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# Eye fascia

The eye fascia is a thin sheath around the eyeball with a supporting hammock below; it lets the eye turn smoothly and holds it up.

Official name: Suspensory ligament of eyeball

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## What it is

A thin sheath around the eyeball with a hammock underneath.

## What it does

Lets the eye turn smoothly and supports it from below.

## Key points

- The fascial sheath (Tenon capsule) wraps the eyeball from the optic nerve to near the limbus; the episcleral (sub-Tenon) space between it and the sclera lets the eye turn like a ball in a socket
- The tendons of all six extraocular muscles pierce it and it sends sleeves back along them; expansions of the medial and [lateral rectus](https://durgical.com/en/anatomy/lateral-rectus-muscle/) sleeves form the check ligaments, which limit those movements
- The suspensory ligament (Lockwood) is built mainly from the fused sheaths of the [inferior rectus](https://durgical.com/en/anatomy/inferior-rectus-muscle/) and [inferior oblique](https://durgical.com/en/anatomy/inferior-oblique-muscle/), joined at each end to the check ligaments

## Key facts

**Attaches**
Fascial sheath (Tenon capsule) from the optic nerve to the limbus; suspensory ligament (Lockwood) slung below the eye between the lacrimal and zygomatic bones

**Function**
Socket in which the eye turns; holds the eye up if the orbital floor breaks

## Relations

**Superficial**
Bulbar conjunctiva, fused to it in the last few millimetres before the limbus

**Deep**
[Sclera](https://durgical.com/en/anatomy/sclera/), separated by the thin episcleral space crossed by fine connective strands

**Behind**
Blends with the dural sheath of the [optic nerve](https://durgical.com/en/anatomy/optic-nerve/); orbital fat lies behind and around it

**Medial**
Medial check ligament to the [lacrimal bone](https://durgical.com/en/anatomy/lacrimal-bone/), behind the posterior lacrimal crest

**Lateral**
Lateral check ligament to the orbital tubercle of the [zygomatic bone](https://durgical.com/en/anatomy/zygomatic-bone/)

**Below**
The suspensory ligament, a hammock under the globe; in front it continues as the capsulopalpebral fascia into the lower lid, so the lower lid follows the eye on downgaze

## How to find it

It is met in surgery after the bulbar conjunctiva is opened near the limbus: a whitish layer over the sclera, thicker in young people, which is opened in turn to reach the rectus muscle insertions.

## On imaging

Orbital ultrasound (B-scan) in posterior scleritis shows fluid in the sub-Tenon space around the back of the globe and the optic nerve, the "T sign".

## Clinical notes

- Sub-Tenon anaesthesia: a blunt cannula passed into the episcleral space spreads anaesthetic around the globe for cataract and other eye surgery, without a sharp needle behind the eye
- After removal of the eye (enucleation), an orbital implant is placed inside the sheath and the recti are attached to it, so the artificial eye can move
- In strabismus surgery the muscles are reached through the conjunctiva and the sheath; in glaucoma filtering surgery, scarring of the sheath over the drainage bleb is a main cause of failure

## Related conditions

- [Orbital cellulitis](https://durgical.com/en/conditions/orbital-cellulitis/)

## Test yourself

Think of the answer, then tap the question to see it.

## What is the fascial sheath of the eyeball (Tenon capsule), and what does the space beneath it allow?

A sheath wrapping the globe from the optic nerve to near the limbus; the episcleral (sub-Tenon) space lets the eye turn like a ball in a socket.

## What forms the suspensory ligament of the eye (Lockwood)?

Mainly the fused sheaths of the inferior rectus and inferior oblique, joined at each end to the check ligaments; it slings the globe from below.

## How is sub-Tenon anaesthesia given for eye surgery?

A blunt cannula is passed into the episcleral space to spread anaesthetic around the globe, without a sharp needle behind the eye.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
ligamentum suspensorium bulbi TA2 6818

**Official Spanish (DeCS)**
Vaina del globo ocular

**English (TA2)**
Suspensory ligament of eyeball

**Also called**
lockwood’s ligament

Sources: Terminologia Anatomica (TA2); [Anatomy, Head and Neck, Eye Extraocular Muscles](https://www.ncbi.nlm.nih.gov/books/NBK519565/); [Anatomy, Head and Neck, Orbit](https://www.ncbi.nlm.nih.gov/books/NBK539843/).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/suspensory-ligament-of-eyeball/