Skip to main content
SpringerLink
Log in

Clinical Anatomy of the Orbit and Periorbital Area

  • Chapter
Orbital Fractures

  • 1517 Accesses

Abstract

The orbit is a paired bony socket in the facial portion of the skull located on both sides of the nasal root. The three-dimensional reconstruction of the orbit is more likely to be shaped like a pear than like a quadrilateral pyramid losing one of its facets in the orbital apex area (as it is conventionally described in the textbooks (Fig. 1.1a).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Conjunctival injection, ocular hypertension, in some cases a deficit of abduction. CT-confirmed expansion of the superior ophthalmic vein and swelling of the extraocular muscles.

References

  1. Lemke B. N. (1987). Anatomy of ocular adnexa and orbit. In B. C. Smith (Ed.), Ophthalmic plastic and reconstructive surgery (Vols. 1 and 2, pp 3–74). St. Louis: C.V. Mosby.

    Google Scholar 

  2. Whitnall, S. E. (1932). Anatomy of the human orbit. London: Oxford University Press.

    Google Scholar 

  3. Simonton, J. T., Garber, P. F., & Ahl, N. (1977). In margins of safety in lateral orbitotomy. Archives of Ophthalmology, 95(7), 1229–1231.

    Article  CAS  PubMed  Google Scholar 

  4. Whitnall, S. E. (1911). On a tubercle on the malar bone, and on the lateral attachments of the tarsal plates. Journal of Anatomy and Physiology, 45(pt 4), 426–432.

    CAS  PubMed Central  PubMed  Google Scholar 

  5. Fink, W. H. (1948). The surgical anatomy of the superior oblique muscle. Transactions of the American Ophthalmological Society, 46, 154–184.

    CAS  PubMed Central  PubMed  Google Scholar 

  6. Helveston, E. M., Merriam, W. W., Ellis, F. D., et al. (1982). The trochlea: A study of the anatomy and physiology. Ophthalmology, 89(2), 124–133.

    Article  CAS  PubMed  Google Scholar 

  7. Jo, A., Rizen, V., Nikolic, V., & Banovic, B. (1989). The role of orbital wall morphological properties and their supporting structures in the etiology of “blow-out” fractures. Surgical and Radiologic Anatomy, 11(3), 241–248.

    Article  CAS  PubMed  Google Scholar 

  8. Song, W. K., Lew, H., Yoon, J. S., et al. (2009). Role of medial orbital wall morphologic properties in orbital blow-out fractures. Investigative Ophthalmology & Visual Science, 50(2), 495–499.

    Article  Google Scholar 

  9. Blaylock, W. K., Moore, C. A., & Linberg, J. V. (1990). Anterior ethmoid anatomy facilitates dacryocystorhinostomy. Archives of Ophthalmology, 108(12), 1774–1777. Philadelphia: Saunders.

    Google Scholar 

  10. Ploder, O., Klug, C., Voracek, M., et al. (2002). Evaluation of computer-based area and volume measurement from coronal computed tomography scans in isolated blowout fractures of the orbital floor. Journal of Oral and Maxillofacial Surgery, 60(11), 1267–1272.

    Article  PubMed  Google Scholar 

  11. Evans, B. T., & Webb, A. A. (2007). Post-traumatic orbital reconstruction: Anatomical landmarks and the concept of the deep orbit. The British Journal of Oral & Maxillofacial Surgery, 45(3), 183–189.

    Article  CAS  Google Scholar 

  12. Nguyen, P. N., & Sullivan, P. (1992). Advances in the management of orbital fractures. Clinics in Plastic Surgery, 19(1), 87–98.

    CAS  PubMed  Google Scholar 

  13. Movassaghi, K., & Janecka, I. (2005). Optic nerve decompression via mid-facial translocation approach. Annals of Plastic Surgery, 54(3), 331–335.

    CAS  PubMed  Google Scholar 

  14. Bergen, M. P. (1981). A literature review of the vascular system in the human orbit. Acta Morphologica Neerlando-Scandinavica, 19(4), 273–305.

