Anatomy

Human Eye Anatomy
Basic Human Anatomy

CPU-College of Medicine
1st Year, Second Semester
Jeffrey J. Gumban, EyeMD
Part I Embyology & Ocular Ad

nexae
Course Outline
Part I
Part II
Part III
Part IV
Embryology & Ocular Adnexae

Conjunctiva, Sclera & Cornea
Lens, Ciliary Body & Vitreous
Retina, Optic Nerves & Pathways

nexae
Embryology

nexae
Orbital Anatomy
7 bones
30 cc (35 mm width x 40
mm height)
25-30 mm orbital optic
nerve
Rim
Zygomatic
Maxillary
Frontal
Floor (3 bones)
Zygomatic, maxillary and
palatine
Medial wall (4 bones)

Sphenoid, lacrimal, ethmoid,
maxillary
Roof ( 2 bones)
Frontal, sphenoid
Lateral wall (2 bones)

Zygomatic, sphenoid (greater
wing)

nexae
The Dean A . M cGee

E Y E I N S T I T UT E
Orbital Anatomy (cont.)

Inferior orbital fissure
Bound by sphenoid,
maxillary and palatine
bones
Transmits V2 which exits
skull through foramen
rotundum
Annulus of Zinn
Fibrous rings formed by
rectus muscles
Does not include IV

nexae
The Dean A . M cGee

Orbital Anatomy (cont.)

Optic foramen
Superior orbital fissure
8-10 mm
Located within lesser wing
of sphenoid
Transmits optic nerve,
ophthalmic a. and
sympathetic nerves
Bound by greater and

lesser sphenoid wings
Outside annulus (luscious
French tarts)
lacrimal, frontal, IV
Inside annulus (sit naked

in anticipation)
III-sup, nasociliary III-inf, VI

nexae
The Dean A . M cGee

Superficial Eyelid Landmarks

Eyebrow
Peaks at 9:00 limbus
1 cm above orbital rim in youth
Flatter in males, more flared in females
Palbebral Fissure
Horizontal
Vertical
28-30 mm
9-11 mm

nexae

Upper Eyelid Margin
Peaks slightly nasal to the pupil
upper limbus in youth
1.5 - 2.0 mm below in adult
Lower Eyelid Margin

inferior limbus
Margin above superior limbus or below inferior limbus

termed retraction or scleral show

nexae

Lateral commissure
5 mm nasal to lateral rim
2 mm above medial in males
4 mm above medial in females
Medial commissure

nexae

Upper Eyelid Crease
7 - 8 mm above the margin in males
9 - 10 mm above the margin in females
Lower Eyelid Crease

poorly defined
5 mm below the margin

nexae
Eyelid Anatomy
Divided into anterior
and posterior lamella
Anterior Lamella
Skin
Orbicularis
Posterior Lamella
Conjunctiva
Tarsus
nexae
Eyelid Anatomy (cont.)

skin and subcutaneous tissue
orbicularis muscle and
submuscular fibroadipose tissue
orbital septum
preaponeurotic fat
retractors
tarsus and conjunctiva

nexae
Skin and Subcutaneous Fascia

Thinnest of the body (~ 1mm) - thinnest medially
Little or no subcutaneous fat
Subjected to the most movement; stretching
and relaxing

nexae
Skin and Subcutaneous Fascia

Upper eyelid crease
9-10 mm in females, 7-8 mm in males
formed by levator attachments to pretarsal skin
lower in Asians because septum joins levator at a
lower point allowing inferior fat migration
Lower eyelid crease

marks the lower edge of tarsus
slopes from 5 mm medially to 7 mm laterally
nexae
Eyelid Protractors
Orbicularis oculi - horseshoe-shaped muscle
Orbital
Preseptal
Pretarsal

nexae
Orbital Orbicularis
Voluntary
Above - inserts to the anterior supraorbital
margin medial to the supraorbital foramen;
shares a common insertion with corrugator
supercilli
Below - inserts to the anterior infraorbital margin
medial to infraorbital foramen

nexae
Preseptal Orbicularis
Involuntary
Laterally: continuous overlying lateral canthal
tendon
Medial insertion
anteriorly to medial canthal tendon
posteriorly (Jones muscle) to the lacrimal
diaphragm; upper may also insert on posterior
lacrimal crest
nexae
Pretarsal Orbicularis
Firmly attached to tarsus
Lateral - gives rise to lateral canthal tendon
Medial
Superficial heads form the medial canthal tendon which
inserts to the medial orbital margin
Deep heads (Horners muscle) insert into the lacrimal bone at
posterior lacrimal crest
Riolans muscle forms grey line

nexae
Medial Orbicularis Attachments

nexae
Orbital Septum
Orbital septum + tarsus = middle lamella of the
eyelid
Originates at the arcus marginalis
(periosteum)
Superior - fuses with the levator aponeurosis 25 mm (avg. 3.4 mm) above the superior tarsal
border
nexae
Orbital Septum
Inferior - fuses with inferior border of tarsus,
separated from capsulopalpebral fascia by
postseptal fat
Lateral - inserts anterior to lateral canthal
tendon
Medial - inserts on posterior lacrimal crest (i.e,
lacrimal sac is outside orbit)

