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The ophthalmic artery (OA) is an artery of the head. It is the first branch of the
internal carotid artery The internal carotid artery (Latin: arteria carotis interna) is an artery in the neck which supplies the anterior circulation of the brain. In human anatomy, the internal and external carotids arise from the common carotid arteries, where these b ...
distal to the
cavernous sinus The cavernous sinus within the human head is one of the dural venous sinuses creating a cavity called the lateral sellar compartment bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica. Structure The cave ...
. Branches of the ophthalmic artery supply all the structures in the
orbit In celestial mechanics, an orbit is the curved trajectory of an object such as the trajectory of a planet around a star, or of a natural satellite around a planet, or of an artificial satellite around an object or position in space such as a p ...
around the eye, as well as some structures in the
nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes th ...
,
face The face is the front of an animal's head that features the eyes, nose and mouth, and through which animals express many of their emotions. The face is crucial for human identity, and damage such as scarring or developmental deformities may aff ...
, and
meninges In anatomy, the meninges (, ''singular:'' meninx ( or ), ) are the three membranes that envelop the brain and spinal cord. In mammals, the meninges are the dura mater, the arachnoid mater, and the pia mater. Cerebrospinal fluid is located in th ...
. Occlusion of the ophthalmic artery or its branches can produce sight-threatening conditions.


Structure

The ophthalmic artery emerges from the
internal carotid artery The internal carotid artery (Latin: arteria carotis interna) is an artery in the neck which supplies the anterior circulation of the brain. In human anatomy, the internal and external carotids arise from the common carotid arteries, where these b ...
. This is usually just after the internal carotid artery emerges from the
cavernous sinus The cavernous sinus within the human head is one of the dural venous sinuses creating a cavity called the lateral sellar compartment bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica. Structure The cave ...
. In some cases, the ophthalmic artery branches just before the internal carotid exits the cavernous sinus. The ophthalmic artery emerges along the medial side of the
anterior clinoid process In the sphenoid bone, the posterior border, smooth and rounded, is received into the lateral fissure of the brain; the medial end of this border forms the anterior clinoid process, which gives attachment to the tentorium cerebelli; it is sometimes ...
. It runs anteriorly, passing through the
optic canal The ''optic foramen'' is the opening to the optic canal. The canal is located in the sphenoid bone; it is bounded medially by the body of the sphenoid and laterally by the lesser wing of the sphenoid. The superior surface of the sphenoid bone is b ...
inferolaterally to the
optic nerve In neuroanatomy, the optic nerve, also known as the second cranial nerve, cranial nerve II, or simply CN II, is a paired cranial nerve that transmits visual information from the retina to the brain. In humans, the optic nerve is derived fro ...
. It can also pass superiorly to the optic nerve in a minority of cases. In the posterior third of the cone of the orbit, the ophthalmic artery turns sharply and medially to run along the medial wall of the orbit. Because of the obvious importance of the ocular globe, branches of the ophthalmic artery often are subdivided into two groups: those that supply the eyeball (ocular group) and those that supply non-ocular orbital structures (orbital group).


Orbital group

The orbital group, distributing vessels to the orbit and surrounding parts, includes: *
Lacrimal artery The lacrimal artery is an artery of the orbit. It is a branch of the ophthalmic artery. It accompanies the lacrimal nerve along the upper border of the lateral rectus muscle, travelling forward to reach the lacrimal gland. It supplies the lacrima ...
''A. lacrimalis'' *
Supraorbital artery The supraorbital artery is a branch of the ophthalmic artery. It passes anteriorly within the orbit to exit the orbit through the supraorbital foramen or notch alongside the supraorbital nerve, splitting into two terminal branches which go on to f ...
''A. supraorbitalis'' *
Posterior ethmoidal artery The posterior ethmoidal artery is an artery of the head which supplies the nasal septum. It is smaller than the anterior ethmoidal artery. Course Once branching from the ophthalmic artery, it passes between the upper border of the medial rectus mu ...
''A. ethmoidalis posterior'' *
Anterior ethmoidal artery The anterior ethmoidal artery is a branch of the ophthalmic artery in the orbit. It exits the orbit through the anterior ethmoidal foramen. The posterior ethmoidal artery is posterior to it. Structure The anterior ethmoidal artery branches from t ...
''A. ethmoidalis anterior'' *
Medial palpebral artery The medial palpebral arteries (internal palpebral arteries) are arteries of the head that contribute arterial blood supply to the eyelids. They are derived from the ophthalmic artery; a single medial palpebral artery issues from the ophthalmic arte ...
''A. palpebralis medialis'' *
Frontal artery The supratrochlear artery (or frontal artery) is one of the terminal branches of the ophthalmic artery. It arises within the orbit. It exits the orbit alongside the supratrochlear nerve. It contributes arterial supply to the skin, muscles and peric ...
, also called the Supratrochlear artery ''A. supratrochlearis'' *
Dorsal nasal artery The dorsal nasal artery is an artery of the face. It is one of the two terminal branches of the ophthalmic artery. It contributes arterial supply to the lacrimal sac, and outer surface of the nose. Structure Origin The dorsal nasal artery is on ...
''A. dorsalis nasi''