    CAS  PubMed  Google Scholar 

  15. Bergen, M. P. (1982). Relationships between the arteries and veins and the connective tissue system in the human orbit. Acta Morphologica Neerlando-Scandinavica, 20(1), 1–15.

    CAS  PubMed  Google Scholar 

  16. Bergen, M. P. (1982). Relationships between the arteries and veins and the connective tissue system in the human orbit. Acta Morphologica Neerlando-Scandinavica, 20(1), 17–26.

    CAS  PubMed  Google Scholar 

  17. Bergen, M. P. (1982). Relationship between the arteries and veins and the connective tissue system in the human orbit. Acta Morphologica Neerlando-Scandinavica, 20(1), 27–42.

    CAS  PubMed  Google Scholar 

  18. Bergen, M. P. (1982). A spatial reconstruction of the orbital vascular pattern in relation with the connective tissue system. Acta Morphologica Neerlando-Scandinavica, 20(2), 117–137.

    CAS  PubMed  Google Scholar 

  19. Bergen, M. P. (1982). Microvessels in the human orbit in relation to the connective tissue system. Acta Morphologica Neerlando-Scandinavica, 20(2), 139–150.

    CAS  PubMed  Google Scholar 

  20. Bergen, M. P. (1982). Some histological aspects of the structure of the connective tissue system and its relationships with the blood vessels in the human orbit. Acta Morphologica Neerlando-Scandinavica, 20(4), 293–308.

    CAS  PubMed  Google Scholar 

  21. Reymond, J., Kwiatkowski, J., & Wysocki, J. (2008). Clinical anatomy of the superior orbital fissure and the orbital apex. Journal of Cranio-Maxillo-Facial Surgery, 36(6), 346–353.

    Article  PubMed  Google Scholar 

  22. Lang, J. (1975). The vascularization of the periorbita. Gegenbaurs Morphologisches Jahrbuch, 121(2), 174–191.

    CAS  PubMed  Google Scholar 

  23. Manson, P. N., Clifford, C. M., Su, C. T., et al. (1986). Mechanisms of global support and posttraumatic enophthalmos: I. The anatomy of the ligament sling and its relation to intramuscular cone orbital fat. Plastic and Reconstructive Surgery, 77(2), 193–202.

    Article  CAS  PubMed  Google Scholar 

  24. Koornneef, L. (1977). Details of the orbital connective tissue system in the adult. Acta Morphologica Neerlando-Scandinavica, 15(1), 1–34.

    CAS  PubMed  Google Scholar 

  25. Koornneef, L. (1977). New insights in the human orbital connective tissue. Result of a new anatomical approach. Archives of Ophthalmology, 95(7), 1269–1273.

    Article  CAS  PubMed  Google Scholar 

  26. Koornneef, L. (1977). The architecture of the musculo-fibrous apparatus in the human orbit. Acta Morphologica Neerlando-Scandinavica, 15(1), 35–64.

    CAS  PubMed  Google Scholar 

  27. Dutton, J. J. (1994). Atlas of clinical and surgical orbital anatomy. Philadelphia: Saunders.

    Google Scholar 

  28. Koornneef, L. (1979). Orbital septa: Anatomy and function. Ophthalmology, 86(5), 876–880.

    Article  CAS  PubMed  Google Scholar 

  29. Jordan, D. R., & Anderson, R. L. (1996) Surgical anatomy of the ocular adnexa: A clinical approach (Ophthalmology monographs: 9) (p. 134). LEO.

    Google Scholar 

  30. Hosokawa, H. (1956). A note on the fibrous apparatus surrounding the human eyeball. Okajimas Folia Anatomica Japonica, 28(1–6), 165–181.

    Article  CAS  PubMed  Google Scholar 

  31. Knize, D. M. (2002). The superficial lateral canthal tendon: Anatomic study and clinical application to lateral canthopexy. Plastic and Reconstructive Surgery, 109(3), 1149–1157.

