Superior orbital fissure

Last revised by Raymond Chieng on 21 Apr 2023

The superior orbital fissure is the communication between the cavernous sinus and the apex of the orbit. It is straddled by the tendinous ring which is the common origin of the four rectus muscles (extraocular muscles).

Gross anatomy

Boundaries
Contents

Through the fissure (from superior to inferior) pass:

  1. lacrimal nerve (a branch of the ophthalmic division of the trigeminal nerve)

  2. frontal nerve (a branch of the ophthalmic division of the trigeminal nerve)

  3. superior ophthalmic vein

  4. trochlear nerve (CN IV)

  5. superior division of the oculomotor nerve (CN III)

  6. nasociliary nerve (a branch of the ophthalmic division of the trigeminal nerve)

  7. inferior division of the oculomotor nerve (CN III)

  8. abducens nerve (CN VI)

  9. a branch of the inferior ophthalmic vein

The order of the nerves may be remembered by these mnemonics.

Radiographic features

Plain radiograph

Superior orbital fissure is best seen on occipitofrontal view with 20 degrees caudal angulation 3.

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Cases and figures

  • Figure 1: anterior view of the orbit
    Drag here to reorder.
  • Case 2: orbital apex diagram
    Drag here to reorder.
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