Ocular group

The ocular group, distributing vessels to the eye and its muscles, includes: *
Long posterior ciliary arteries The long posterior ciliary arteries are arteries of the head arising, together with the other ciliary arteries, from the ophthalmic artery. There are two in each eye. Course They pierce the posterior part of the sclera at some little distance fr ...
''Aa. ciliares posteriores longae'' *
Short posterior ciliary arteries The short posterior ciliary arteries, around twenty in number, arise from the medial posterior ciliary artery and lateral posterior ciliary artery, which are branches of the ophthalmic artery as it crosses the optic nerve. Course and target They p ...
''Aa. ciliares posteriores breves'' * Anterior ciliary artery ''A. ciliares anterior'' *
Central retinal artery The central retinal artery (retinal artery) branches off the ophthalmic artery, running inferior to the optic nerve within its dural sheath to the eyeball. Structure The central retinal artery pierces the eyeball close to the optic nerve, sendin ...
''A. centralis retinae'' * Superior muscular artery ''A. supraorbitalis'' * Inferior muscular artery ''A. infraorbitalis''


Central retinal artery

The
central retinal artery The central retinal artery (retinal artery) branches off the ophthalmic artery, running inferior to the optic nerve within its dural sheath to the eyeball. Structure The central retinal artery pierces the eyeball close to the optic nerve, sendin ...
is the first, and one of the smaller branches of the ophthalmic artery and runs in the dura mater inferior to the optic nerve. About 12.5mm (0.5 inch) posterior to the globe, the central retinal artery turns superiorly and penetrates the optic nerve, continuing along the center of the optic nerve, entering the eye to supply the inner retinal layers.


Lacrimal artery

The next branch of the ophthalmic artery is the
lacrimal artery The lacrimal artery is an artery of the orbit. It is a branch of the ophthalmic artery. It accompanies the lacrimal nerve along the upper border of the lateral rectus muscle, travelling forward to reach the lacrimal gland. It supplies the lacrima ...
, one of the largest, arises just as the OA enters the orbit and runs along the superior edge of the
lateral rectus muscle Lateral is a geometric term of location which may refer to: Healthcare *Lateral (anatomy), an anatomical direction *Lateral cricoarytenoid muscle *Lateral release (surgery), a surgical procedure on the side of a kneecap Phonetics *Lateral cons ...
to supply the
lacrimal gland The lacrimal glands are paired exocrine glands, one for each eye, found in most terrestrial vertebrates and some marine mammals, that secrete the aqueous layer of the tear film. In humans, they are situated in the upper lateral region of each or ...
,
eyelids An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. The human eye ...
and
conjunctiva The conjunctiva is a thin mucous membrane that lines the inside of the eyelids and covers the sclera (the white of the eye). It is composed of non-keratinized, stratified squamous epithelium with goblet cells, stratified columnar epithelium ...
.


Posterior ciliary arteries

The ophthalmic artery then turns medially, giving off 1 to 5 posterior ciliary arteries (PCA) that subsequently branch into the long and short posterior ciliary arteries (LPCA and SPCA respectively) which perforate the sclera posteriorly in the vicinity of the optic nerve and macula to supply the posterior uveal tract. In the past, anatomists made little distinction between the posterior ciliary arteries and the short and long posterior ciliary arteries often using the terms synonymously. However, recent work by Hayreh has shown that there is both an anatomic and clinically useful distinction. The PCAs arise directly from the OA and are end arteries which is to say no PCA or any of its branches anastomose with any other artery. Consequently, sudden occlusion of any PCA will produce an infarct in the region of the choroid supplied by that particular PCA. Occlusion of a short or long PCA will produce a smaller choroidal infarct, within the larger area supplied by the specific parent PCA.


