Anatomy Of The Eyelids
Upcoming SlideShare
Loading in...5
×

Like this? Share it with your network

Share

Anatomy Of The Eyelids

  • 21,412 views
Uploaded on

With a knowledge of anatomy, diseases of eyelids cannot be dealt with. Here we submit our presentation on anatomy of eyelids which will be helpful to all ophthalmogists, and students.

With a knowledge of anatomy, diseases of eyelids cannot be dealt with. Here we submit our presentation on anatomy of eyelids which will be helpful to all ophthalmogists, and students.

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
  • VERY DIFFICULT TO DECIPHER AS ADJACENT LETTER INTERFERE WITH NEXT DOOR LETTERS - MORE AKIN TO AMBLYOPIA!
    Are you sure you want to
    Your message goes here
  • find it very helpful so thanks
    Are you sure you want to
    Your message goes here
No Downloads

Views

Total Views
21,412
On Slideshare
21,385
From Embeds
27
Number of Embeds
1

Actions

Shares
Downloads
833
Comments
2
Likes
6

Embeds 27

http://www.slideshare.net 27

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. Dr. Mrinmayee Ghatak (DOMS Final Year) Dr. Ankit Punjabi (DOMS Final Year) Dept of Ophthalmology, KIMS Hospital, Bangalore, Karnataka, INDIA Email: dr.mrin@gmail.com
  • 2.  
  • 3.
    • Extent
    • Lid folds
    • Position of eyelids
    • Canthi
    • Eyelid Margins
    • Eyelashes
    • Palpebral aperture or fissure
    Gross Anatomy
  • 4.
    • Upper eyelid
        • From eyebrow downward to end in a free margin
        • Superior boundary of palpebral fissure
    • Lower eyelid
        • Merge into skin of cheek
  • 5.
    • Superior lid fold
        • Orbital & tarsal portion
        • Formed by fibrous slips, from tendon of levator
    • Inferior lid fold
        • On skin of lower eyelids
        • Fibrous slips from fascia of inferior rectus
  • 6.
    • In primary position of gaze
        • Upper eyelid covers 1/6 th of cornea
        • Lower eyelid just touches the cornea
  • 7.  
  • 8.  
  • 9.
    • 2-3 rows
    • When lids close eyelashes do not interlace
    • Cilia
        • 20 – 120 microns
        • Taper & end in fine point
        • Lifespan 3-4 months
    • Glands of Zeis & Moll- empty into infundibulum of each piliary gland
  • 10.
    • Elliptical space b/w upper & lower lid margins
    • At Birth
        • Horizontally– 18 to 21 mm
        • Vertically -- 8mm
    • In Adults
        • 28 to 3o mm (hor)
        • 9 to 11 mm (ver)
    • Caucasians & the X- axis
    • Mongoloid & antimongoloid slant
  • 11.
    • From without inwards, each lid has following layers:
      • Skin
      • Layer of subcutaneous areolar tissue
      • Layer of striated muscles
      • Sub muscular areolar tissue
      • Fibrous layer
      • Layer of non-striated muscle fibres
      • Conjunctiva
  • 12.  
  • 13.
    • Elastic , fine texture, thinnest in the body
    • Epidermis
      • 6-7 layers , stratified squamous epithhelium
      • Basal layer- unicellular sebaceous glands, sweat glands
    • Dermis
      • Thin layer , dense connective tissue
      • Rich network : BV, elastic fibers, lymphatics, nerve
      • Variable no. of melanocytes
  • 14.
    • Beneath the skin
    • No fat
    • Readily distended by blood/ oedema
    • Nonexistent
      • Near ciliary margin
      • At lid folds
      • Medial & lateral angles
  • 15.
    • Orbicularis muscle , thin oval sheet across eyelids
    • Upper eyelid- also has levator muscle
  • 16.  
  • 17.
    • From anterior part of the medial palpebral ligament & adjacent bones
    • Cover orbital margins , large ellipse , meet at lateral palpebral raphe
    • Intermingle with frontalis
    • MUSCULUS SUPERCILIARIS
    • MUSCULUS MALARIS
  • 18.
    • Preseptal fibres
    • Pretarsal fibres
  • 19.
      • Deep head & superficial head
      • From lacrimal fascia, posterior lacrimal crest, MPL
      • Pass superiorly & inf. In front of orbital septum
      • Unite at lateral palpebral raphe
  • 20.
    • Deep head
      • From lacrimal fascia & post. Lacrimal crest
    • Superficial head
      • From medial palpebral ligament
    • Overlying upper & lower tarsus
    • Join laterally to form lateral canthal tendon
    • It is inserted over lateral orbital tubercle of WHITNALL
    • Pars lacrimalis (Horner’s muscle)
