Anatomy of the Orbit

Prof. Dr. M. ASHRAF EL-DESOUKY

TANTA UNIVERSITY
 Orbit
◆ The eyes lie in 2 bony cavities on
either side of the root of the nose,
the orbits.
◆ The general shape of the orbit
resembles a pear, with the optic
nerve its stalk.
◆ It is formed of seven bones;
frontal,sphenoid, maxilla, lacrimal, ethmoid,zygoma, palatine.
 Orbit
◆A quadrangular prominent bony
margin. The base of the pyramid
◆ The apex is formed of the optic
N. foramen + Superior orbital F
Adult Orbital Dimensions
◆ Horizontal entrance width 40 mm
◆ Vertical entrance height 35 mm
◆ Volume 30 cc
◆ Orbital depth (measured from rim to the
optic foramen 40 mm
◆ Distance from back of globe to optic
foramen 18 mm
◆ Orbital segment of optic nerve 24 mm
Orbital opennings
1. The optic canal:
 opt. N.
2. Superior orbital fissure:
 ocular motor nerves III,IV, VI& sensory
(trigeminal N), ophthalmic A&V.

3. The inferior orbital fissure

4. The ethmoidal foramina.
Superior orbital fissure
◆ makes boundary between lateral orbital wall and
roof.
◆ a. Posteriorly communicates with cavernous
sinus and middle cranial fossa.
◆ b. Transmits:
◆ (1) Oculomotor n. (CN III)
◆ (2) Trochlear n. (CN IV)
◆ (3) Abducens n. (CN VI)
◆ (4) Terminal branches of ophthalmic n.
◆ (5) Superior ophthalmic vein.
The optic foramen
◆ The optic foramen contains optic n. and
ophthalmic artery.
◆ Together with the SOF they form the
orbital apex.
Orbital soft tissues
◆ Globe, optic nerve & meninges
◆ Adnexa;lacrimal sac, lac. Gland, EOM
◆ orbital fascia: periorbita, orbital septum,
Tennon’s capsule,(facia bulbi)
◆ orbital fat ( supports the orbital contents)
◆ orbital nerves; ocular motor nerves III,IV, VI&
sensory (trigeminal N),
◆ orbital vessels. ophthalmic A&V.
ORBITAL relations.

1. Frontal lobe of the brain Roof

2. Cavernous sinus orbital apex
3. Paranasal sinuses
◆ The paranasal sinuse are very small at birth
and they increase in size through
adolescence.

◆ They lie adjacent to the floor, medial wall

and anterior portion of the orbital roof.
Orbital walls.
◆ Roof: 2 bones; frontal,sphenoid.
Lac. Gland fossa
◆ Medial wall: 4bones; maxilla, lacrimal, ethmoid,sphenoid.
Lac.sac
the 2 medial walls are parallel
◆ Lateral wall: 2bons; zygomatic, sphenoid.
◆ the 2 lateral walls are at right angle
◆ the only wall not related to nasal sinuses
◆ Floor: 3bones; zygomatic, maxilla, palatine
◆ The medial wall and orbital floor are the
weakest portions of the orbit. (fracture
sites)
◆ The medial orbital wall is the thinnest of all
orbital walls particularly in children
(transmitting infections)
Visual system : Eye & optic N
Ocular motility system : EOM
Policeman of the orbit: orbital Fat
Vessels and nerves
Adnexa
Impaired ocular movements
Axial proptosis
Non axial (excentric) proptosis
False & true
False & true
False & true
Unilateral & bilateral
Adult & child
Enophthalmos
◆ An important sign which is usually
overlooked or misdiagnosed as
contralateral proptosis.
◆ There are three mechanisms that may
work singly or in combination;
Enophthalmos
I. Structural abnormalities:
◆ post-traumatic blow out fracture
◆ congenital orbital bony defects; absent
greater wing of sphenoid in
nurofibromatosis or maxillary
hypoplasia.
absent lateral orbital wall
Enophthalmos
II. atrophy of orbital conntents:
◆ postirradiation for malignancy
◆ Senile or cachexia
3 weeks
One year after treatment
2 years after treatment
Post radiation
Enophthalmos
III. Traction:
◆ cicatrizing metastatic carcinoma most
frequently from breast.
◆ Postinflammatory cicatrization of EOM
as in sclerosing orbital inflammations
(pseudotumors syndrome).
◆ Post-surgical shortening of EOM
following excessive resection.