ANATOMY OF A BLACK EYE - A NEWLY DESCRIBED FASCIAL SYSTEM OF THE LOWER EYELID

The anatomy of a black eye is examined in a series of cadaver dissecti ons in which a previously unreported fascial system of the lower eyeli d is identified. This fascia originates at the orbital rim, and is in continuity with the orbital septum and with the periosteum of the orbi tal floor and anterior maxillary wail. This fascia contributes to the thickened area along the orbital rim called the arcus marginale. At th e level of the orbicularis oculi muscle, this fascia was noted microsc opically to fuse with a fibrous septa of the superficial cheek fat. Th is creates one long continuous membrane from the orbital rim above to the cheek skin below. Dye injection techniques show that this membrane is impermeable and traps injected dye in the same place where a black eye forms. After periorbital injury, extravasated hemoglobin pigment is confined to the area above the cutaneous insertion of this membrane . This fascial system has been named the septum malaris: malar describ es its origin along the orbital rim of the cheek, and septum further d escribes the partitioning nature of this ultra-thin membrane. (C) 1998 Wiley-Liss. Inc.