Anatomy of Eyelid

1. Anatomy of the Eyelid
dr. Frenky R. de Jesus
National Eye Centre
Postgraduate diploma in Ophthalmology

2. Anatomy of the eyelid
Introduction
• Is a mobile, flexible, multilamellar structure that covers globe anteriorly.
• Assist in distribution of tears over the anterior surface of the eyeball.
• Provide protection from excessive light, desiccation and air borne foreign
matter.

3. Anatomy of the eyelid
Embryology
Eyelid development
(A) Eyelid fusion (8 to 10 weeks' gestation)
(B) Development of margin structures (3 to 4 months' gestation); eyelid dysjunction
(5 to 6 months gestation).

4. Anatomy of the eyelid
Anatomy
• From eyebrow downward to end in a free
margin
• Superior boundary of palpebral fissure.
EXTENTION
• Orbital & tarsal portion
• Formed by fibrous slips, from tendon of
levator
Upper eyelid
Lower eyelid
Superior Lid folds
Inferior Lid folds
• Merge into skin of cheek, where
nasojugal, malar sulci limit it.
• On skin of lower eyelids
• Fibrous slips from fascia of inferior rectus
LIDSFOLDS

5. Anatomy of the eyelid
Position of eyelid
In primary position of gaze
• Upper eyelid covers 1/6
th
of cornea
• Lower eyelid just touches the cornea
Anatomy
Eyelids meet at medial and lateral canthi
Canthi
Lateral canthus
Medial canthus
• 5-7 mm from the lateral orbital margin
• 1 cm from frontozygomatic suture.
• 60 degrees with eyes wide open.
• 30-40 degrees with eyes open in normal way.
• Rounded, more obtuse.
• Has a horizontal lower rim, superiorly sloping, inferomedially continues to a ridge produce by
medial palpebral ligaments.

6. Anatomy of the eyelid
• The two eyelids are separated by lacus lacrimalis, in the centre of which is a
small pinkish elevation;
• The caruncula lacrimalis. It is a small area of tissue derieved from skin,
contains large modified sweat glands and sebaceous glands.
• A semilunar fold called plica semilunaris lies on lateral side of caruncle.
Represents the third eye lid of other vertebrae.
Anatomy

7. Anatomy of the eyelid
• 2 mm in width.
• Lacrimal punctum.
• Divided into 2:
Anatomy
Eyelid margin
• Grey Line - junction of skin and
conjunctiva.
• Lid vascularity increases with
age, particularly in women.
✴ Lacrimal portion - punctum to medial canthus.
✴ Ciliary portion; rounded anterior, sharp posterior, inter-
marginal strip.

8. Anatomy of the eyelid
• Eyelashes
• 2-3 rows
• When lids close eyelashes do not interlace
• Upper lid : 100-150
Lower lid : 50-75
• Cilia
Anatomy
Eyelashes
✴ 20 – 120 microns
✴ Taper & end in fine point
✴ Lifespan 5 months.
✴ Replacement is fully grown in 10 wks.
• Glands of Zeis & Moll-empty into infundibulum of each piliary gland
Ciliary follicles
Cilia have no erector muscles set obliquely, anterior to palpebral muscle reach
the tarsal plate, have a sensory innervation.

9. Anatomy of the eyelid
• Elliptical space between upper & lower lid margins
• At Birth
✴ Horizontally: 18 to 21 mm
✴ Vertically: 8mm
Anatomy
Palpebral aperture
• In Adults
✴ Horizontally: 28 to 30mm
✴ Vertically: 9 to 11mm

10. Anatomy of the eyelid
1. Skin
2. Subcutaneous Areolar Tissue
3. Layers of Striated Muscles
4. Submuscular Areolar Tissue
5. Fibrous Layer
6. Non Striated Muscles Fibres
7. Conjunctiva
Layers of the Eyelid

11. Anatomy of the eyelid
• Palpebral skin is thinnest in body (<1 mm)
• Elastic & folds easily contributing to speed of
mobility of upper eyelid
• Nasal skin:
✴ Smoother and more oily
✴ Few rudimentary hairs
1. Skin
Layers of the Eyelid
• Lateral skin:
✴ Numerous sweat gland
•Epidermis
✴ Consists of 6-7 layers of stratified squamous epithelium
✴ Unicellular sebaceous glands & sweat glands
•Dermis
✴ Dense connective tissue
✴ Rich network of elastic fibers, blood vessels, lymphatics & nerves.
✴ Many unicellular sebaceous glands (hence Xanthelasma
develops on the nasal side)

12. Anatomy of the eyelid
• Loose connective tissue arrangement
• No fat
• Applied anatomy:
✴ Fluid from oedema or haemorrhage rapidly engorges into the loose
subcutaneous eyelid tissue & produce swelling of eyelids
2. Subcutaneous Areolar Tissue
Layers of the Eyelid
3. Layers of Striated Muscles
Consists of:
✴ Orbicularis oculi (forms thin oval sheet
over eyelid)
• Complex striated muscle sheet
• Divided anatomically into;
✴ Orbital
✴ Palpebral (Pretarsal & Preseptal)
✴ Upper eyelid also contains Levator
palpebral superioris.

