The Bony Orbit

Borders and Anatomical Relations

The bony orbit has a pyramidal shape, with its apex directed posteriorly and its base opening anteriorly onto the face.

The orbital walls are formed by seven bones, and their relationships with neighbouring structures are clinically important, particularly in trauma and the spread of infection.

The borders and anatomical relations of the bony orbit are as follows:

• Roof (superior wall) – Formed by the frontal bone and the lesser wing of the sphenoid. The frontal bone separates the orbit from the anterior cranial fossa.
• Floor (inferior wall) – Formed by the maxilla, palatine and zygomatic bones. The maxilla separates the orbit from the underlying maxillary sinus.
• Medial wall – Formed by the ethmoid, maxilla, lacrimal and sphenoid bones. The ethmoid bone separates the orbit from the ethmoid sinus.
• Lateral wall – Formed by the zygomatic bone and greater wing of the sphenoid.
• Apex – Located at the opening to the optic canal, the optic foramen.
• Base – Opens out into the face, and is bounded by the eyelids. It is also known as the orbital rim.

By TeachMeSeries Ltd (2025)

Fig 1
The anterior and lateral views of the bony orbit.

Contents

The bony orbit contains the eyeballs and their associated structures:

• Extra-ocular muscles – These muscles are separate from the eye. They are responsible for the movement of the eyeball and superior eyelid.
• Eyelids – These cover the orbits anteriorly.
• Nerves – Several cranial nerves supply the eye and its structures; optic, oculomotor, trochlear, trigeminal and abducens nerves.
• Blood vessels – The eye receives blood primarily from the ophthalmic artery. Venous drainage is via the superior and inferior ophthalmic veins.

Any space within the orbit that is not occupied is filled with orbital fat. This tissue cushions the eye, and stabilises the extraocular muscles.

By TeachMeSeries Ltd (2025)

Fig 2
Diagram of the arterial supply to the eye.

Pathways into the Orbit

There are three main pathways by which structures can enter and leave the orbit:

• Optic canal – transmits the optic nerve and ophthalmic artery.
• Superior orbital fissure – transmits the lacrimal, frontal, trochlear (CN IV), oculomotor (CN III), nasociliary and abducens (CN VI) nerves. It also carries the superior ophthalmic vein.
• Inferior orbital fissure – transmits the zygomatic branch of the maxillary nerve, the inferior ophthalmic vein, and sympathetic nerves.

There are other minor openings into the orbital cavity. The nasolacrimal canal, which drains tears from the eye to the nasal cavity, is located on the medial wall of the orbit.

Other small openings include the supraorbital foramen and infraorbital canal – they carry small neurovascular structures.

By TeachMeSeries Ltd (2025)

Fig 3
The major openings into the orbit.

Clinical Relevance

Fractures of the Bony Orbit

There are two major types of orbital fractures:

• Orbital rim fracture – a fracture of the bones forming the outer rim of the bony orbit. It usually occurs at the sutures joining the three bones of the orbital rim – the maxilla, zygomatic and frontal.
• ‘Blowout’ fracture – partial herniation of the orbital contents through one of its walls. This usually occurs via blunt force trauma to the eye. The medial and inferior walls are the weakest, with the contents herniating into the ethmoid and maxillary sinuses respectively.

Any fracture of the orbit will result in intraorbital pressure, raising the pressure in the orbit, causing exophthalmos (protrusion of the eye). There may also be involvement of surrounding structures, – e.g haemorrhage into one of the neighbouring sinuses.

By James Heilman, MD [CC-BY-SA-3.0] via Wikimedia Commons

Fig 4
CT scan of a blowout fracture of the eye, through the inferior wall. The contents of the orbit have herniated into the maxillary sinus.