The orbital septum is a thin fibrous membrane extending from the orbital rim periosteum (arcus marginalis) to the tarsal plates of the upper and lower eyelids. It forms the anterior boundary of the orbital fat compartments and separates the preseptal (anterior) from the postseptal (orbital) spaces.
| Origin | Periosteum of the orbital rim (arcus marginalis) |
|---|---|
| Insertion | Levator aponeurosis in the upper eyelid and the lower border of the tarsal plate in the lower eyelid |
Separates the pre-orbital (preseptal) from the orbital (postseptal) compartments; anterior barrier limiting spread of preseptal infection into the orbit.
The orbital septum is the critical surgical landmark distinguishing preseptal from orbital cellulitis. Infection posterior to the septum constitutes orbital cellulitis, a potentially life-threatening condition requiring IV antibiotics and urgent imaging. Blepharoplasty surgery opens the orbital septum to access the orbital fat. Ptosis surgery addresses the relationship between the septum and the levator aponeurosis. Orbital fractures may herniate orbital fat through the septal plane.
Distinction between infection anterior to the orbital septum (preseptal, less severe) and posterior to the septum (orbital, sight-threatening), based on proptosis, ophthalmoplegia, and loss of vision indicating postseptal involvement.
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