    Article  PubMed  Google Scholar 

  32. Flowers, R. S., Nassif, J. M., Rubin, P. A., et al. (2005). A key to canthopexy: the tarsal strap. A fresh cadaveric study. Plastic and Reconstructive Surgery, 116(6), 1752–1758.

    Article  CAS  PubMed  Google Scholar 

  33. Fink, W. H. (1957). An anatomical study of the check mechanism of the vertical muscles of the eyes. American Journal of Ophthalmology, 44(6), 800–809.

    Article  CAS  PubMed  Google Scholar 

  34. Whitnall, S. E. (1911). On a ligament acting as a check to the action of the levator palpebrae superioris muscle. Journal of Anatomy and Physiology, 45(pt 2), 131–139.

    CAS  PubMed Central  PubMed  Google Scholar 

  35. Anderson, R. L., & Dixon, R. S. (1979). The role of Whitnall’s ligament in ptosis surgery. Archives of Ophthalmology, 97(4), 705–707.

    Article  CAS  PubMed  Google Scholar 

  36. Anderson, R. L., & Beard, C. (1977). The levator aponeurosis. Attachments and their clinical significance. Archives of Ophthalmology, 95(8), 1437–1441.

    Article  CAS  PubMed  Google Scholar 

  37. Collin, J. R., Beard, C., & Wood, I. (1978). Experimental and clinical data on the insertion of the levator palpebrae superioris muscle. American Journal of Ophthalmology, 85(6), 792–801.

    Article  CAS  PubMed  Google Scholar 

  38. Stasior, G. O., Lemke, B. N., Wallow, I. H., et al. (1993). Levator aponeurosis elastic fiber network. Ophthalmic Plastic and Reconstructive Surgery, 9(1), 1–10.

    Article  CAS  PubMed  Google Scholar 

  39. Hawes, M. J., & Dortzbach, R. K. (1982). The microscopic anatomy of the lower eyelid retractors. Archives of Ophthalmology, 100(8), 1313–1318.

    Article  CAS  PubMed  Google Scholar 

  40. Lockwood, C. B. (1886). The anatomy of the muscles, ligaments, and fascia of the orbit, including an account of the capsule of tenon, the check ligaments of recti, and of the suspensory ligament of the eye. Journal of Anatomy and Physiology, 20(pt 1), 1–25.

    Google Scholar 

  41. Anderson, R. L., Panje, W. R., & Gross, C. E. (1982). Optic nerve blindness following blunt forehead trauma. Ophthalmology, 89(5), 445–455.

    Article  CAS  PubMed  Google Scholar 

  42. Chang, E. L., & Bernardino, C. R. (2004). Update on orbital trauma. Current Opinion in Ophthalmology, 15(5), 411–415.

    Article  PubMed  Google Scholar 

  43. Papageorgiou, K. I., Mathew, R. G., Ghazi-Nouri, S. M., et al. (2007). Optochiasmal avulsion secondary to minor occipital trauma. Orbit, 26(1), 71–74.

    Article  CAS  PubMed  Google Scholar 

  44. Soparkar, C. N. S., & Patrinely, J. R. (2007). The eye examination in facial trauma for the plastic surgeon. Plastic and Reconstructive Surgery, 120(7 Suppl. 2), S49–S56.

    Article  Google Scholar 

  45. Castanares, S. (1951). Blepharoplasty for herniated intraorbital fat: Anatomical basis for a new approach. Plastic and Reconstructive Surgery, 8(1), 46–58.

    Article  CAS  PubMed  Google Scholar 

  46. Putterman, A. M., & Urist, M. J. (1974). Surgical anatomy of the orbital septum. Annals of Ophthalmology, 6(3), 290–294.

    CAS  PubMed  Google Scholar 

  47. Meyer, D. R., Linberg, J. V., Wobig, J. L., & McCormick, S. A. (1991). Anatomy of the orbital septum and associated eyelid connective tissues. Ophthalmic Plastic and Reconstructive Surgery, 7(2), 104–113.

