EYELID PPT

1. Presenter: MAAZ UL HAQ
C L Gupta Eye Institute
1
Eyelid

2. Definition of Eyelid
• Eyelids are the mobile tissue curtains
• These act as shutters protection the eyes
• Spread the tear film over the cornea and
conjuctiva
• Important contribution to the facial features
• Relay much useful information regarding –
wakefulness/attention

3. Gross Anatomy
• Extent
• Lid folds
• Position of eyelids
• Canthi
• Eyelid Margins
• Eyelashes
• Palpebral aperture or fissure

4. Extent
 Upper eyelid
• From eyebrow downward to end in a free
margin Superior boundary of palpebral
fissure
 Lower eyelid
• Merge into skin of cheek where
nasojugal,malar sulci limit it.

5. Lid folds
 Superior lid fold
• Between orbital & tarsal
portion
• Formed by fibrous slips,
from tendon of levator
 Inferior lid fold
• On skin of lower eyelids
• Fibrous slips from fascia of
inferior rectus

6. Position of eyelids
• In primary position of gaze
• Upper eyelid covers 1/6th of cornea
• Lower eyelid just touches the cornea

7. Canthi
The two eyelids meet each other at
medial and lateral angle
Lateral cantus
 5-7mm from lateral orbital margin
 1cm from frontzgomatic suture
 60 degree with wide open
 30-40 degree with eyes open in
normal way
Medial cantus
 Rounded in structure

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• 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
derived from skin,contains large modified sweat
glands and sebaceous glands.
A semilunar fold called plica semilunaris lies on
lateral side of caruncle.

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11. Eyelid margin
• The opposing margins of the eyelids are
nearly flat some 2 mm in width
• Each lid margin is divided into two parts
• Lacrimal papilla- ls a small elevation
present on the medial side which is
contained the hole – lacrimal puctum in its
center
• Ciliary portion-
• Rounded anterior
• Sharp posterior
•

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• Inter marginal strip- between the two
borders.
• Grey line-(junction of the skin and conjunctiva)
• Inter marginal strip-
• divides the strip into anterior strip which bears
the lashes
• posterior strip which contains openings of
meibomian glands

14. Eyelashes
• 2-3 rows
• When lids close eyelashes do not interlace
• Upper lid : 100-150
• Lower lid : 50-75
Cilia
• 20 – 120 microns
• They taper throughout their length to end in a fine sharp point
• Lifespan 5 months.
• Replacement is fully grown in 10 wks.
• They are darker then the scalp hair and tend to remain so throughout life

15. Palpebral aperture
• Elliptical space b/w upper & lower lid
• margins
At Birth
• Horizontally– 18 to 21 mm
• Vertically -- 8mm
In Adults
• 28 to 3o mm (hor)
• 9 to 11 mm (ver)

16. Structure
• Skin
• Layer of subcutaneous areolar tissue
• Layer of striated muscles(orbicularis oculi)
• Sub muscular areolar tissue
• Fibrous layer and tarsal plate.
• Septum orbitale
• Layer of non-striated muscle fibres
• Conjunctiva

18. skin
• The skin covering the eyelids is elastic ,having a fine texture
•
• Is thinnest in the body and folds easily thereby contributing to
the case and speed of mobility of the upper eyelids
• Nasal part of the skin in smooth shinning and greasy in
comparison to the temporal part

19. Epidermis
• Epidermis - 6-7 layers of stratified squamous epithelium
• 1. Keratin layer (stratum corneum or horny layer) -
• 2. Granular cell layer (stratum granulosum) - .
• 3. Prickle cell layer (stratum spinosum) -
• 4. Basal cell layer (stratum basale) –
Dermis
thin layer of dense connective tissue with rich network elastic
fibres, blood vessels, lymphatics and nerves. Melanocytes are
also present which increase their pigment production in
response to chronic edema or inflammation

20. Subcutaneous areolar tissue
• Loose connective tissue No fat
• Readily distended during oedema or blood.
• Non existent - ciliary margin, lid folds and medial and lateral
angles

22. Layer of striated muscles
• Consists of orbicularis muscle which forms a
thin oval sheet across the eyelids
• • Levator palpebrae superioris also present

23. Orbicularis oculi
It can be devided in two part
• Orbital part
• Papebral part
 Orbital part origin
• From anterior part of the medial palpebral ligament & adjacent
bones
Papebral part
Preseptal fibres
Pretarsal fibres

24. Function of orbicularisoculi
 Orbital part
• Forced closure of eyelids
• Thus pull eyebrows downwards
 Palpebral part
• Helps in gentle closure during blinking, sleep, softvoluntary
closure
Entire muscle supplied by branches of 7th
nerve

