A short review about the anatomy, clinical anatomy and parts of eye lids.

1. EYE LIDS

2. EYE LIDS
Covered anteriorly by skin and posteriorly by mucous membrane-the tarsal
conjunctiva
Contains muscles ,blood vessels ,nerves and glands all bound together by
connective tissue
The binding connective tissue is thicker particularly dense at the posterior
part where it forms a stiff plate –tarsus
Peculiarities -thinness of skin
absence of fat in its corium
loose attachment

3. STRUCTURE
Skin
Subcutaneous areolar tissue
Layer of striated muscle
Submuscular areolar tissue
Fibrous tissue ( tarsal plate and septum orbitale )
Layer of unstriped muscle fibres
Conjuctiva

6. CILIA OR EYE LASHES
The eyelids are covered by downy hairs provided with small
sebaceous glands and sweat glands
At margins these structures are specialised
Called eyelashes
Cilia are strong ,short curved hair arranged in two or more closely
set rows

7. ZEIS GLANDS
The sebaceous follicles ,like the cilia themselves ,are
specially differentiated at the margins called as zeis glands
Apart from being large they are identical to the other
sebaceous glands

8. MOLL GLANDS
They are the specially differentiated sweat glands near
the edge of the lids
They are situated immediately behind the hair follicles
and their ducts open into the ducts of zeis glands or hair
follicles not directly onto the surface of skin as elsewhere

9. INTER MARGINAL STRIP
Covered with stratified squamous epithelium
Forms a transition between skin and conjunctiva
Rounded anterior border
Sharp posterior border in contact with globe

10. MEIBOMIAN GLANDS
Also known as tarsal glands
Nearly straight tubes ,directed vertically,each opening by a single
duct on the margin of the lid
Immediately anterior to the posterior border of the inter marginal
strip ,the ducts of the Meibomian glands form a single row ,visible
to the naked eye
20 -30 glands in each lid

11. MUSCLES
Orbicularis palpebrarum
occupies space between tarsus and skin
Levator palpebrae superioris
Central band inserted into upper border of tarsus
Anterior slip passes between bundles of orbicularis to be inserted into
skin of middle of lid
Posterior slip inserted into conjunctiva at fornix
laterally attached to medial and lateral palpebral ligaments

12. Inferior rectus and oblique muscles
Sends fibrous strands forwards into lower lid and attached
to tarsus and palpebral ligament
Whitnall ligament
Capsulopalpebral facsia
Originates from inferioir rectus and inserted by an
aponeurosis to inferior tarsal border
Muller muscle
unstriped muscles seen in eyelids

14. BLOOD SUPPLY
Arteries of the lids (medial and lateral palpebral) form marginal arterial arcades which lie
in the submuscular plane in front of the tarsal plate, 2 mm away from the lid margin, in
the upper lid and about4 mm away in the lower lid.
In the upper lid another arcade (superior arterial arcade) is formed which lies near the
upper border of the tarsal plate.
Branches go forward and backward from these arches to supply various structures.
Veins. Arranged in two plexuses:
a posttarsal which drains into ophthalmic veins
a pretarsal opening into subcutaneous veins.

15. Lymphatics
To Submandibular nodes from the medial third of upper eyelid and two
thirds of lower eyelid
To the pre auricular nodes from the lateral two thirds of upper eyelids and
one third of lower lid
Nerve supply
Trigeminal nerve – sensory ( upper lid- ophthalmic division and lower lid –
maxillary division )
Sympathetic nerves –muller muscle
Oculomotor nerve – levator palpebrae
Facial nerve –orbicularis oculi

16. CLINICAL ANATOMY
Oedema of the lids –inflammatory or passive
Inflammation of the lids – blepharitis
Inflmmmation of the glands
hordeolum externum or stye – suppurative inflammation of zeis gland
hordeolum internum- suppurative inflammation of Meibomian glands
chalazion – chronic inflammatory granuloma of Meibomian gland
Anomalies in the position of the lashes and lids
blepharospasm, trichiasis, ptosis , lagophthalmos
symblepharon,ectropion