    Article  CAS  PubMed  Google Scholar 

  48. Reid, R. R., Said, H. K., Yu, M., et al. (2006). Revisiting upper eyelid anatomy: Introduction of the septal extension. Plastic and Reconstructive Surgery, 117(1), 65–66.

    Article  CAS  PubMed  Google Scholar 

  49. Hayreh, S. S., & Dass, R. (1962). The ophthalmic artery: I. Origin and intracranial and intracanalicular course. British Journal of Ophthalmology, 46(2), 65–98.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  50. Hayreh, S. S., & Dass, R. (1962). The ophthalmic artery: II. Intraorbital course. British Journal of Ophthalmology, 46(3), 165–185.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  51. Hayreh, S. S. (1962). The ophthalmic artery: III. Branches. British Journal of Ophthalmology, 46(4), 212–247.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  52. Hayreh, S. S. (1963). The central artery of the retina. Its role in the blood supply of the optic nerve. British Journal of Ophthalmology, 47(11), 651–663.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  53. Hayreh, S. S. (1963). The cilio-retinal arteries. British Journal of Ophthalmology, 47(2), 71–89.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  54. Duke-Elder, S., & Wybar, K. C. (1961). The anatomy of the visual system. In S. Duke-Elder (Ed.), System of ophthalmology (pp. 551–567). New York: Kimpton.

    Google Scholar 

  55. Sherman, D. D., Gonnering, R. S., Wallow, I. H., et al. (1993). Identification of orbital lymphatics: Enzyme histochemical light microscopic and electron microscopic studies. Ophthalmic Plastic and Reconstructive Surgery, 9(3), 153–169.

    Article  CAS  PubMed  Google Scholar 

  56. Gausas, R. E., Gonnering, R. S., Lemke, B. N., et al. (1999). Identification of human orbital lymphatics. Ophthalmic Plastic and Reconstructive Surgery, 15(4), 252–259.

    Article  CAS  PubMed  Google Scholar 

  57. Cook, B. E., Lucarelli, M. J., Lemke, B. N., et al. (2002). Eyelid lymphatics I: Histochemical comparisons between the monkey and human. Ophthalmic Plastic and Reconstructive Surgery, 18(1), 18–23.

    Article  PubMed  Google Scholar 

  58. Cook, B. E., Lucarelli, M. J., Lemke, B. N., et al. (2002). Eyelid lymphatics II: A search for drainage patterns in the monkey and correlations with human lymphatics. Ophthalmic Plastic and Reconstructive Surgery, 18(1), 99–106.

    Article  PubMed  Google Scholar 

  59. Doxanas, M. T., & Anderson, R. L. (1984). Clinical orbital anatomy. Baltimore: Williams & Wilkins.

    Google Scholar 

  60. Zide, B. M., & Jelks, G. W. (1985). Surgical anatomy of the orbit. New York: Raven.

    Google Scholar 

  61. Koornneef, L. (1988). Eyelid and orbital fascial attachments and their clinical significance. Eye, 2(pt 2), 130–134.

    Article  PubMed  Google Scholar 

  62. Jones, L. T., & Wobig, J. L. (1977). The Wendell L. Hughes Lecture. Newer concepts of tear duct and eyelid anatomy and treatment. Transactions. Section on Ophthalmology. American Academy of Ophthalmology and Otolaryngology, 83(4 Pt 1), 603–616.

    Google Scholar 

Further Reading

  • Collin, J. R., Beard, C., & Wood, I. (1979). Terminal course of nerve supply to Müller’s muscle in the rhesus monkey and its clinical significance. American Journal of Ophthalmology, 87(2), 234–246.

    Article  CAS  PubMed  Google Scholar 

  • Gioia, V. M., Linberg, J. V., & McCormick, S. A. (1987). The anatomy of the lateral canthal tendon. Archives of Ophthalmology, 105(4), 529–532.

