THE ORBIT AND EYE 



1347 



Orbicularis. Paralysis of this, the palpebral portion, leads to epiphora, the 

 puncta being no longer kept in their normal backward direction against the 

 conjunctiva. (4) Palpebral fascia, reaching from the orbit to the tarsal cartilage. 

 This is usually strong enough to prevent haemorrhage, due to fractured base of 

 skull, becoming subcutaneous. (5) Levator palpebrae. (6) Tarsal plate; in 

 reality, densely felted fibrous tissue. (7) Tarsal (Meibomian) glands, lashes, 

 and sebaceous follicles. 



Localised inflammation starting in any of these last three structures, especially the last, will 

 cause a 'stye.' The frequency with which the lid-border is the seat of that most troublesome 

 chronic inflammation, blepharitis, and its result, 'blear eye,' is explained by these anatomical 

 points. Its circulation is terminal and slow; half skin and half mucous membrane, it is moister 

 and more liable to local irritation than the skin; while its numerous glands readily partici- 

 pate in any inflammation. 



Fig. 1094. — Sagittal Section Through the Upper Eyelid. 



Cutaneous surface 

 just above supe- 

 rior palpebral fold 



Orbicularis fibres, cut. 



across 

 Sweat-gland — - 



Fine hair with sebaceous 

 gland at its base 



Orbicularis fibres, cut 



across 



(After Waldeyer and Fuchs.) 



7 



. Conjunctiva near fornix 



' y Anterior layer of insertion 



of levator palpebrffi 



superions 



Superior tarsal muscle 



of Miiller 

 Fibres from levator passing 

 through orbicularis to skin 



"~ Superior vascular arch, cut 

 across 



,^-- Mucous glands 



Conjunctival papillae over 

 attached border of tarsus 



— Mucous gland 



Ciliary gland of Moll "" ' '<<K-C ^^//J!} ~J)-^- 

 Cihum -^.^ \i^y^ / ) -- 



Tarsal (Meibomian) gland 



— - — Musculus ciliaris Riolani 



"Posterior edge of lid-margin 

 Opening of duct of tarsal gland 



(8) The conjunctiva. To trace this important membrane, the lids should -be 

 everted, when the following will be noted. The conjunctiva over the tarsal part 

 of the lid is closely adherent, and through it a series of nearly straight, parallel, 

 light yellow lines and granules, the tarsal glands, can be seen. Owdng to their 

 position here (fig. 1094) and to avoid scarring, a tarsal cyst is always opened on its 

 conjunctival surface. 



Beyond the tarsi, the palpebral conjunctiva is thicker and freely movable 

 owing to the abundant lax submucous tissue. Underlying vessels are visible 

 here. Leaving the eyelid the conjunctiva is reflected onto the eyeball at the 

 fornix. Into the lateral part of the upper fornix open the ducts of the lacrimal 

 gland. The bulbar conjunctiva is continued over the front of the ej^eball to the 

 corneal margin. It is thin and contains fine vessels which are distinguished from 

 subjacent episcleral vessels by the fact that they move with the conjunctiva. 