13. Anatomy of the eyelid
Layers of the Eyelid
Horner’s Muscle:
• Prominent bundle of fibers, formed by fusion of the
deep heads of the pretarsal orbicularis
• Runs just behind the posterior limb of the canthal
tendon.
• Insertion – posterior lacrimal crest
• Functions:
✴ Helps to maintain the posterior position of the
canthal angle
✴ Tightens the eyelids against the globe during
eyelid closure
✴ Aids in the lacrimal pump mechanism
Muscle of Riolan
• Small bundle of striated muscle fibers at the eyelid
margin
• Extension of pretarsal portion of orbicularis oculi
fibers
Function:
• Keep the lids in close apposition to the globe

14. Anatomy of the eyelid
Upper lid
✴ Levator palpabrae superioris
✴ Muller’s muscle
Layers of the Eyelid
Eyelid retractor
• Major eyelid retractor
• Origin:
✴ At the apex of orbit from the under Surface of lesser wing of the sphenoid
above annulus of zinn
• Course and attachment:
✴ Passes forward below the roof of the orbit, above the superior rectus
✴ At septum orbital, it fans out into white tendon called aponeurosis of LPS
and forms medial and lateral horns.
✴ Levator Palpebral Superioris
Lower lid
✴ Capsulopalpebral fascia

15. Anatomy of the eyelid
• Sympathetic accessory retractor of upper eyelid
• Modulates the position of the upper and lower eyelid when the eye is open
• Origin – From under surface of the LPS
• Insertion – orbital margin of the tarsal plateMuller’s muscle

16. Anatomy of the eyelid
✴ Capsulopalpebral Fascia
• Fibrous sheet in the lower eyelid, that arises from the Lockwood’s ligament
• Fuses with fibers of the orbital septum, forms a common fascial sheet & inserts
onto the lower border of the tarsal plate

17. Anatomy of the eyelid
• Present between orbicularis muscle & fibrous layer
• Superiorly communicates with the subaponeurotic stratum of the scalp
• This plane can be entered by incision at the grayline
• The nerves & vessels of the eyelids also lie in this layer, and so to anaesthetise the lid,
injection is made in this plane.
4. Submuscular Areolar Tissue
5. Fibrous layer
• Framework of lid
• Consists of:
✴ Central thick part Tarsal Plate
✴ Peripheral thin part of the Septum Orbital
6. Non Striated MusclesFibres
• Consists of smooth muscles fibres of Muller’s muscles which lie just deep to septum
orbitale in upper & lower lid
• Origin:
✴ From the inferior terminal striated fibres of LPS in Upper Eye Lid & expansion of inferior
rectus in the Lower Eye Lid
✴ Runs vertically & gets inserted in the orbital margin of the tarsal plate
• Supplied by sympathetic nerves

18. Anatomy of the eyelid
• Tarsal/Meibomian Glands
• Gland of Zeis
• Gland of Moll
Glands of the Eyelid
a) Tarsal/Meibomian Glands
• Modified sebaceous gland
• Present on the posterior part of stroma of tarsal plate
• 30 - 40 no. in upper eyelid & 20-30 no. in lower eyelid
• Oily secretion
• Functions:
✴ Forms hydrophobic barrier at the margin of the eyelid, preventing
spillage of tears at the lid margin
✴ Forms oily layer of tear film over cornea &bulbar conjunctiva
Retards evaporation of tears.

19. Anatomy of the eyelid
b) Glands of Zeis
• Modified sebaceous glands
• Attached to eyelash follicles (usually two glands with each cilium)
• Sebum secretion
• Functions: Prevents eyelashes from being dry & brittle
c) Glands of Moll
• Modified sweat gland
• Lies between cilia
• Numerous in lower lid than upper lid

20. Anatomy of the eyelid

21. Anatomy of the eyelid
• Act to protect the anterior surface of the globe from local injury.
• Aid in regulation of light reaching the eye.
• Tear film maintenance by distributing the protective optically
important tear film over the cornea during blinking.
• Tear flow by their pumping action on the conjunctival sac and
lacrimal sac.
Functions of the Eyelid

22. Anatomy of the eyelid
Motor Nerve Supply:
• Motor nerves to the orbicularis oculi muscle - facial nerve (temporal &
zygomatic branches)
• Motor nerve to the levator palpebrae superioris - superior division of
oculomotor nerve
• Motor nerve to the Müller muscle - sympathetic nervous system.
Nerve supply of the Eyelid
Sensory Nerve Supply: ophthalmic & maxillary divisions of the trigeminal nerve
• Upper eyelid - supraorbital, supratrochlear & lacrimal nerves (ophthalmic division)
• Lateral portion of upper eyelid & zygomaticotemporal - branch of the maxillary
nerve.
• Extreme Medial portion of both upper & lower eyelid - infratrochlear nerve.
• Lower eyelid - infraorbital nerve (maxillary division)
• Lateral portion of lower eyelid - zygomaticofacial branch of the maxillary nerve

23. Anatomy of the eyelid

24. Anatomy of the eyelid
Upper eyelid
• Marginal Arcade – 2-3 mm from the eyelid margin; either between the tarsal
plate & the orbicularis or within the tarsus
• Peripheral Arcade - along the upper border of tarsal between the levator
aponeurosis & Müller muscle supplied by superior medial palpebral vessel (the
terminal ophthalmic artery and superior lateral palprebal Vessel from lacrimal
artery)
Lower eyelid:
By medial and lateral palpebral vessel
Vascular supply of the Eyelid

25. Anatomy of the eyelid
Vascular supply of the Eyelid

26. Anatomy of the eyelid

27. Anatomy of the eyelid
• Not well defined
• Can be divided into two portions: a superficial, or pretarsal system & a deep,
or posttarsal system
• Mainly into several large vessels of the facial system
Venous drainage system

28. Anatomy of the eyelid
Two systems - superficial and
deep system.
• Superficial system- drains skin
and orbicularis oculi.
• Deep system- drain tarsi and
conjunctiva.
• Upper lid, lateral 1/3 of lower
lid and lateral canthus ->
preauricular Lymph Node
and deep parotid nodes ->
deep cervical Lymph Node.
• Medial part of Upper lid,
medial 2/3 of Lower Lid and
medial canthus ->
submandibular Lymph Node
-> internal jugular vein.
Lymphatic drainage system

29. Anatomy of the eyelid
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