The lacrimal artery is the largest branch of the ophthalmic artery, arising near the optic foramen and running along the superior border of the lateral rectus muscle to the lacrimal gland at the superolateral orbit. It supplies the lacrimal gland, the lateral eyelids, and the conjunctiva. Its zygomatic branch anastomoses with the zygomaticoorbital artery from the superficial temporal system.
The lacrimal artery is the primary blood supply to the lacrimal gland, and its preservation is important during lateral orbital wall surgery and lacrimal gland tumour biopsy. In dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction, the lacrimal sac is exposed but the lacrimal artery at the gland level is not usually encountered. The recurrent meningeal branch of the lacrimal artery passes through the superior orbital fissure to supply the anterior cranial fossa dura and may be a fistula pedicle in orbital dural arteriovenous fistulae.
Lateral orbital wall osteotomy for lacrimal gland tumour excision or sphenoid wing meningioma resection risks the lacrimal artery at the superolateral orbital rim; inadvertent division produces lacrimal gland ischaemia contributing to postoperative dry eye and keratitis sicca.
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