    • Pars ciliaris (muscle of Riolan)
  • 21.
    • Orbital part
      • Forced closure of eyelids
      • Thus pull eyebrows downwards
    • Palpebral part
      • Helps in gentle closure during blinking, sleep, soft voluntary closure
    • Entire muscle supplied by branches of 7 th nerve
  • 22.
    • Origin
    • Course & attachments
    • Superior transverse ligament of Whitnall
    • Nerve supply & action
  • 23.  
  • 24.
    • At apex of orbit
    • Under surface of lesser wing of sphenoid
    • Above Annulus of Zinn
    • Short tendon
    • Blended with origin of SR
  • 25.
    • Ribbon like belly
    • Axis slightly nasal
    • Medial & lateral horns
    • Aponeurosis passes through septum orbitale
    • LPS inserted – pretarsal skin of lid- sup.lid fold
    • Thickened posterior part- ant tarsal surface
    • Few fibrous slips – post.LPS- sup.conj. Fornix
    • Check lig. Of LPS
  • 26.
    • Thickened band of orbital fascia
    • From trochlear pulley to the capsule of orbital lobe of lacrimal gland
    • How is it formed??
    • Importance in ptosis surgery…
  • 27.
    • Branch of superior division of 3 rd nerve
    • Elevator of upper lid
  • 28.
    • Layer of loose connective tissue
    • b/w orbicularis muscle & fibrous layer
    • Nerves & vessels lie in this layer
    • Splits lid into anterior & posterior lamina
    • Superiorly communicates with subaponeurotic layer of scalp
  • 29.  
  • 30.
    • Framework of the lids
    • Central thick part- tarsal plate
    • Peripheral thin part- septum orbitale / palpebral fascia
  • 31.  
  • 32.
    • Dense fibrous tissue, skeleton of lids
    • 29mm long, 1mm thick
    • Dimensions of upper & lower tarsus
    • Borders – septum orbitale, muller’s muscle
    • Surfaces
    • Extremities
    • Tarsal glands embedded in substance of tarsal plates
  • 33.  
  • 34.
    • Thin , floating membrane of connective tissue
    • Takes part in all movements of lids
  • 35.  
  • 36.
    • Lacrimal vessels & nerves
    • Supraorbital vessels & nerves
    • Supratrochlear artery & nerve
    • Infratrochlear nerve
    • Anastomosing vein b/w angular & ophthalmic
    • Superior & inferior palpebral arteries
    • Aponeurosis of levator muscle in upperlid
    • Expansion of inferior rectus in lower lid
  • 37.
    • Triangular band of connective tissue
    • Attached to frontal process of maxilla
    • From ant. Lacrimal crest
    • To suture line of frontal process with nasal bone
    • Divided into 2 parts
      • Ant. part of MPL
      • Post. part of MPL
  • 38.  
  • 39.
    • Thin band
    • Lateral- whitnall’s tubercle
    • Anterior surface- lat.palpebral raphe
    • Posterior surface- check ligament of LR
    • Upper border- aponeurosis of levator muscle
    • Lower border- IO ,IR
  • 40.  
  • 41.  
  • 42.  
  • 43.  
  • 44.  
  • 45.
    • Modified sebaceous glands
    • Structure
    • Microscopy
        • epithelium on basement membrane
        • Cuboidal cells actively dividing
    • Secretion
        • Sebum, prevents lashes becoming dry
        • Oily layer of tear film
  • 46.
    • Modified sweat gland
    • Gross structure
        • Unbranched spiral shape
        • Fundus, body, ampullary portion & neck
    • Microscopic structure
        • Secretory part- cylindrical cell
        • b/w cells & bm – myoepithelial cells
        • Ducts lined by one/two layers of cells
  • 47.  
  • 48.
    • Mainly by medial & lateral palpebral arteries
    • Marginal Arterial arcades
        • Medial palpebral + lateral palpebral
    • Superior or peripheral arterial arcade
        • Superior branches of medial palpebral artery
    • Tarsal arcades
        • Superficial temporal artery
        • Transverse facial artery
        • Infraorbital artery
  • 49.  
  • 50.
    • Pretarsal Venous Plexus
        • Superficial to the tarsus
        • Angular vein – Internal jugular vein , sup. temporal, lacrimal vein
        • External jugular vein
    • Post-tarsal venous plexus
        • Structures posterior to tarsal plate
        • Ophthalmic veins
  • 51.  
  • 52.
    • Sympathetic nerves
        • Supply Muller’s muscle
        • Vessels & glands of skin
    • Arrangement of Nerves
        • Submuscular plane
        • Forward branches for orbicularis & skin
        • Backward to tarsal structures & conjunctiva