25. Levator palpebrae superioris
 Origin
• At apex of orbit from the Under surface of lesser wing of
sphenoid above Annulus of Zinn by a Short tendon which is
Blended with origin of SR
 Course & attachments
• Muscle has a flat ribbon like belly.
• It passes forwards below the roof of the orbit, above the
superior rectus

26. Nerve supply & action of LPS
• Branch of superior division of 3rd nerve
• Acts as Elevator of upper lid

27. Submuscular areolar tissue
• Layer of loose connective tissue between orbicularis muscle
and fibrous layer
• (consisting of tarsal plate and septum orbitale). The nerves and
vessels of the lids lie in
• this layer and so to anaesthetise the lid, injection is made in
this plane
• This layer splits the eyelid into two - anterior lamina and
posterior lamina

28. Fibrous layer
• Framework of the lids
• Consists of the following –
• Tarsal plate
• Septum orbitale
• Medial palpebral ligamen
• Lateral palpebral ligament

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• Tarsal plates
• Tarsi are firm plates of dense fibrous tissue that form the
skeleton of the eyelids giving them shape and firmness
• Size
• Tarsi about 29mm long
• Tarsi 1 mm thick
• Upper tarsus 10-11mm in height
• Lower tarsus is 4-5mm in height

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• Border of tarsal plates
• Free borders are straight, whereas the opposite attached
borders are convex
• Superior border of upper tarsus –
• Septum orbital and Muller’s muscle
• Inferior border of lower tarsus –
• Orbital septum,Capsulopalpebral fascia and inferior
palpebral

31. Surface
• Anterior surface of each tarsus is convex Posterior surface is
concave In upper lid
 Extremities
• Lateral ends are attached to Whitnall’s tubercle by lateral
palpebral ligament and medial ends attached by medial
palpebral ligaments to anterior lacrimal crest
 Tarsal ( meibomian)
• Glands are embedded in the subtance of the tarsal plates

32. Layer of non striated muscle fibres
• The layer consists of smooth muscle fibres of Muller’s muscle
• (superior and inferior palpebral muscles) which lie deep to the
septum orbitale in the upper and lower eyelids, respectively
• • Origin - inferior terminal striated fibres of the LPS muscle in
the and gets inserted into the orbital margin of tarsal plate
• Supplied by sympathetic nerve fibres

34. Glands of eyelid
• Tarsal (meibomian gland)
• Glands of zeis
• Glands of moll
• Accessory lacrimal glands

35. Tarsal (meibomian gland)
• Modified sweat glands present in the posterior
part of the stroma of the tarsal plates Arranged
in a single row vertically parallel to each other
20 to 30 each lid
• Structure
• Each tarsal gland consist of a central duct
which ran straight perpendicular to the lid
margin
• Occupies the entire thickness of the tarsal plate
• Into central central open 10-15 acini from the
side

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• Opening of meibomian glands arrange in
single row
• On the lid margin between grey line and
posterior border of the lids
• Secretions are oily in nature (sebum) and
have the following function -
• Prevent outflow
• Prevent evaporation - smooth movements
• Ensure the air tight closure of the eyelids

37. Glands of zeis
• Modified sebaceous glands attached to the eyelash follicle
directly
• Two glands associated with each cilium
• Structure - single cul-de-sac or two/three lobules are present
 Secretions-
• Zeis gland (sebum) prevent the eyelashes from becoming dry
and brittle
• Its also contributes towards oily layer of tear film

38. Glands of moll
• Modified sweat glands which lie between the cilia
• • Lower > Upper
• Structure - Each gland is 1.5-2mm long and has unbranched
spiral shape.
• It has a fundus, a body, an ampullary portion and a neck.
• Duct of the gland passes through the dermis, epidermis and
may terminate separately between the two lashes or between
the lash and its epithelium covering or into the ducts of Zeis
gland

39. Accessory lacrimal gland of wolfring
• These are microscopic accessory lacrimal glands present along
the upper border of superior tarsus and along with the lower
border of the inferior tarsus.
• These are 2 - 5 in upper lid and 2 -3 in lower lid

40. Arterial supply
• Mainly supplied by the medial and lateral palpebral arteries
which are branches of the dorsal nasal and lacrimal arteries
• The superior and inferior arteries pierce through the above
septum orbitale and below medial palpebral ligament and enter
the upper and lower eyelids respectively

41. Vessels and nerves of the eyelid

42. Lymphatic drainage

44. Nerve supply

46. References
• ocular anatomy and physiology AK khurana