OPT 033: Ocular Prosthesis Group 1 Reports PDF
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Southwestern University PHINMA
Adelle Katherine R. Intan
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Summary
This document describes the bony orbit, skeletal structure that houses and protects the eye, and its associated structures. It details the seven bones comprising the orbit: the frontal bone, maxilla, zygomatic bone, ethmoid bone, lacrimal bone, sphenoid bone, and palatine bone. The document also mentions contents of the orbit, ocular globe, and blood vessels, and discusses extrinsic muscles and nerves within the orbit.
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OPT 033: OCULAR PROSTHESIS roup Reports G Doctor of Optometry │ Fourth Year - Second Semester│ Academic Year 2024 - 2025 It helps maintain their position within the bony orbit....
OPT 033: OCULAR PROSTHESIS roup Reports G Doctor of Optometry │ Fourth Year - Second Semester│ Academic Year 2024 - 2025 It helps maintain their position within the bony orbit. GROUP 1: ORBITAL MARGIN 7 Cranial Bones Bony Orbit he maxilla, palatine, ethmoid, and lacrimal bones are all T he bony orbit, also known as the orbital cavity, is a skeletal T important components of the eye's orbit, each contributing to structurewithintheskullthathousesandprotectstheeyeandits different aspects of the orbital structure. associated structures. Below isabreakdownoftheirlocation,function,andimportance It is composed of seven bones: the frontal bone, maxilla, in relation to the orbital margins of the eye: zygomatic bone, ethmoid bone, lacrimal bone, sphenoid bone, and palatine bone. Maxilla Bone These bones form the boundaries of the orbit and provide mechanical protection for the eye, as well as support for the ocation: The maxilla is the upper jawbone and forms a L muscles that control eye movement. significant part of the medial and inferior walls of the orbit. It The bony orbit also contains several foramina and fissures connects to the lacrimal, ethmoid, and zygomatic bones. through which important neurovascular structures, such as the Function: Forms the inferior margin oftheorbitandpartofthe optic nerve, pass. medial wall. Houses the nasolacrimal duct, which drains tears from the eye to the nasal cavity. Providesstructuralsupportfor the eye and helps form the floor of the orbit. Contents of the Orbit Importance: The maxilla is critical for thestabilityoftheorbital structure and plays a key role in tear drainage through the ontentsoftheorbitwhichincludesvariousstructuresthatsupportthe C nasolacrimal duct. function and protection of the eye. Palatine Bone Ocular Globe ocation:Thepalatineboneislocatedatthebackportionofthe L The eyeball itself occupies about 1/5 of the orbital volume inferiorwalloftheorbit.Itcontributestotheposteriorpartofthe orbital floor. Blood Vessels Function: Primarily supports the orbital floor at the back, here are 2 types of blood vessels, these are the arteriesand T providing structural integrity. Part of the hardpalate(roofofthe veins. mouth) and also involved in forming part of the nasal cavity. So, in the orbit there are also blood vessels, this includes the Importance:Thoughitdoesnotdirectlyaffecttheorbitalmargin, ophthalmicartery,abranchoftheinternalcarotidartery,andveins thepalatinebonesupportstheoverallstrengthoftheorbitandthe such as the superior and inferior ophthalmic veins. facial skeleton. They supply blood to the eye andsurroundingstructuresofthe orbit Ethmoid Bone ocation: Theethmoidboneislocatedatthemedialpartofthe L Extrinsic Muscles orbit,formingpartofthemedialwall.Itliesbetweenthelacrimal Thisreferstothemusclesthatarelocatedoutsideastructurethat bone and maxilla. ove or control it. m Function: Forms the anterior portion of the medial orbitalwall. Inthecaseoftheeye,wehaveaspecificgroupofmuscleswhich Containstheethmoidsinusesandformspartofthenasalcavity.It are called extraocular muscles. housesthelacrimalfossa,whichholdsthelacrimalsac,involved The six extraocular muscles control the movement of the eye: in tear drainage. ○ Superior rectus Importance: The ethmoid bone contributes to the protectionof ○ Inferior rectus theeyeandallowsforteardrainageintothenasalcavity.Italso ○ Lateral rectus helps separate the orbit from the nasal cavity. ○ Medial rectus ○ Superior oblique Lacrimal Bone ○ Inferior oblique Location: The lacrimal bone is located at the front part of the edial wall of the orbit, between the maxilla and ethmoid bone m Nerves Function: Forms the medial orbital margin and contains the Intheorbit,thereareseveralcranialnervesthatpassthroughor lacrimalfossa,whichhousesthelacrimalsac.Thelacrimalsacis