Medial canthal tendon: the anchor of the eyelid
- Highlighted area
Quick facts
- Definition
- Fibrous band that attaches the eyelids to the bone at the inner corner of the eye, near the nose.
- Where it anchors
- At the anterior lacrimal crest, on the medial rim of the orbit.
- Function
- To support the inner corner and the eyelid, and to relate to the tear drainage system.
- Neighbors
- Lacrimal sac, angular artery and vein.
- Relevance in HOF
- Reference for the medial part of the tear trough and the nasojugal groove.
The medial canthal tendon is a strong fibrous band that attaches the upper and lower eyelids to the bone on the nose side, at the inner corner of the eye. It anchors on the medial rim of the orbit, in the area of the lacrimal crest, and lies close to the lacrimal sac. Together with the lateral canthal tendon, it keeps the eyelids taut against the eyeball.
What does it do?
Besides supporting the inner corner, the tendon takes part in the mechanics of blinking and of pumping tears into the drainage system, through its relationship with fibers of the orbicularis oculi muscle. This is a general anatomical notion: managing changes of the tear system is an ophthalmology matter and is not part of HOF.
Why does it matter for the medial under-eye hollow?
The inner corner is the starting point of the nasojugal groove, the depression that runs down toward the cheek and is usually the most pronounced part of the "hollow under-eye". The medial area has very thin skin, ligaments that tether the skin to the bone and little covering fat, which helps explain the characteristic shadow. The tear trough is the procedural term for this area.
| Structure | Role in the area |
|---|---|
| Medial canthal tendon | Anchors the eyelid at the inner corner |
| Lacrimal bone and maxilla | Form the medial bony wall of the orbit |
| Thin skin of the lower eyelid | Makes the color of the vessels more visible |
| Nasojugal groove | Depression that starts at the inner corner |
Why does the area call for attention?
Near the inner corner are the angular artery and the angular vein, vessels that connect with the ocular circulation. For this reason the area is treated as high vascular risk in procedures with dermal filler. Anatomical knowledge, conservative volume, hyaluronidase on hand (when hyaluronic acid is used) and an action plan for signs of vascular occlusion are part of the preparation. The decision on whether to treat, and how, belongs to the licensed professional, according to the rules of their professional council in Brazil.
In Harmy
The Tear Trough area of the app's marking covers this region. Harmy's projection is an illustration: it does not represent deep structures such as the tendon, nor does it replace the in-person assessment of the periorbital area.
Also called: medial canthal ligament, medial palpebral tendon.
Frequently asked questions
Is the medial canthal tendon related to under-eye circles?
Indirectly. The inner corner is where the nasojugal groove begins, and the anchoring and ligaments of this area help explain why the medial hollow is so pronounced in many people.