Orbital fat lies posterior to the orbital septum and anterior to the levator aponeurosis (upper eyelid) or the capsulopalpebral fascia (lower eyelid). In the upper eyelid, there are 2 fat pads: medial and central (preaponeurotic). In the lower eyelid, there are 3 fat pads: medial, central, and lateral (Fig 9-15). The inferior oblique muscle runs between the medial and central fat pads (Fig 9-16). These pockets are surrounded by thin fibrous capsules that are continuations of the anterior orbitoseptal system. The central orbital fat pad is an important landmark in both elective eyelid surgery and eyelid laceration repair because it lies directly behind the orbital septum and in front of the levator aponeurosis.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.