The orbital margin is the thick bony rim around the opening of the eye socket. The frontal bone forms the upper rim, the zygomatic bone the lateral rim and part of the lower rim, and the maxilla the medial and the rest of the lower rim. It protects the eye from blows and carries the exit points of the supraorbital and infraorbital nerves.
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| Landmarks |
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| Ossification | Built from the frontal, zygomatic and maxillary bones, which ossify in membrane from about the 6th-8th weeks of fetal life. |
A step or tenderness along the lower or lateral rim after a blow to the cheek suggests a zygomaticomaxillary complex fracture, often with numbness of the cheek and upper lip from infraorbital nerve injury. In a blowout fracture the thin orbital floor breaks while the rim stays intact. Cuts over the upper rim are common in boxing because the skin is pinned against bone, and the supraorbital nerve is blocked at the notch for forehead procedures.
With the eyes gently closed, run a fingertip around the bony edge of the eye socket, never pressing on the eyeball itself. Along the upper rim under the eyebrow, about a third of the way out from the midline, feel for a small dip, the supraorbital notch. Continue around the firm lateral rim, where a slight dip marks the frontozygomatic suture, and along the lower rim; compare both sides for symmetry or steps.
Fracture of the cheekbone and its links to the orbit, causing a flattened cheek, a palpable step at the rim and numbness below the eye.
A blow to the eye raises pressure in the orbit and breaks the floor or medial wall, causing double vision and sunken eye while the rim is intact.
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