 It gives attachment to the

septum orbitale.
 Apex Of Orbit

 Orbital apex is the posterior

end of the orbit.

 Four orbital walls converge.

 Two orifices:
• Optic Canal
• Superior orbital fissure
 Optic Canal
 It connects the orbit to the
middle cranial fossa.

 It transmits:
• Optic Nerve
• Ophthalmic artery.
 Superior Orbital Fissure
 Structure passing:
 Upper lateral part:
• Lacrimal and frontal nerves
• Trochlear nerve
• Superior ophthalmic vein
• Recurrent branch of
ophthalmic artery.
 Middle part:
• Superior and inferior divisions
of occulomotor nerve
• Nasociliary branch of
ophthalmic division of
trigeminal nerve.
• Abducent nerve.
 Lower medial part:
• Inferior ophthalmic vein.
 Superior Orbital Fissure
 Clinical applications:

• Radiographic enlargement of superior orbital fissure may

accompany pathologic processes,
 Aneurysm
 Meningioma
 Choroidoma
 Pituitary adenoma
 tumours of orbital apex.
• When idiopathic inflammation involves the superior orbital fissure,
the “Tolosa Hunt syndrome” which is painful ophthalmoplegia
results.
 Inferior orbital fissure

the inferior orbital fissure is a gap between the greater

wing of sphenoid bone, and the maxilla. It connects

the orbit (anteriorly) with the infratemporal

fossa and pterygopalatine fossa (posteriorly).

The fissure gives passage to multiple structures, including:
Infraorbital nerve, artery[ and vein inferior ophthalmic vein
Zygomatic nerve.
Orbital branches of the pharyngeal nerve[
 Periorbita
 Periorbita refers to periosteum
lining the orbitlal surface of the
bones of orbit.
 Loosely adherent to the bones.
 Fixed firmly at-
• Orbital margins
• Suture lines
• Various fissures and foramina
• Lacrimal fossa.
 Applied Anatomy-
• Surgery in the orbital roof in
the areas of fissures and
suture lines may be
complicated by cerebrospinal
fluid leakage.
 Orbital Fascia
 It is a complex interwoven thin
connective tissue membrane
joining the various intraorbital
contents.

 Parts-
• Fascia bulbi,
• Muscular sheaths,
• Intermuscular septa,
• Membranous expansions of
the extraocular muscles,
• Ligament of Lockwood.
 Contents Of The Orbit
 Eyeball
 Fascia: Orbital and bulbar.
 Muscles: Extraocular.
 Vessels:
• Ophthalmic artery
• Superior and inferior ophthalmic
vein
• Lymphatics.
 Nerves: Optic,Oculomotor,
Trochlear, Abducent, Branches of
ophthalmic nerves and
sympathetic nerves.
 Ciliary ganglion
 Lacrimal gland and lacrimal sac
 Orbital fat.