The Anatomy of the Ophthalmic Artery

The ophthalmic artery supplies blood to the eyes and parts of the face

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Emerging as the first branch of the internal carotid artery to the side of the cavernous sinus, the ophthalmic artery and its branches supply structures in the orbit of the eye (the cavity that holds the eyeball), parts of the nose, face, and meninges (the membranes that surround the brain). This artery passes into the inside of the eye, or orbit, via the optic canal and is especially important for vision. As such, occlusion or blockage of its course can cause blindness or severe vision impairment.

Anatomy

Structure and Location

The ophthalmic artery emerges from the internal carotid artery next to the anterior clinoid process, a bony projection from the skull’s sphenoid bone at the side of the head (making up one of the borders of the eye’s orbit). From there, it passes through the optic canal into the eye’s orbit just next to the optic nerve. This artery then gives rise to a range of important branches, including:

  • Central retinal artery: The first branch runs in the dura mater—the firm, outer membrane that surrounds the spinal cord and cranium—around the optic nerve, before coursing towards the inner layers of the retina (the part of the eye involved with vision).
  • Lacrimal artery: The largest artery to emerge from the ophthalmic artery, the lacrimal artery enters the orbit, crossing the upper edge of the lateral rectus muscle, one of the six muscles involved in eye movement.   
  • Posterior ciliary arteries: These arteries, of which there are several, pass through the sclera (the white, outer membrane of the eyeball), supplying the back of the uveal tract, which is the layer of tissue between the inner and outer membranes.
  • Supraorbital artery: This branch passes through the supraorbital foramen—a cavity located above the eyeball—to reach the forehead. 
  • Inferior and superior muscular vessels: These vessels are involved in supplying blood to the extra-orbital muscles, which regulate eye movement. 
  • Additional branches: Smaller branches of the ophthalmic artery including the ethmoid arteries (supplying the sinuses, nose, and the meninges, the membrane enclosing the brain and spinal cord), and the medial palpebral arteries (which reach the upper and lower eyelids), among others. 

Anatomical Variations

Variations in the anatomy of this artery, present at birth, tend to relate to the way the orbit of the eye is supplied. In most cases, supply is split between the ophthalmic artery and the supraorbital branch of the middle meningeal artery, but there are differences in how it all takes shape:

  • In the largest proportion of cases—around 50% of the time—the communicating branch between the ophthalmic artery and the middle meningeal artery runs through the superior orbital fissure. This is known as the sphenoidal artery, recurrent meningeal artery, or the orbital branch of the middle meningeal artery.
  • About 15% of the time, there are multiple communicating branches between the middle meningeal and ophthalmic arteries. In these cases, there are one or more additional foramen (cavities) to the side of the superior orbital fissure, an opening in between two bones of the skull.
  • In other cases, there is a complete absence of ophthalmic artery, and the middle meningeal artery supplies the entire orbit.

Another aspect of ophthalmic artery anatomy that sees a great deal of variation has to do with where it originates and where it enters the orbit. These differences include:

  • In some cases, the middle meningeal artery arises directly from the ophthalmic artery.
  • The ophthalmic artery can also arise from the middle meningeal artery, the middle cerebellar artery, or the posterior communicating artery.       
  • In rare cases, the artery emerges from the cavernous internal carotid, a branch of the common carotid artery near the sinus.

Function

The ophthalmic artery supplies the structures inside the eye’s orbit, as well as those on the face and nose. Playing a key role in vision, it supplies the retina of the eye (the opening), the sclera (the white outer membrane), the uvea (a membrane between the eye’s layers), the eyelids, and the lacrimal gland (which produces tears). This artery also ensures muscles involved in eye movement—the extra-orbital muscles—are nourished. Finally, branches of the ophthalmic artery supply significant parts of the sinuses, face, and muscles and skin of the forehead.

Clinical Significance

Given the importance of this artery for vision and role in providing blood to the face, disorders of this artery can be dangerous or damaging in their own right, while also being signs of other illnesses or diseases. These include:

  • Aneurysm: Aneurysm is the localized enlargement, or "bubbling," of any artery that results from weakening of the artery wall. Aneurysms can rupture, which can cause life threatening bleeding, and in the setting of an ophthalmic artery, aneurysm rupture can cause morbidity or mortality from subarachnoid hemorrhage, which is a type of stroke.
  • Carotid artery disease: A condition defined by the build-up of a waxy plaque within the carotid arteries, of which the ophthalmic artery is a part. This is a leading cause of stroke, and among the dangers are clotted blood material occluding this artery.  
  • Central retinal artery occlusion: Blockages of blood flow within the ophthalmic artery can end up within the retinal artery, which supplies the eye’s retina. As such, this condition can lead to blindness.
  • Retinoblastoma: A rare type of eye cancer, retinoblastoma develops in early childhood and usually affects only one eye. Without medical management, like other cancers, this one can become very dangerous; however, specialized approaches, such as chemotherapy of the ophthalmic artery, can greatly improve prognosis.          
  • Giant cell arteritis: This rare disorder of the arteries is characterized by inflammation of certain arteries and vessels. Giant cell arteritis is most often localized in the temples, but it can affect many parts of the body, including the ophthalmic artery. Blindness, which results from such inflammation, can occur if the disease does untreated.
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Article Sources

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