Muscular branches

The ophthalmic artery continues medially the superior and inferior muscular branches arise either from the ophthalmic artery directly or a single trunk from the ophthalmic artery subsequently divides into superior and inferior branches to supply the
extraocular muscles The extraocular muscles (extrinsic ocular muscles), are the seven extrinsic muscles of the human eye. Six of the extraocular muscles, the four recti muscles, and the superior and inferior oblique muscles, control movement of the eye and the othe ...
.


Supraorbital artery

The
supraorbital artery The supraorbital artery is a branch of the ophthalmic artery. It passes anteriorly within the orbit to exit the orbit through the supraorbital foramen or notch alongside the supraorbital nerve, splitting into two terminal branches which go on to f ...
branches from the ophthalmic artery as it passes over the optic nerve. The supraorbital artery passes anteriorly along the medial border of the superior rectus and levator palpebrae and through the supraorbital foramen to supply muscles and skin of the forehead.


Ethmoidal arteries

After reaching the medial wall of the orbit, the ophthalmic artery again turns anteriorly. The
posterior ethmoidal artery The posterior ethmoidal artery is an artery of the head which supplies the nasal septum. It is smaller than the anterior ethmoidal artery. Course Once branching from the ophthalmic artery, it passes between the upper border of the medial rectus mu ...
enters the nose via the posterior ethmoidal canal and supplies the posterior ethmoidal sinuses and enters the skull to supply the meninges. The OA continues anteriorly, giving off the
anterior ethmoidal artery The anterior ethmoidal artery is a branch of the ophthalmic artery in the orbit. It exits the orbit through the anterior ethmoidal foramen. The posterior ethmoidal artery is posterior to it. Structure The anterior ethmoidal artery branches from t ...
which enters the nose after traversing the anterior ethmoidal canal and supplies the anterior and middle ethmoidal sinuses, as well as the frontal sinus and also enters the cranium to supply the meninges.


Medial palpebral arteries

The OA continues anteriorly to the trochlea, where the medial palpebral arteries (superior and inferior) arise and supply the eyelids.


Terminal branches

The OA terminates in two branches, the supratrochlear (or frontal) artery and the dorsal nasal artery. Both exit the orbit medially to supply the forehead and scalp.


Function

Branches of the ophthalmic artery supply: * Frontal belly of the
occipitofrontalis muscle The occipitofrontalis muscle (epicranius muscle) is a muscle which covers parts of the skull. It consists of two parts or bellies: the occipital belly, near the occipital bone, and the frontal belly, near the frontal bone. It is supplied by th ...
*
Inferior oblique muscle The inferior oblique muscle or obliquus oculi inferior is a thin, narrow muscle placed near the anterior margin of the floor of the orbit. The inferior oblique is one of the extraocular muscles, and is attached to the maxillary bone (origin) and ...
*
Inferior rectus muscle The inferior rectus muscle is a muscle in the orbit near the eye. It is one of the four recti muscles in the group of extraocular muscles. It originates from the common tendinous ring, and inserts into the anteroinferior surface of the eye. It de ...
*
Lacrimal gland The lacrimal glands are paired exocrine glands, one for each eye, found in most terrestrial vertebrates and some marine mammals, that secrete the aqueous layer of the tear film. In humans, they are situated in the upper lateral region of each or ...
*
Lateral rectus muscle Lateral is a geometric term of location which may refer to: Healthcare *Lateral (anatomy), an anatomical direction *Lateral cricoarytenoid muscle *Lateral release (surgery), a surgical procedure on the side of a kneecap Phonetics *Lateral cons ...
*
Levator palpebrae superioris muscle The levator palpebrae superioris ( la, elevating muscle of upper eyelid) is the muscle in the orbit that elevates the upper eyelid. Structure The levator palpebrae superioris originates from inferior surface of the lesser wing of the sphenoid bon ...
*
Medial rectus muscle The medial rectus muscle is a muscle in the orbit near the eye. It is one of the extraocular muscles. It originates from the common tendinous ring, and inserts into the anteromedial surface of the eye. It is supplied by the inferior division of t ...
*
Nasalis muscle The nasalis muscle is a sphincter-like muscle of the nose. It has a transverse part and an alar part. It compresses the nasal cartilages, and can "flare" the nostrils. Some people can use it to close the nostrils to prevent entry of water when un ...
*
Procerus muscle The procerus muscle (or pyramidalis nasi) is a small pyramidal slip of muscle deep to the superior orbital nerve, artery and vein. ''Procerus'' is Latin, meaning tall or extended. Structure The procerus muscle arises by tendinous fibers from t ...
*
Superior oblique muscle The superior oblique muscle, or obliquus oculi superior, is a fusiform muscle originating in the upper, medial side of the orbit (i.e. from beside the nose) which abducts, depresses and internally rotates the eye. It is the only extraocular musc ...
*
Superior rectus muscle The superior rectus muscle is a muscle in the orbit. It is one of the extraocular muscles. It is innervated by the superior division of the oculomotor nerve (III). In the primary position (looking straight ahead), its primary function is elevatio ...