nexae
Orbital Fat Pads

Upper Eyelid
preaponeurotic
nasal - whiter shade
Lower Eyelid
nasal - whiter shade
central
temporal

nexae
Eyelid Retractors

nexae
Retractors of Upper Eyelid

Levator palpebrae superioris
Originates at orbital apex
Horizontal (40 mm) and vertical (15-20 mm)
components
Changes from horizontal to vertical at Whitnalls
ligament
Vertical component has two layers
levator aponeurosis
superior tarsal muscle (Mullers)
nexae

Levator Aponeurosis
forms lateral and medial horns - attach to respective
retinaculae
attaches into the pretarsal muscle and skin and
anterior lower 1/3 of anterior tarsal surface

nexae

Superior Tarsal Muscle (Mullers)
innervated by cervical sympathetic system
inserts at superior tarsal border
medially attaches to the medial horn
Horners syndrome is due to Mullers muscle
paralysis

nexae

nexae
Retractors of Lower Eyelid

capsulopalpebral head given off by inferior
rectus
splits around inferior oblique and reunites as
Lockwoods ligament
capsulopapebral fascia projects anteriorly from
Lockwoods ligament and attaches to inferior
tarsal border

nexae
Retractors of Lower Eyelid

inferior tarsal muscle (mullers) terminates 2.5
mm beneath inferior tarsal border

nexae
Tarsus
Dense irregular connective tissue - not collagen
Meibomian glands
orifices located posterior to lashes and grey line
30-40 upper
20-30 lower
Cilia bulbs - on top

of tarsus

nexae
Tarsus
Dense irregular connective tissue - not collagen
Meibomian glands
orifices located posterior to lashes and grey line
30-40 upper
20-30 lower
Cilia bulbs - on top

of tarsus

nexae
Lateral Whitnalls Orbital Tubercle

Lateral retinaculum
lateral horn of levator aponeurosis
lateral canthal tendon
inferior suspensory Lockwoods ligament
check ligament of lateral rectus
Whitnalls ligament inserts 10 mm superior to

lateral orbital tubercle (NOT on Whitnalls
tubercle)
nexae
Posterior Lacrimal Crest

Medial ocular retinaculum
inferior transverse Lockwoods ligament
medial rectus check ligament
deep heads of pretarsal muscle
medial horn of levator aponeurosis
orbital septum

nexae
Vascular Supply

nexae
Lymphatic Drainage

nexae
Sensory Nerve Supply

nexae
Sensory Nerve Supply

nexae
Basic Secretors
Basic secretors
decreases with age
no efferent innervation

nexae
The Dean A . M cGee

Mucin Secretors
Goblet Cells
throughout the conjunctiva,
denser nasally
Crypts of Henle
upper 1/3 of upper tarsus
lower 1/3 of lower tarsus
Glands of Manz
circumcorneal ring of the limbal
conj.
nexae
The Dean A . M cGee

Aqueous Secretors
Glands of Krause
fornix - subconjunctival
40 in upper, 6-8 in lower
Glands of Wolfring
upper and lower border of tarsus
2-5 in upper, 2 in lower

nexae
The Dean A . M cGee

Oil Secretors
Meibomian glands
in the tarsal plates
25-40 in upper, 20 in lower
Zeis
follicles of eyelashes
Moll
root of eyelashes

nexae
The Dean A . M cGee

Basic Secretors - Re-cap

nexae
The Dean A . M cGee

Reflex Secretors
Lacrimal gland - main (orbital) and palpebral
lacrimal glands
exocrine glands
efferent parasympathetic innervation
hypersecretion

nexae
The Dean A . M cGee

Main (Orbital) Lacrimal Gland

20mm x 12mm x 15mm
.78 gm
4 ligaments firmly hold gland in place
Sommerings ligament - periosteum from roof
Posterior - inferior ligament of Schwalbe
Superior transverse Whitnalls ligament
Lateral horn of levator aponeurosis
nexae
The Dean A . M cGee

Main (Orbital) Lacrimal Gland

Lacrimal foramen
2 to 6 excretory ducts - pierce conjunctiva 5 mm
above lateral margin of the tarsus

nexae
Palpebral Lacrimal Gland

About 30 loosely knit lobules each with a
secretory duct that empties into a main
excretory duct
Upper lobules present at lacrimal foramen
Can be prolapsed into view
May have 1 to 2 main excretory ducts

nexae
The Dean A . M cGee

Reflex Secretors
Fifth cranial nerve is the reflex, afferent pathway
for the main and palpebral lacrimal glands
Other areas that may initiate a response
- retina
- thalamus
- frontal cortex
- hypothalamus
- basal ganglia
- cervical sympathetic ganglia
nexae
The Dean A . M cGee

