EYELIDS: REVIEW OF CLINICAL
ANATOMY AND PHYSIOLOGY
05.09.2014
Ayesha S. Abdullah
Learning outcomes


Correlate the structure of the eyelids with their functions
Identify the anatomical landmarks and histological
structures on photographs and microphotographs of the
eyelids.
Important superficial anatomical
landmarks
Upper lid crease
Palpebral fissure height
(max)
Lid margin
Palpebral fissure length (max)
Anatomy
Mobile tissue curtains placed in front of the eyeballs
 1. Cutaneous layer
Delicate, elastic with fine downy hair
Loose areolar layer beneath it
Gross oedema
 2. Muscular layer
i.
Orbicularis oculi
ii. Levator palpabrae superioris
iii. Muller’s muscle
 3. Fibrous layer
i.
Septum orbitale
ii. Tarsal plate with meibomian glands.
 4. Mucous membrane

Conjunctiva
CMFM
The eyelid margin
Glands of the eyelids
1. Mebomian glands:
Modified sebaceous glands,
30-40 in upper lid, 20-30 in lower lid.
2. Glands of Zeis:
Sebaceous glands along the hair follicles of lashes
3. Glands of Moll:
Modified sweat glands, lies between the lashes, opens
directly on lid margin or into the glands of Zeis.
Blood Supply




Lacrimal and palpebral branches of ophthalmic
Facial artery
Superficial temporal artery
Infraorbital artery
Upper lid has two arterial arcades
Lower lid has one arterial arcade
Nerve Supply


Supratrochlear, supraorbital and lacrimal are branches
of ophthalmic division of V. nerve.
Infraorbital, a branch of the maxillary division of V.
nerve
Venous & Lymphatic Drainage



Ophthalmic Vein
Temporal vein
Facial vein
Outer portion drains to preauricular L.nodes.
Inner portion to submandibular nodes.
Physiology

Protective
 Reflex
blinking—protects from air-born particles and intense
light.





Optical—spreads tear, oily layer
Supportive– stabilizes globe
Lacrimal- pump mechanism in drainage of tears down
the canaliculi
Cosmetic
Facial Expressions
Opening movements

LPS muscle – primary elevator

Fronatalis muscle – Accessory elevator

Muller’s muscle

Lower lid retractors
Closing movements

Orbicularis muscle – 3 diff functional units

Spontaneous blinking & tactile corneal reflex Pretarsal

Voluntary blinking and sustained activity - Preseptal and Pretarsal

Forceful closure – pretarsal, preseptal and orbitral fibres
Congenital anomalies

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

Coloboma
Epicanthus
Distichiasis
Blephrophimosis syndrome
Anchyloblephron
Congenital ectropion
Telecanthus
Anomalies of Eyelashes



Trichiasis
Congenital or acquired
Trachoma, chronic blephritis, membranous
conjunctivitis
Madarosis (Scanty eyelashes)
chronic blepharitis, skin disorders and leprosy
Poliosis (Whitening of eyelashes)
chronic blepharitis and trachoma
HW

What is the significance of Gray Line at the lid margin?
 One
line answer
 Due date: Friday 12th Sep
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