Lockwood ligament is the inferior suspensory ligament of the eyeball, a hammock-shaped condensation of the inferior orbital fascial system formed by the fused sheaths of the inferior rectus and inferior oblique muscles, the check ligaments, and the orbital septum. It spans across the floor of the orbit from the medial to lateral orbital walls, supporting the globe from below and preventing inferior displacement.
| Origin | Lacrimal bone medially, blending with the medial check ligament |
|---|---|
| Insertion | Lateral orbital tubercle of the zygomatic bone, blending with the lateral check ligament |
Provides the primary inferior support for the globe within the orbital fat cone, prevents enophthalmos from inferior displacement, and contributes to globe positioning alongside the check ligaments and the levator-aponeurosis complex superiorly.
Lockwood ligament disruption or stretching in orbital floor blowout fractures allows the globe to descend, contributing to enophthalmos and hypoglobus. In orbital floor reconstruction, placing the implant at the correct posterior depth is essential to avoid persistent enophthalmos. Because the ligament slings the globe between the medial and lateral orbital walls, an intact Lockwood ligament can support the eye even when the orbital floor is removed in maxillectomy, so preserving it helps prevent post-operative globe displacement. In thyroid eye disease, fibrosis of the inferior rectus and Lockwood structures restricts upgaze.
Expansion of the orbital volume through an orbital floor fracture, combined with stretching of the Lockwood suspensory ligament, produces progressive enophthalmos of the globe that may not be apparent acutely due to haematoma, requiring delayed orbital floor repair to restore globe projection.
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