The Orbital Septum of a Pediatric Patient

The orbital septum is not just a myth—Dr. Richard Allen demonstrates how robust this structure can be in a pediatric patient undergoing levator resection surgery for congenital ptosis. After making an incision, Dr. Allen uses a needle tip cautery to dissect through the orbicularis muscle to expose the orbital septum. This is an important dissection in children with congenital ptosis because the levator can often be infiltrated with fat, and thus making it difficult to distinguish from preaponeurotic fat. Dr. Allen uses gentle palpation on the globe to identify prolapse of the preaponeurotic fat, which can help to identify its location posterior to the septum.