In the past, anatomy has been considered a rather static discipline, not requiring frequent revisions of textbooks. The rapid advance of electronmicroscopy, how. Eugene Wolff's Anatomy of the Eye and Orbit. F. C. Blodi, MD Download the PDF to view the article, as well as its associated figures and tables. Abstract. PDF. Book Review. Wolff's Anatomy of the Eye and Orbit. Free. Loading This is a PDF-only article. The first page of the PDF of this article appears above.
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The terminal branches of the ophthalmic artery are the supratrochlear and dorsal nasal arteries. The latter anastomoses with branches of the facial artery and provides another example of an anastomosis between the internal and external carotid arteries. The ophthalmic veins.
The superior and inferior ophthalmic veins drain the orbit and have important communications with the facial vein, pterygoid plexus, and cavernous sinus, in which they end directly or indirectly. The superior ophthalmic vein is formed near the root of the nose and allows the spread of superficial infections of the face to the cavernous sinus figs. The venae vorticosae fig. The oculomotor third cranial nerve supplies all the muscles of the eyeball except the superior oblique and the lateral rectus muscles.
It emerges from the brain stem, passes lateral to the posterior clinoid process, traverses the lateral wall of the cavernous sinus, and divides into superior and inferior divisions, which pass through the superior orbital fissure within the common tendinous ring fig.
The oculomotor nerve supplies the levator palpebrae superioris and superior rectus by its superior division and the medial rectus, inferior rectus, and inferior oblique muscle by its inferior division.
The oculomotor nerve "opens" the eye, whereas the facial nerve" closes" it by the orbicularis oculi.
The oculomotor nerve also conveys preganglionic parasympathetic nerve fibers to the orbit. A parasympathetic communication arises from the nerve branch to the inferior oblique muscle. This nerve enters the ciliary ganglion and synapses there. Postganglionic parasympathetic nerve fibers pass from the ganglion to the eyeball through the short cilliary nerves, innervating the sphincter pupillae and ciliary muscle figs. In the act of focusing the eyes on a near object fig.
Paralysis of the oculomotor nerve results in ptosis paralysis of the levator , abduction unopposed lateral rectus , and other signs. The trochlear nerve. The trochlear fourth cranial nerve supplies only the superior oblique muscle of the eyeball. It emerges from the dorsum of the brain stem, winds around the cerebral peduncle, traverses the lateral wall of the cavernous sinus, and passes through the superior orbital fissure just superior to the tendinous ring fig.
It then enters the superior oblique muscle. The trochlear nerve is tested by asking the subject to look downward when the eye is in adduction fig. The abducent nerve. The abducent sixth cranial nerve supplies only the lateral rectus muscle of the eyeball. It emerges from the brain stem at the junction of the pons and the medulla.
It enters the dura matter over the dorsum sellae and follows the slope of this bone supeior and anterior, bending sharply anteriorward across the superior border of the apical portion of the petrous part of the temporal bone. This perhaps accounts for abducent involvement in almost any cerebral lesion that is accompanied by increased intracranial pressure.
The nerve next traverses the cavernous sinus, passes through the superior orbital fissure within the common tendinous ring fig. Paralysis of the lateral rectus results in inability to abduct the eye and horizontal diplopia double vision which is worst when attempting to look toward the side of the nerve injury. Ciliary ganglion The ciliary ganglion fig. It is situated between the optic nerve and the lateral rectus fig.
Communications with the nasociliary nerve convey afferent fibers from the eye.
A parasympathetic root from the oculomotor nerve contains the only fibers that synapse in the ganglion. The postganglionic parasympathetic fibers pass to the short ciliary nerves which are branches of the ganglion and supply the ciliary muscle and sphincter pupillae. Postganglionic sympathetic fibers from the internal carotid plexus reach and pass through the ciliary ganglion. By way of the short ciliary nerves, the sympathetic fibers supply the dilator pupillae and blood vessels, as well as smooth muscle in the eyelid superior tarsal muscle and in the inferior orbital fissure orbitalis.
A sympathetic lesion Horner syndrome results in a small pupil miosis and mild ptosis fig. Muscles of eyeball extraocular muscles The eyeball is moved chiefly by six extrinsic muscles: four recti and two oblique muscles fig. These skeletal muscles arise from the posterior aspect of the orbit except for the inferior oblique muscle and are inserted into the sclera. The four recti arise from a common tendinous ring that surrounds the optic canal and a part of the superior orbital fissure.
