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.
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, restoring the Lockwood ligament tension by precisely placing the floor implant at the correct posterior depth is essential for avoiding persistent enophthalmos. In lower eyelid surgery, disruption of the orbital septum-Lockwood relationship contributes to inferior globe malposition. 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.
