Anophthalmos

Anophthalmos
Anatomy
Cosmetic & Reconstructive Facial Eyelid & Orbital surgery @ Eye Plastics. Cosmetic & Reconstructive Facial Eyelid & Orbital surgery @ Eye Plastics.
Cosmetic & Reconstructive Facial Eyelid & Orbital surgery @ Eye Plastics. Cosmetic & Reconstructive Facial Eyelid & Orbital surgery @ Eye Plastics.

Orbital volume and dimensions: = 30 cc, 35(Height) x 45(Width) x 45 mm(medial wall depth), globe 25 x 25 mm

Bones: (F)rontal, (M)axillary,(Z)ygomatic, (L)acrimal, (E)thmoid, (P)alatine, (S)phenoid

Roof :
  • Bones
    • Frontal
    • Lesser wing of sphenoid
  • Cotnents
    • lacrimal gland fossa
    • trochlea 4mm posterior to margin for superior oblique tendon
    • supraobital notch/foramen
  • Clincal Correlations
    • subperisteal abscess
  
  • Bones
    • Maxillary
    • Lacrimal
    • Ethmoid - thinest
    • Sphenoid
  • Contents
    • lacrimal sac fossa
    • cribiform plate is medial to anterior orbit at the level of fronto-ethmoidal suture
  • Clincal Correlations
    • Nasoclacrimal duct
      obstructions./tumors/DCRs
    • Medial wall fractures
    • subperisteal abscess
    • Orbital cellulitis/proptosis from
      ethmodial extension

Floor:

  • Bones
    • Maxillary- second thinnest, thins posteriorly
    • Zygoma
    • Palatine
  • Conents
    • infraorbital foramen
    • inferior oblique origin
    • slopes 20 degrees down
    • suspensory ligament of eyeball,
  • Clincal Correlations
    • subperiosteal abscess
    • blow-out fracturs
 Lateral wall:
  • Bones
    • Zygomatic bone
    • Greater wing of sphenoid
  • Contents
    • lateral orbital tubercle is 11mm below F-Z suture,
      • serves as attachment of check ligament of lateral rectus
  • Clincal Correlations
    • Tripod fractures
    • Ruptured globes
    • Lateral tarsal strips
    • adjacent to middle cranial fossa, temporal fossa, and pterygopalatine fossa
  • The medial orbital walls are nearly parrallel and are 25 mm apart
  • The orbit is widest not at its entrance, but 1 cm from the orbital rim
  • Holes & Fissures

Holes & Fissures

Fissures Holes/Notches/Canals

Superior orbital fissure (SOF):

  • 22 mm long

  • separates greater wing of spenoid from lesser wing of sphenoid

  • transmits third, fourth, sixth and V1 AND SYMPATHETIC FIBERS

  • lateral rectus origin separates into superior and inferior divisions

    • Superior division transmits lacrimal, frontal and trochlear nerves

    • Inferior division transmits superior and inferior divisions of CN III, nasociliary branch of CN V, CN IV, superior ophthalmic vein, and sympathetic nerve plexus

    Venous system: supeior ophthalmic vein

Inferior orbital fissure (IOF)

  • located between lateral orbital wall and the orbital floor

  • Transmits V2 ( maxillary) , pterygoid nerves nerve arising from pterygopalatine ganglion

  • infraorbital nerve (a branch of V2) enters the infraobital groove and infraorbital canal for sensation to lower eyelid, cheek, upper lid, upper teeth

  • Venous system inferior ophthalmic vein

Nasolacrimal canal

  • lacrimal sac fossa to the inferior meatus

  • nasolacrimal ducts

Supraorbital foramen/notch:

  • transmits blood vessels

  • supraorbital nerve

  • Anterior/posterior ethmoidal foramen: transmits ethmoidal blood vessels and nerve

  • Zygomatic foramen: transmits zygomaticofrontal and zygomaticotemporal nerves, zygomatic artery

  • Nasolacrimal duct (NLD): exits into inferior meatus

  • Infraorbital canal: transmits infraorbital nerve (V2)

Ethmoidal foramina

  • anterior ethmodial artery

  • posterior ethmoidal artery

  • allows infections and neoplasms to enter to orbit from the sinuses

Optic Canal

  • 8-10 mm long

  • located within the less wing of sphenoid

  • separated from SOF by OTIC STRUT

  • Transmits. Ophthamic nerve, ophthalmic artery, sympathtic nerves

  • Optic foramen is 6.5 mm wide: it may be enlarged in the presence of optic nerve glioma; 1 mm of assymetry between right and left is abnormal

AXIAL ORBITAL MRI

Operation photogallery
 
before operation after operation