terminate in the orbit. part of the system that drains tears from the eye into the These are: nasolacrimal duct, ultimately draining into the nasal cavity. ○ Optic nerve (CN II)– Vision ○ Oculomotor nerve (CN III) – Controls most extraocular Frontal Bone muscles The frontal bone formsthesuperiorpartoftheorbit,specifically ○ Trochlear nerve (CN IV) – Controls the superior oblique the roof. muscle Itplaysacriticalroleinteardrainageandhelpsprotecttheeyeby ○ Abducens nerve (CN VI) – Controls the lateral rectus contributing to the medial boundary of the orbit. muscle It contributes to the protection of the eye and houses the ○ Branches of the trigeminal nerve (CN V) – Provides supraorbital foramen or notch, which allows nerves and blood sensation vessels to pass through. The bone's orbital plate provides structural integrity, separating Adipose (Fat) Tissue the orbital cavity from the frontal sinus and the anterior cranial Itsfunctionistoactlikeacushionandstabilizetheocularglobe fossa. nd other orbital structures. a Transes by: Adelle Katherine R. Intan 1 OPT 033: OCULAR PROSTHESIS roup Reports G Doctor of Optometry │ Fourth Year - Second Semester│ Academic Year 2024 - 2025 This role in theorbitiscrucialforshieldingtheeyefromtrauma Optic Foramen (Optic Canal) nd supporting the structures of the forehead and brow region. a Function: Transmits the optic nerve(CNII)andtheophthalmic rtery into the orbit. a Zygomatic Bone Location: Found in the lesser wingofthesphenoidbone,near lsoknownasthemalarbone,isapairedboneinthefacethat A the apex of the orbit. forms the prominence of the cheek. Theopticforamenisanopeninglocatedinthelesserwingofthe It connects with the maxilla, frontal bone, and temporal bone, sphenoid bone within the bony orbit. contributingtothestructureoftheeyesocket(orbit)andproviding It serves as a crucial passageway for the optic nerve (cranial support for the face’s musculature. nerve II) and the ophthalmic artery to enter the eye. Thisforamenisessentialforvision,asitallowstheopticnerveto Sphenoid Bone transmit visual information from the retina to the brain. complex, butterfly-shaped bone located at the base of the skull. A Itformspartoftheeyesocket,thesideoftheskull,andthefloor Superior Orbital Fissure (Sphenoidal Fissure) of the cranial cavity. unction: An opening that lets important nerves and blood F The sphenoid connects with several other bones, including the vessels travel between your brain and eye. Ithelpscontroleye frontal,temporal,andoccipital,andcontainsimportantstructures movements, vision, and automatic eye functions like pupilsize. like the sella turcica, which houses the pituitary gland. Transmits several important structures, including: Itsshapeandpositionmakeitcrucialforthestructuralintegrityof ○ Oculomotor nerve (CN III) – Controls most of the eye’s the skull and the protection of the brain. movements and helps with pupil constriction. ○ Trochlear nerve (CN IV) – Controls one eye muscle that helps you look down. ○ Abducensnerve(CNVI)– Controlsthemusclethatmoves the eye outward. ○ Branches oftheophthalmicnerve(CNV1)–Thesehelp with feeling in the forehead, upper eyelid,andpartsofthe eye. ○ Sympathetic Nerve Branches – Help control automatic functions like pupil dilation (how wide or narrow the pupil is). ○ Superior Ophthalmic Vein – Carriesbloodawayfromthe eye and connects to the brain’s blood vessels. Location:Betweenthegreaterandlesserwingsofthesphenoid bone, connecting the orbit to the middle cranial fossa. In the middle of the fissure, there is a fibrous ring called the AnnulusofZinn.Thisringactsasthestartingpointforsomeof the eye muscles that help you move your eye in different directions. GROUP 2: PAIRED BONES Paired bones are essential components of the human skeletal ystem. s They exist in symmetrical pairs, one on each side of the body. This symmetry allows for balanced movement and function, making them crucial for our daily activities. Foramen and Fissure Fromprotectingvitalorganstoenablingcomplexmotions,paired bonesplayafundamentalroleinmaintainingourbody'sstructure and overall health. oramenandfissuresarepassagewaysthroughthebonesofthe F The human body includes several paired bones, such as the skullsthatallowdifferentstructuresofthenervousandcirculatory parietal and temporal bones of the skull, the clavicle system to enter and exit the skull. (collarbones), and the scapulae (shoulder blades). Thedifferencebetweenforamenandfissureisthatthefissureisa Thesebonesaremirrorimagesofeachotherworkingtogetherto different shape of hole (mura ug crack) that typically occurs provide stability and support. between separate anatomical structures. Three