Anatomy of eyelid-ophthalmology MBBS. Description of anatomy of eyelid

Arshiya khan
Ug-mbbs
Anatomy of eyelid

1. Anatomy of Eyelid
Khan arshiya elyas
21M064

2. OBJECTIVES
•Introduction
•Embryology
•Gross Anatomy
•Structures
•Glands of eyelid
•Vessels and nerve supply

3. INTRODUCTION
•Eyelids are mobile tissues infront of the eyeballs . Upper + lower eyelid.
•Functions:
1. Acts as shutter protects from injuries
2.Help in spreading tear film over cornea and conjunctiva via blinking
and also helps
eliminate tears from lacrimal lake.
3. Contribute to facial features.
4.Relay info regarding state of wakefulness and attention of the person.

4. EMBRYOLOGY
•Development of the five pharyngeal arches
occurs in the first few weeks of gestation

Mesenchymal proliferation occurs cephalad to
the first brachial arch to form the facial
processes: the frontonasal, medial nasal,
lateral nasal, maxillary and mandibular
•

The upper eyelids are formed from the
frontonasal process
•

The lower eyelids are formed from the
maxillary proces

5. •The appearance of the eyelid fold marks the beginning of eyelid development
during the sixth or seventh week of gestation.
Incomplete eyelid dev -> congenital eyelid anomalies.
A.Eyelid fusion - 8 to 10 weeks
Colobomas of eyelid margin
B.Dev of eyelid structures- 3 to 4 months gestation.
Congenital ptosis
C.Eyelid dysfunction
Ankyloblepheron ,epicanthus etc.

6. GROSS ANATOMY
1.EXTENT AND POSITION : Upper eyelid extents from eyebrow to superior
boundary of palpebral fissure and covers 1/6th of cornea. Lower eyelid extends
from inf boundary of palpebral fissure to merge into cheeks.
2.PARTS OF EYELID : Orbital+tarsal part -> horizontal sulcus .Additional folds in
lower lid- nasojugal fold medially and the malar fold laterally. These folds limit the
spread of blood downward from eyelids to cheek.
3.CANTHUS: Upper+lower eyelid meet at an angle of 60degrees medially and
laterally forming Canthus.

7. •Medial canthus: separated from globe by lacus lacrimalis.
•In the center is small pinkish elevation - caruncul lacrimalis.
•Lateral to it is semilunar fold called plica semilunaris.
4.EYELID MARGINS;
2mm wide, covered by cutaneous epi ,lacrimal papillae which divides margin
into medial 1/6th and lateral 5/6th .
lacrimal part- medial to punctum rounded devoid of lashes and glands ,
lacrimal canaluculi present
Ciliary part- lateral to punctum rounded ant and sharp posterior border.

8. 5.GREY LINES : Represents the line of demarcation between the anterior
portion of the eyelid formed by the skin and orbicularis muscle (ant. lamina) and
the posterior formed by the tarsus and conjunctiva (post lamina).
Histologically corresponds to most superficial portion of orbicularis oculi,
muscle of Riolan, and to the avascular plane of lid.
Surgically Important: For splitting of eyelid with minimal scarring.
6.PALPEBRAL FISSURES/APERTURES: space between upper+lower eyelid
margin.
7.EYELID MARGINS
8.EYELASHES: 2-3 rows, life span 3-4 months . 100-150 in upper eyelid & 50-75
in lower eyelid

10. CONTENTS
1.Skin and subcutaneous tissue
2.Muscles of protraction
3.Orbital septum
4.Muscles of retraction
5.Tarsus
6.Conjunctiva

11. 1.SKIN:thinnest in body. Contains fine hair , sweat & sebaceous glands.
2.SUBCUTANEOUS TISSUE: loose CT, no fat , rich in elastic fibres .Applied
anatomy - fluid from oedema or haemorrhage rapidly engorges the loose
subcutaneous eyelid tissue
3.PROTRACTORS:
Orbicularis oculi
Striated muscle
Concentrically arranged.
Nerve sypply- facial nerve
(temporal+zygomatic branch)
Applied- lagopthalmous
Inadequate closure of lids

12. 4.ORBITAL SEPTUM:
Functions-Holds the orbital fat in position Barrier function prevent the
transmission of infection
from lids to orbital cavity and viceversa During the normal ageing process the
thining of the septum and the laxity of the orbicularis muscle causes
the anterior herniation of the orbital fat.
5.ORBITAL FAT: upper lid- 2 fat pockets
Lowerlid-3 fat pockets . Landmark of elective eyelid
Surgery and lid laceration surgery .

13. 6.MUSCLES OF RETRACTION: 
Upper lid: Levator palpebrae superioris along with Mullers muscle.

Lower lid: Capsulopalpebral fascia
Applied-

1.Disinsertion of lower lid retractors
from tarsus may lead to spastic entropion.

2.Paralysis of LPS | 3rd nerve palsy,
myasthenia]:

Ptosis
Loss of superior palpebral fold and
Horizontal furrow

14. 5.TARSAL PLATE: dense & fibrous tissues, gives shape and firmness to eyelid.
In upper eyelid- larger,crescentric, orbital muscles+LPS fibres attached.
In lower eyelid-smaller, orbital septum attached
6.CONJUNCTIVA: thin mucus membrane lining eyelids ,
composed of nonkeratanizing squamous epithelium .
contains goblet cells and accessory lacrimal glands .

15. GLANDS OF EYELID
1.TARSAL/MEIBOMIAN GLANDS: modified holocrine sebaceous glands, lies
within tarsal plate. APPLIED= a)meibomian gland dysfunction-dry eyes. b) tarsal
cyst-inflammation of gland c) internal hordeolum- secondary to (b).
2.GLANDS OF MOLL: modified sweat gland . Duct opens into ciliary follicles or
glands of Zeus.
3.GLAND OF ZEIS: modified sebaceous gland. Discharge directly into eyelash
follicles . APPLIED= external hordeolum/stye- suppurative inflamm.
4.ACCESSOR GLANDS OF WOLFRING: present along upper border of superior
tarsus and lower border of inferior tarsus.

16. ARTERIAL SUPPLY OF EYELID
•INTERNAL CAROTID ARTERY: by ophthalmic artery and its branches
(supraorbital and lacrimal)
•EXTERNAL CAROTID ARTERY: by arteries of face(angular and temporal)
•LATERAL PALPEBRAL ARTERY: branch of lacrimal artery
•MEDIAL PALPABERAL ARTERY: direct branch of ophthalmic artery.

17. VENOUS DRAINAGE OF EYELIDS
•PRESEPTAL
1. medially= angular vein ->internal jugular vein
2.laterally= superficial temporal vein->external jugular vein
•POSTSEPTAL
Orbital veins and facial veins-> pterygoid plexus

18. LYMPHATIC DRAINAGE OF EYELID
•Lower lid and medial portion drains into submandibular lymph node.
•

Upper lid and lateral portion drains into superficial preauricular lymph node

Deeper cervical nodes

19. NERVE SUPPLY OF EYELIDS
MOTOR NERVE SUPPLY: Orbicularis oculi muscle - facial nerve
(temporal & zygomatic branches)

Levator palpebrae superioris - superior division of oculomotor nerve
AUTONOMIC NERVE SUPPLY: Superior and inferior tarsal muscle -
sympathetic nerve fibers from superior cervical ganglion
SENSORY NERVE SUPPLY:

21. Thank you!