Clinical significance

Severe occlusion of the ophthalmic artery causes
ocular ischemic syndrome Ocular ischemic syndrome is the constellation of ocular signs and symptoms secondary to severe, chronic arterial hypoperfusion to the eye. Amaurosis fugax is a form of acute vision loss caused by reduced blood flow to the eye; it may be a warn ...
. As with
central retinal artery The central retinal artery (retinal artery) branches off the ophthalmic artery, running inferior to the optic nerve within its dural sheath to the eyeball. Structure The central retinal artery pierces the eyeball close to the optic nerve, sendin ...
occlusions, ophthalmic artery occlusions may result from systemic
cardiovascular disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, h ...
s; however, a
cherry-red spot A cherry-red spot is a finding in the macula of the eye in a variety of lipid storage disorders and in central retinal artery occlusion. It describes the appearance of a small circular choroid shape as seen through the fovea centralis. Its appe ...
is typically absent and the vision is usually worse.
Amaurosis fugax Amaurosis fugax (Greek ''amaurosis'' meaning ''darkening'', ''dark'', or ''obscure'', Latin '' fugax'' meaning ''fleeting'') is a painless temporary loss of vision in one or both eyes. Signs and symptoms The experience of amaurosis fugax is clas ...
is a temporary loss of vision that occurs in two conditions which cause a temporary reduction in ophthalmic artery pressure:
orthostatic hypotension Orthostatic hypotension, also known as postural hypotension, is a medical condition wherein a person's blood pressure drops when standing up or sitting down. Primary orthostatic hypertension is also often referred to as neurogenic orthostatic hyp ...
and positive acceleration. Even complete occlusion of the ophthalmic artery may possibly leave the eye without symptoms, probably because of
circulatory anastomoses A circulatory anastomosis is a connection (an anastomosis) between two blood vessels, such as between arteries (arterio-arterial anastomosis), between veins (veno-venous anastomosis) or between an artery and a vein (arterio-venous anastomosis) ...
A case of ophthalmic artery occlusion without manifestation of ocular ischemic syndrome.
Authors;SHIMABUKURO MIKIKO (Izumisano City Hosp.) OJI MASATO (Osaka Univ., Med. Sch.) AOMATSU ICHIKO (Osaka Police Hosp.) FUKUI TAKEHIRO (Osaka Police Hosp.) TSUKAMOTO HIROKO (Osaka Police Hosp.) TANAKA YASUO (Osaka Police Hosp.) NISHIKAWA NORIKIYO (Osaka Police Hosp.) KITANISHI KUNIKO (Shiritsuizumiotsubyoin) OZAKI TOSHIYA (Kojunkaiobpkurinikku). Journal Title;Japanese Journal of Clinical Ophthalmology. Journal Code:Z0515B. . VOL.54;NO.1;PAGE.97-101(2000)


See also

*
Fluorescein angiography Fluorescein angiography (FA), fluorescent angiography (FAG), or fundus fluorescein angiography (FFA) is a technique for examining the circulation of the retina and choroid (parts of the fundus) using a fluorescent dye and a specialized camera. S ...


References


External links

* * * {{Authority control Arteries of the head and neck