Eyelid Neurology
Eyelid and Nictitans Movement Michael Davidson Professor, Ophthalmology Diplomate, American College of Veterinary Ophthalmologists Department of Clinical Sciences College of Veterinary Medicine North Carolina State University Raleigh, North Carolina, USA Eyelid Innervation: Efferent Motor Dorsal ramus of CNIII: – Levator palpebral superioris (opening) Palpebral and dorsal buccal branches of CNVII: – obicularis oculi (closure) – levator anguli oculi medialis, frontalis, retractor anguli (opening) – malaris mm. (lower eyelid depressor) Eyelid Muscles Opening: – levator palpebrae superioris m. – frontalis m. – retractor anguli m. – malaris m. – Muller’s m. Closure: – obicularis oculi m. Eyelid Innervation: Sensory Afferent maxillary branch Ophthalmic and ophthalmic branch Maxillary Divisions of CNV mandibular branch trigeminal ganglion trigeminal n. Eyelid Innervation: Sensory Afferent Ophthalmic division CNV: – Frontal n. = upper eyelid, forehead, frontal sinus Frontal n. – Lacrimal n. = lateral orbit, Infratrochlear n. lacrimal gland, upper eyelid, Short Ciliary n. lateral canthus – Nasociliary n.: • Long ciliary nerve = cornea, Long Ciliary n. iris, ciliary body, sclera, sympathetics to eye; Nasociliary n. branches of short ciliary Lacrimal n. nerves (parasympathetics to Ophthalmic branch eye) join long ciliary nerve Zygomatic branch and enter eye Maxillary branch • Infratrochlear nerve = medial canthal skin, medial Trigeminal ganglion conjunctiva, sympathetics to Trigeminal n. upper Muller’s mm. Eyelid Innervation: Sensory Afferent Frontal n. Maxillary division of CNV: Infratrochlear n. – Zygomatic n. to: Short Ciliary n. Zygomaticotemporal Zygomaticofacial • zygomaticofacial = upper eyelid and conjunctiva • zygomaticotemporal = Long Ciliary n. lower eyelid and Nasociliary n. conjunctiva, sympathetics to lower Ophthalmic branch Muller’s m. and Zygomatic branch parasympathetics to Maxillary branch lacrimal gland Trigeminal ganglion Trigeminal n. Eyelid Innervation: Sympathetic Efferent Through terminal Frontal n. branches of trigeminal Infratrochlear n.
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