36 SURGICAL APPLIED ANATOMY, [dap. iv. 



the muscle sheath. When the insertions of the recti 

 muscles are divided in cases of strabismus, the capsule 

 is distinctly seen after the conjunctiva has been cut 

 through, and requires also to be divided before the 

 section of the muscle can be properly made. The 

 capsule is of some importance in this procedure. 

 After its division, the muscle does not entirely 

 retract and lie shrunken within the orbit. Its con- 

 nections with the capsule still give it some hold upon 

 the globe, and still enable it to act upon that structure. 

 Moreover, from the capsule, as it is reflected about 

 the recti muscles, four processes are given off, one 

 corresponding to each rectus, which are attached to 

 the margin of the orbit. These attachments prevent 

 the muscles from entirely retracting, and, even when 

 the globe has been removed, they give them some 

 basis to act upon, and thus tend to preserve some 

 little mobility in the stump. 



The orbit behind Tenon's fascia is occupied by a 

 large quantity of loose fat, in addition to the ocular 

 muscles, the vessels, and nerves. It is by the absorp- 

 tion of this fat that the sunken eye is produced in 

 cases of emaciation and prolonged illness. This 

 tissue affords a ready means for the spread of orbital 

 abscess. Such an abscess may follow injuries, 

 certain ocular inflammations, periostitis, etc., or may 

 spread from adjacent parts. The pus may occupy the 

 entire cavity, displacing the eye-ball forwards, limit- 

 ing its movements, and causing, by interference with 

 the circulation, great redness of the conjunctiva and 

 swelling of the lids. 



Foreign bodies, some of them of remarkable size 

 and shape, have lodged for long periods of time in 

 the orbital fat without causing much trouble. Thus 

 Lawson reports a case where a piece of an iron 

 hat-peg, three inches long, was embedded in the 

 orbit for several days without the patient being 