    Article  CAS  PubMed  Google Scholar 

  • Goldberg, R. A., Hannani, K., & Toga, A. W. (1992). Microanatomy of the orbital apex. Computed tomography and microcryoplaning of soft and hard tissue. Ophthalmology, 99(9), 1447–1452.

    Article  CAS  PubMed  Google Scholar 

  • Kakizaki, H., Zako, M., Nakano, T., et al. (2005). The levator aponeurosis consists of two layers that include smooth muscle. Ophthalmic Plastic and Reconstructive Surgery, 21(4), 281–284.

    PubMed  Google Scholar 

  • Kakizaki, H., Jinsong, Z., Zako, M., et al. (2006). Microscopic anatomy of Asian lower eyelids. Ophthalmic Plastic and Reconstructive Surgery, 22(6), 430–433.

    Article  PubMed  Google Scholar 

  • Lowe, J. B., Cohen, M., Hunter, D. A., et al. (2005). Analysis of the nerve branches to the orbicularis oculi muscle of the lower eyelid in fresh cadavers. Plastic and Reconstructive Surgery, 116(6), 1743–1749.

    Article  CAS  PubMed  Google Scholar 

  • Lyon, D. B., Lemke, B. N., Wallow, I. H., & Dortzbach, R. K. (1992). Sympathetic nerve anatomy in the cavernous sinus and retrobulbar orbit of the cynomolgus monkey. Ophthalmic Plastic and Reconstructive Surgery, 8(1), 1–12.

    Article  CAS  PubMed  Google Scholar 

  • Sacks, J. G. (1984). The shape of the trochlea. Archives of Ophthalmology, 102(6), 932–933.

    Article  CAS  PubMed  Google Scholar 

  • Stewart, W. B. (Ed.). (1993). Surgery of the eyelid, orbit, and lacrimal system (Vol. 3, Ophthalmology monographs: 8). LEO, San Francisco: American Academy of Ophthalmology.

    Google Scholar 

  • Tucker, S. M., & Linberg, J. V. (1994). Vascular anatomy of the eyelids. Ophthalmology, 101(6), 1118–1121.

    Article  CAS  PubMed  Google Scholar 

  • Warwick, R. (1976). Eugene Wolff’s anatomy of the eye and orbit (7th ed.). Philadelphia: WB Saunders.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Saint Petersburg State Hospital No. 2, Saint-Petersburg, Russia

    Vadim P. Nikolaenko MD, PhD

  2. Department of Otolaryngology and Ophthalmology, Medical Faculty, Saint-Petersburg State University, Saint-Petersburg, Russia

    Vadim P. Nikolaenko MD, PhD

  3. Department of Ophthalmology, I.P. Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russia

    Yury S. Astakhov

  4. City Ophthalmologic Center at Saint Petersburg State Hospital No. 2, Saint-Petersburg, Russia

    Yury S. Astakhov

  5. Department of Normal Anatomy, Kirov Military Medical Academy, Saint-Petersburg, Russia

    Ivan V. Gaivoronsky

  6. Department of Morphology, Saint-Petersburg State University, Saint-Petersburg, Russia

    Ivan V. Gaivoronsky

Authors
  1. Vadim P. Nikolaenko MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yury S. Astakhov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ivan V. Gaivoronsky
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vadim P. Nikolaenko MD, PhD .

Editor information

Editors and Affiliations

  1. Ophthalmology, Saint-Petersburg State Hospital No. 2, Saint-Petersburg, Russia

    Vadim P. Nikolaenko

  2. Ophthalmology, I.P. Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russia

    Yury S. Astakhov

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Nikolaenko, V.P., Astakhov, Y.S., Gaivoronsky, I.V. (2015). Clinical Anatomy of the Orbit and Periorbital Area. In: Nikolaenko, V., Astakhov, Y. (eds) Orbital Fractures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46208-9_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-46208-9_1

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-46207-2

  • Online ISBN: 978-3-662-46208-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation