Whitnall's ligament: the support of the eyelid levator
Quick facts
- Definition
- Fibrous suspensory band of the upper eyelid levator muscle, at the transition between muscle and aponeurosis.
- Function
- Serve as a support and change the direction of the levator's force, to lift the eyelid.
- Location
- Upper eyelid, in the upper part of the orbit.
- Clinical relevance
- Helps explain eyelid ptosis and the position of the crease.
Whitnall's ligament is a band of fibrous tissue in the upper part of the orbit. It supports the levator muscle of the upper eyelid at the transition between the muscular part and the aponeurosis, and works like a pulley: it changes the direction of the muscle's force, which is horizontal, to lift the eyelid.
Why does it matter?
Knowing it helps in understanding the mechanics of the upper eyelid. When the levator or its supports are weak or stretched, the eyelid drops: this is eyelid ptosis. The position of the aponeurosis also influences the upper eyelid crease, the visible fold of the eye. The fat in the area is the preaponeurotic fat.
| Structure | Role |
|---|---|
| Levator muscle | Lifts the eyelid |
| Whitnall's ligament | Suspension and change in the direction of force |
| Aponeurosis | Transmits the force to the eyelid |
| Orbital septum | Barrier that contains the fat |
Is it relevant for the HOF patient?
Yes, indirectly. Eyelid droop after toxin is a known source of complaints, and understanding the anatomy of the area helps in talking with the patient and in recognizing what is a complication and what is a pre-existing condition. See ptosis after botulinum toxin.
Frequently asked questions
What is the function of Whitnall's ligament?
It is a support for the upper eyelid levator muscle: it works like a pulley that changes the direction of the muscle's force, allowing the eyelid to lift.