All the structures that enter the orbit through the optic canal and adjacent part of the fissure lie at first within the cone of the recti fig. The four muscles are inserted into the anterior portion of the sclera, mm posterior to the sclerocorneal junction limbus. The superior oblique muscle arises from the sphenoid bone superomedial to the optic canal.
It passes anteriorward, superior to the medial rectus, and through a cartilaginous pulley the trochlea attached to the frontal bone. The tendon is thereby directed posterolaterally, running inferior to the tendon of the superior rectus to insert into the posterior sclera. The inferior oblique muscle arises from the maxilla at the anteromedial floor of the orbit, passes in a posterolateral direction, immediately inferior to the inferior rectus to insert into the posterior sclera.
The superior oblique muscle is supplied by the trochlear nerve, the lateral rectus by the abducent nerve, and the others by the oculomotor nerve. Mnemonic: S04, LR6, remainder 3. Actions of extraocular muscles fig. The eye is poised in the fascia and fat of the orbit, and equilibrium is maintained by all the muscles, none of which ever acts alone. Moreover, the two eyes move together in unison conjugately. Movements may be considered to be around a vertical axis abduction and adduction , a lateromedial axis elevation and depression and even an anteroposterior axis extorsion and intorsion.
The recti extend from the posterior aspect of the orbit to the anterior aspect of the sclera. The lateral and medial recti are purely an abductor and an adductor, respectively. The superior and inferior recti elevate and depress, respectively, and because of their lateral course, are the only muscles that can do so when the eye is abducted. The trochlea of the superior oblique muscle serves as its functional origin, and hence the two oblique muscles may be said to extend from the anteromedial orbit to the posterior sclera.
The superior and inferior oblique muscles depress and elevate, respectively, and because of their lateral course, are the only muscles that can do so when the eye is adducted fig. Paralysis of an extrinsic eye muscle is noted by 1 limitation of movement in the field of action of the paralyzed muscle and 2 the presence of two images diplopia that are separated maximally when an attempt is made to move the eye in the direction of primary action of the paralyzed muscle. Optic nereve The optic second cranial nerve is the nerve of sight, and it extends from the eye to the optic chiasm.
Developmentally, it may be considered as a tract between the retina a derivative of the brain and the brain. The nerve fibers, which arise in the retina, converge on the optic disc, pierce the layers of the eye, and receive myelin sheaths.
The optic neerve, itself, is surrounded by meningeal sheaths continuous with those of the brain, and also by the subarachnoid space. The optic nerve lies within the cone of the recti fig. Intracranially, the optic nerve is related on its inferior side to the internal carotid and ophthalmic arteries and to the hypophysis. The nerve ends in the optic chiasm fig. The decussating fibers are those that transmit the perception of vision in the temporal side of the visual field.
Examination of the optic nerve includes ophthalmoscopy, testing of visual acuity, and plotting of the visual field. Eyelids The eyelids palpebrae fig. Reflex blinking distributes tears and prevents drying of the cornea. The upper eyelid, more extensive and mobile, meets the lower at the medial and lateral angles canthi. In some people, chiefly Asian, the medial canthus is covered by a fold of skin epicanthus.
Eugene Wolff's Anatomy of the Eye and Orbit
The palpebral fissure, the space between the lids, is the opening to the conjunctival sac. The free margin of each lid possesses hairs termed eyelashes cilia. Three types of glands associated with the names, Moll, Zeis, and Meibom, respectively drain into the margins of the lids: 1 ciliary sweat glands, 2 sebaceous glands attached to the follicles of the eyelashes, and 3 tarsal glands about 35 in the upper lid , situated further posteriorly.
Infection of one of these three types of glands may result in a stye hordiolum. Chronic inflammation or obstruction of a tarsal gland produces a small mass or cyst chalazion. Medially, the margin of the lid presents the lacrimal punctum and, between the lids, an area termed the lacrimal lake. The floor of the lake shows a "fleshy" mass, the lacrimal caruncle, which lies on a conjunctival fold, the plica semilunaris fig. The upper eyelid is composed of skin and subcutaneous tissue, muscle the palpebral part of the orbicularis oculi and the levator palpebrae superioris , fibrous tissue including the tarsal plate , and mucous membrane the palpebral part of the conjunctiva.
The subcutaneous tissue usually contains no fat, and fluid can readily accumulate there. The levator palpebrae superioris arises from the sphenoid bone superior to the optic canal and is inserted into the skin of the upper lid and also into the upper border of the tarsal plate by means of the superior tarsal muscle fig.