most important of these are: Maxilla Bone ○ Nasolacrimal (tear) canal ○ Optic foramen Location: Centrally located within the skull and makes up the ○ Superior orbital (sphenoidal fissure) enter of the face. c Function: It provides critical bone structure to the skull and Nasolacrimal Canal defines the face. Forms the floor and lateral wall of the nasal cavity. Function:Drainstearsfromthelacrimalsacintothenasalcavity Involved in the formation of the orbit, nose, palate. ( specifically into the inferior meatus). Location: Found at the medial wall of the orbit, between the Palatine Bone maxilla and lacrimal bones. Location: Situated at the back of the nasalcavitybetweenthe axilla and sphenoid. m Function:Helpsformthenasalandoralcavities,theroofofthe mouth, and the lower portion of the eye sockets (orbits). Transes by: Adelle Katherine R. Intan 2 OPT 033: OCULAR PROSTHESIS roup Reports G Doctor of Optometry │ Fourth Year - Second Semester│ Academic Year 2024 - 2025 Helps in building 3 cavities the skull: oral cavity, nasal cavity, Restricted Eye Movement (Strabismus) rbits o roblem: Abnormalities in the zygomatic, lacrimal, or palatine P bones can affect the alignmentoftheeyeandthemusclesthat Zygomatic Bone controleyemovement,leadingtostrabismus(misalignmentofthe Location: Located just below each eye andextendsupwardto eyes), whether due to trauma, congenital conditions, or disease. the outer side of each eye. Function: A structure which joins the bones of the face while Difficulty with Tear Drainage (Epiphora) protectingthearteries,nerves,veins,andorganswhichliebelow roblem:Lacrimalbonefracturesorcongenitalmalformationsof P the surface. thelacrimalsystemcanleadtoteardrainageproblems,suchas epiphora (excessive tearing). Lacrimal Bone Thiscanoccurduetodamagetothenasolacrimalductorlacrimal ocation:Medial(inner)partofeachorbit,nearthecornerofthe L sac, often resulting from trauma or abnormal bone development. eye, and are situated between the maxilla and the ethmoid bone. Function: The lacrimal bones supportthenasolacrimalductfor Orbital Floor Fractures (Blowout Fractures) tear drainage and contribute to the structure of the orbit, roblem: Orbital blowoutfractures,typicallyinvolvingtheorbital P protecting and supporting the eye. floor(oftenthemaxillarybone),canleadtodamagetothetissues and structures surrounding the eye, such as the inferior rectus Nasal Bone muscle or orbital fat, leading to herniation and changes in eye Location: Upper-middle area of the face, forming thebridgeof positioning. the nose Function: Structural support to the nose, protect internalnasal Cosmetic Concerns structures, and help shape the appearance of the face. roblem: Paired bone abnormalities, such as nasal bone or P zygomatic deformities, can lead tocosmeticconcerns,including Inferior Nasal Conchae Bone asymmetry, a sunken appearance, or altered positioning of the Location: Inside the nasal cavity, alongthelateralwalls,below eyes. the middle nasal conchae. Function:Filterwarmandhumidifyair,increasesurfaceareafor GROUP 3: UNPAIRED BONES airflow,andhelpprotecttherespiratorysystemandenhancethe sense of smell. Frontal Bone Importance of Paired Bones Importance of Paired Bones In Relation to Ocular Prosthesis single bone that forms the smooth curvature of the forehead. A ♡ ymmetry & Balance S ♡ rbital Support O Has two main parts: the squamous part, and the orbit. ♡ Protection ♡ Protection It protects the frontal lobe of the brain & the ethmoid bone’s ♡ Movement ♡ Symmetry & Aesthetics horizontal plate. ♡ Strength & Flexibility ♡ Movement Coordination Cribriform plate – allows the olfactory nerve bundles to pass ♡ Redundancy ♡ Fit & Comfort through its perforated surface and bring theceilingofthenasal cavity. Paired Bones Abnormalities Three regions/parts: Squamous part (Forehead), Orbital part (Orbit), Nasal Part (Nose) Orbital Misalignment Squamous part (Forehead) roblem:Abnormalitiesinthepairedbonesoftheorbit,suchas P ost anterior neurocranium bone M zygomatic, maxillary, or nasal bones, can cause orbital One of the skull bones enclosing the brain (neurocranium) misalignment or displacement. Largest area of the frontal bone ○ Frontal sinuses– located superior to the orbit. Facial Asymmetry ○ Supraorbital notch – superior border of the orbit Problem: Abnormalities in the zygomatic, maxillary, nasal, or (supraorbital margin) where the supraorbital vessels and lacrimal bones can lead to facial asymmetry or deformities. nerve pass through. These abnormalities may be congenital (e.g., in craniofacial ○ Superciliaryarches–aridgeonthefrontalboneabovethe syndromes) or caused by trauma. eye socket. ○ Glabella – smooth and slightlyelevatedsurfaceabovethe Orbital Volume Loss nasal root. ○ Zygomatic processes – alongarchedprocess,projecting roblem: Orbital fractures, particularly to theorbitalfloor(often P from the lower part of the squamous part of temporal bone. involving the maxillary or zygomatic bones), canleadtolossof orbital volume, causing the eye to sink back into the orbit Orbital Part (Enophthalmos). orms the roof of the orbit and the ethmoidal sinuses. F Difficulty Securing the Prosthesis Comprises two openings: ○ Anterior ethmoidal foramen – for the anterior ethmoidal Problem: Abnormalities in the palatine orzygomaticbonescan vessels and nerve lter the shape and depth of the orbit. a ○ Posteriorethmoidalforamen–fortheposteriorethmoidal Ashalloworunderdevelopedorbit(suchasinorbitalhypoplasia) vessels and nerve canmakeitchallengingtosecuretheocularprosthesis,asthere may not be enough structural support for it to stay in place. Transes by: Adelle Katherine R. Intan 3 OPT 033: OCULAR PROSTHESIS roup Reports G Doctor of Optometry │ Fourth Year - Second Semester│ Academic Year 2024 - 2025 Nasal Part phenoid bone contributes to the S onnected to the frontalprocessesofthemaxillaandthenasal C ○ Floor of the middle cranial fossa of the skull bones, forming the stem of the nose ○ Forming of the foramina ○ Forming of the canals of cranium Ethmoid Bone our main parts of Sphenoid Bone F ○ Body (corpus) Singularporousbonethatmakesupthemiddleareaofthefacial ○ Lesser wing of sphenoid tructure. s ○ Greater wing of sphenoid Forms the midfacial region of the skull. ○ Pterygoid processes Importance: Allows theolfactoryfiberstopassthroughinorder for you to smell things Body (corpus) the most centrally positioned portion Ethmoidal Labyrinths Anteriorly– contributes to the nasal cavity Lieonbothlateralsidesandcontainnumerouslittlecavitieswith Laterally– builds the media wall of the optic canal thmoidal cells which are referred to as the ethmoidal sinus. e Superiorly – forms thesellaturcica,thehypophysealfossa,and the dorsum sellae Perpendicular Plate Posterior to the body– clivus slopes is located flattened bony lamina of the ethmoid bone thatisthelargest A Sphenoidal sinuses –locatedinthesphenoidbodybehindthe bony part assisting in forming the nasal septum. nasal cavity and divided by a septum ○ Vertically ○ Inferiorly Lesser Wings of Sphenoid Arisesuperolaterallyfromthesphenoidbodywheretheyformthe ★ ribriform plate– latincribriform= perforated C ptic canal (→optic nerve, ophthalmic artery) o ○ lieswithintheethmoidalnotchofthefrontalboneandforms The inferior surface participates in the lateral margin of the orbit the roof of the nasal cavity. Superior surface forms part of the cranial cavity ★ Crista galli– latincrista galli= crest of the cock ○ small vertical protrusion on top of the plate. Greater Wings of Sphenoid ★ Olfactory bulbs– lie on two grooves lateral to the crista galli he greater wings arise posterolaterally from the body. T Lateral surfaces form the infratemporal surfaces. Sphenoid Bone Anterior surfaces make up part of the posterior aspect of the lateral wall of the orbit he sphenoid bone is 1 of the 8 bones that make up the cranium. T Greeksphenoeides, which means wedge-shaped. Three Important Openings Near their Roots Themostcomplexboneofthehumanbodybecauseofitsshape. ★ oramen rotundum– transmits the maxillary nerve. F Known aswasp bone. ★ Foramen ovale – allows the passage of themandibularnerve, It makes up most of themiddle part of the base of skull accessory meningeal artery, lesser petrosalnerveandemissary Anatomical: It is butterfly-shaped. vein (mnemonic "MALE") ○ Serves as akeystone bone. ★ Foramen spinosum – traversed by the middle meningeal ○ Hasabody,apairofgreaterwings,lesserwings,2pterygoid vessels, spinous nerve (branch of mandibular nerve)liesatthe processes. posterior margin of the greater wings. ○ It forms most of the BASE of the central skull. The Sphenoid Bone has a Common Border ★ ight&leftlesserwingsofthesphenoidresemblewingsofa R moth or bird rontal bone (via the sphenofrontal suture) F ★ Sella Turcica– located at the midline. Parietal bone (via the the sphenoparietal suture) ○ Tuberculum Sellae– forms the anterior wall Squamouspartofthetemporalbone(viathesphenosquamosal ○ Hypophyseal (Pituitary) fossa – rounded depression, suture) deepest part Occipital bone (via the spheno-occipital suture) ○ Dorsum Sellae– forms the posterior wall ○ Note: As the sphenoid and occipital bone fuse during ★ Chiasmatic Groove– sulcus formed by optic chiasm puberty (tribasilar bone) the spheno-occipital suture disappears by the age of 25 Transes by: Adelle Katherine R. Intan 4