Reflex Secretors
VII nerve - parasympathetic/efferent pathway
Arise in pons
Fibers join sensory route of VII
Pass through facial nucleus
Synapse in sphenopalatine ganglion
Post-ganglionic fibers incorporated in zygomatic
nerve (V2)
Fibers join lacrimal nerve (V1)
nexae
The Dean A . M cGee

Reflex Secretors
VII nerve - parasympathetic/efferent pathway

nexae
The Dean A . M cGee

Reflex Secretors
Sympathetic - efferent pathway
Fibers arise in the hypothalamus
Pass to superior cervical ganglion
Post-ganglionic fibers : 3 routes
Sphenopalatine ganglion and zygomatic nerve
Accompany the lacrimal artery
Within the lacrimal nerve

nexae
The Dean A . M cGee

Distributional System
Eyelids
distribute tears
regulate evaporation
expel superfluous tears
assist in the formation of the precorneal tear film

nexae
The Dean A . M cGee

Excretory System
Upper and lower canaliculi

Lacrimal sac
Nasolacrimal duct
Palpebral parts of the orbicularis oculi
Approx. 35 mm in length

nexae
The Dean A . M cGee

Canaliculi
Canaliculi - 10 mm in length, 2 mm vertical and
8 mm horizontal
Diameter - punctum 0.3 mm
- ampulla 2 to 3 mm
- canaliculi 0.5 mm
Lined by stratified squamous epithelium,
surrounded by dense connective tissue
nexae
The Dean A . M cGee

Canaliculi
90% have common
canaliculus - enters
posterior and superior
Dilation of common
canaliculus is the sinus of
Maier
Valve of Rosenmuller at
distal end of common
canaliculus
nexae
The Dean A . M cGee

Lacrimal Sac and Nasolacrimal

Duct
Lined double layered
columnar epithelium
Single structure ~ 35 mm in
length
Canaliculi 8-10 mm
Fundus - 4 mm
Body - 8 mm
Duct - 12 mm
nexae
The Dean A . M cGee

Nasolacrimal Duct
Meatal NLD - 5 mm: guarded
by Hasners valve
Angled slightly lateral and
posterior
Opens into the inferior meatus
Distance from the entrance of
nose to duct is 35 mm (less in
infants)
nexae
Lacrimal Diaphragm
Extension of orbital
periosteum
sac within a sac
Inferior and superior

preseptal muscles insert
into it
Thinnest at lower end of
anterior lacrimal crest
nexae
Lacrimal Pump (cont.)

nexae
The Dean A . M cGee


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Human Eye Anatomy

Basic Human Anatomy

Jeffrey J. Gumban, EyeMD

Part I Embyology & Ocular Ad

Embryology & Ocular Adnexae

Part I Embyology & Ocular Ad

Part I Embyology & Ocular Ad

Medial wall (4 bones)

Lateral wall (2 bones)

Part I Embyology & Ocular Ad

The Dean A . M cGee

Orbital Anatomy (cont.)

Part I Embyology & Ocular Ad

The Dean A . M cGee

Orbital Anatomy (cont.)

Superior orbital fissure

Bound by greater and

Inside annulus (sit naked

Part I Embyology & Ocular Ad

The Dean A . M cGee

Superficial Eyelid Landmarks

Part I Embyology & Ocular Ad

Superficial Eyelid Landmarks

Lower Eyelid Margin

Margin above superior limbus or below inferior limbus

Part I Embyology & Ocular Ad

Superficial Eyelid Landmarks

Part I Embyology & Ocular Ad

Superficial Eyelid Landmarks

Lower Eyelid Crease

Part I Embyology & Ocular Ad

Eyelid Anatomy (cont.)

Part I Embyology & Ocular Ad

Skin and Subcutaneous Fascia

Part I Embyology & Ocular Ad

Skin and Subcutaneous Fascia

Lower eyelid crease

Part I Embyology & Ocular Ad

Part I Embyology & Ocular Ad

Part I Embyology & Ocular Ad

Medial Orbicularis Attachments

Part I Embyology & Ocular Ad

Part I Embyology & Ocular Ad

Orbital Fat Pads

Part I Embyology & Ocular Ad

Part I Embyology & Ocular Ad

Retractors of Upper Eyelid

Retractors of Upper Eyelid

Part I Embyology & Ocular Ad

Retractors of Upper Eyelid

Part I Embyology & Ocular Ad

Retractors of Upper Eyelid

Part I Embyology & Ocular Ad

Retractors of Lower Eyelid

Part I Embyology & Ocular Ad

Retractors of Lower Eyelid

Part I Embyology & Ocular Ad

Cilia bulbs - on top

Part I Embyology & Ocular Ad

Cilia bulbs - on top

Part I Embyology & Ocular Ad

Lateral Whitnalls Orbital Tubercle

Whitnalls ligament inserts 10 mm superior to

Posterior Lacrimal Crest