The levator is supplied by the oculomotor nerve; the innervation of the tarsal muscle is sympathetic. Paralysis of the levator results in drooping ptosis of the upper lid. The tarsal plate is a fibrous support related posteriorly to the tarsal glands. The ends of the plates are anchored to the orbital margin by lateral and medial palpebral ligaments. The medial palpebral ligament, identifiable on drawing the lids laterally, is anterior to the lacrimal sac, to which it serves as a guide fig.
The superior tarsal muscle connects the levator with the tarsal plate and consists of smooth muscle that is supplied by sympathetic fibers.
A lesion of the sympathetic pathway e. Direct injury may cause a superficial hematoma of the eyelids and adjacent tissues a "black eye" , whereas a more deeply placed orbital hematoma occurs after fractures of the anterior or the middle cranial fossa.
Conjunctiva The conjunctiva is a connection conjunction between the eyelids, sclera and cornea. It is the mucous membrane that lines the posterior surface of the eyelids palpebral conjunctiva and the anterior aspect of the globe bulbar conjunctiva fig. The potential space, lined by conjunctiva, between the lids and the globe, is termed the conjunctival sac. The mouth of the sac is the palpebral fissure, which varies in size according to the degree to which the" eye is open".
The reflections of the conjunctiva from the lids to the globe are known as fornices. The lacrimal glands open into the superior fornix. The observed height difference ception ;— Eyes as the center of focus in the visual examination of human faces.
Percept Mot Skills findings of Stewart 27 , similar to the findings of Farkas et al. Yarbus AL. Eye movements and vision. New York: Plenum Press, Our 5. Wilder HH. The physiognomy of the Indians of southern New England.
The human skeleton in forensic medicine. Springfield, 22 that individuals aged more than 50 years have lower lateral IL: Charles C. Thomas, Gatliff BP. Facial sculpture on the skull for identification. Studies using photographs of living skull. In: Taylor KT, editor. Forensic art and illustration. Taylor KT. From skull to visage. J Biocommun ;6: As the globe projection values for cadavers of this study were 27— Taylor R, Craig P.
The wisdom of bones: facial approximation on the skull. Computer-graphic facial seems unlikely that the use of cadavers compromised the value of reconstruction.
Boston: Elsevier Academic Press, ;33— Also note here, that Anastassov and van McGregor JH. Restoring neanderthal man. Nat Hist ;— Wolff E. The anatomy of the eye and orbit. London: H.
However, it should be noted here that we Whitnall SE. The anatomy of the human orbit and accessory organs of found the lateral canthus to corneal apex distance to be halved in vision.
London: Oxford Medical Publications, The anatomy of the human orbit and accessory organs of vision. London: Oxford University Press, Stephan CN. Facial approximation: falsification of globe projection guideline by exophthalmometry literature. J Forensic Sci ;—6. Measurement of eyeball protrusion and its application in facial reconstruction. Soft-hard tissue correla- tions and computer drawings for the frontal view.
Angle Orthod ;— Goldnamer WW. The anatomy of the human eye and orbit.
Chicago: The Professional Press, Evaluation of the anatomical position of the lateral canthal ligament: clinical implications and guidelines. J Craniofac Surg ;— Stephan CN, Henneberg M. Building faces from dry skulls: are they rec- ognized above chance rates?
J Forensic Sci ;— Angel JL Restoration of head and face for identification. Louis, MO. George RM.
The Anatomy of the Eye and Orbit
Anatomical and artistic guidelines for forensic facial recon- The anatomy of the external palpebral lig- struction. Forensic analysis of the ament in man. J Maxillofac Surg ;—7. New York: Wiley-Liss, ;— Yoshino M, Seta S. Skull-photo superimposition. In: Siegel JA, Saukko Encyclopedia of forensic sciences. San Diego, facial features. Forensic analysis of CA: Academic Press, ;— Sills JD. Computer photographic skull reconstruction methods used in This article is only available in the PDF format.
Download the PDF to view the article, as well as its associated figures and tables. In the past, anatomy has been considered a rather static discipline, not requiring frequent revisions of textbooks.
The rapid advance of electronmicroscopy, however, has altered this concept completely. Although the chief difference between the present edition and the fifth, published in , is the inclusion of electron micrographs, there have been a number of alterations and additions to conform with modern thinking.
The basic format of the previous edition has been retained. This book is recommended without reservation for students, residents, and those seeking an anatomical source book. DeVoe AG. Wolff's Anatomy of the Eye and Orbit.
Arch Ophthalmol. All Rights Reserved. Twitter Facebook Email. This Issue.J Craniofac Surg ;— The physiognomy of the Indians of southern New England. Qld Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account.
The nerve next traverses the cavernous sinus, passes through the superior orbital fissure within the common tendinous ring fig.
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