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Lacrimal Nerve

nervus lacrimalis

The lacrimal nerve is the smallest branch of the ophthalmic division of the trigeminal nerve (V1). It enters the orbit through the superior orbital fissure lateral to the frontal nerve and runs along the lateral orbital wall to reach the lacrimal gland. It provides sensory innervation to the lacrimal gland, the conjunctiva of the lateral upper eyelid, and the lateral skin of the upper eyelid. It also carries parasympathetic secretomotor fibres from the zygomaticotemporal branch of V2 to the lacrimal gland.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The lacrimal nerve is the conduit through which parasympathetic secretomotor fibres from the pterygopalatine ganglion (via the zygomaticotemporal nerve and a communication with the lacrimal nerve) reach the lacrimal gland to stimulate tear secretion. Disruption of this pathway produces dry eye from reduced lacrimal gland secretion. The nerve is at risk in lateral orbital wall approaches for orbital decompression in thyroid eye disease and in dacryocystorhinostomy procedures.

Pathology

Common Injuries & Conditions

Dry Eye from Lacrimal Nerve Injury

Injury to the lacrimal nerve or its secretomotor parasympathetic connections during lateral orbital surgery disrupts tear secretion from the lacrimal gland, producing dry eye syndrome requiring lubrication and occasionally punctal occlusion.