The lacrimal gland is composed of a larger orbital lobe and a smaller palpebral lobe. The gland is located within a fossa of the frontal bone in the superotemporal orbit. Ducts from both lobes pass through the palpebral lobe and empty into the upper conjunctival fornix. Frequently, a portion of the palpebral lobe is visible on slit-lamp examination with the upper eyelid everted. Biopsy is generally not performed on the palpebral lobe or temporal conjunctival fornix because it can interfere with lacrimal drainage. The orbital lobe of the lacrimal gland may prolapse inferiorly out of the fossa and present as a mass in the lateral upper eyelid.
Figure 1-10 Sensory innervation of the periorbital area. A, Sensory nerves. 1, CN V (trigeminal); 2, trigeminal ganglion; 3, ophthalmic division of CN V (V1); 4, maxillary division of CN V (V2); 5, mandibular division of CN V (V3); 6, frontal nerve; 7, supraorbital nerve; 8, supratrochlear nerve (trochlea noted by purple); 9, infratrochlear nerve; 10, nasociliary nerve; 11, posterior ethmoidal nerve; 12, anterior ethmoidal nerve; 13, external or dorsal nasal nerve; 14, lacrimal nerve; 15, posterior superior alveolar nerve; 16, zygomatic nerve; 17, zygomaticotemporal nerve; 18, zygomaticofacial nerve; 19, infraorbital nerve; 20, anterior superior alveolar nerve. B, Contributions to the ciliary ganglion.
(Part A reproduced with permission from Zide BM, Jelks GW, eds. Surgical Anatomy of the Orbit. New York: Raven; 1985:12. Part B reproduced with permission from Doxanas MT, Anderson RL. Clinical Orbital Anatomy. Baltimore: Williams & Wilkins; 1984.)
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.