{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:32:51Z","timestamp":1787070771331,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"Abstract<\/jats:title>\n The orbit is defined as the space posterior to the orbital septum. While the orbital septum\u2019s attachment to the bone and soft tissues in the superior and inferior regions has been well documented, its attachment in the medial and lateral canthal areas remains controversial. Consequently, the definition of the orbit in these regions is uncertain. In this study, we aim to precisely define the orbital area.<\/jats:p>\n \n SUPERIOR AREA:<\/jats:title>\n The orbital septum originates from the arcus marginalis and attaches to the levator aponeurosis several millimeters above the upper tarsal plate.<\/jats:p>\n <\/jats:sec>\n \n INFERIOR AREA:<\/jats:title>\n It similarly arises from the arcus marginalis nasally but extends beyond the orbital margin temporally, reaching the anterior surface of the maxillary bone. The space between the orbital septum and the maxillary bone is called the recess of Eisler. The orbital septum\u2019s attachment to the lower eyelid retractors is located several millimeters below the lower tarsal plate.<\/jats:p>\n <\/jats:sec>\n \n MEDIAL CANTHAL AREA:<\/jats:title>\n The orbital septum originates from the anterior lacrimal crest, not the posterior lacrimal crest. In relation to the medial canthal tendon, it faces the posterior surface of this tendon.<\/jats:p>\n <\/jats:sec>\n \n LATERAL CANTHAL AREA:<\/jats:title>\n The orbital septum originates from the arcus marginalis and attaches to the levator aponeurosis and lower eyelid retractors around the temporal palpebral commissure. It does not attach directly to the orbital tubercle; instead, a space filled with orbital fat exists between the orbital septum and the levator aponeurosis-lower eyelid retractors.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/sjopt.sjopt_58_25","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T06:00:28Z","timestamp":1750831228000},"page":"125-127","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Where is the orbit? Definition of orbital septum attachment sites"],"prefix":"10.4103","volume":"39","author":[{"given":"Muhammad","family":"Abumanhal","sequence":"first","affiliation":[{"name":"Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Alsheikh","sequence":"additional","affiliation":[{"name":"King Khaled Eye Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak P.","family":"Edward","sequence":"additional","affiliation":[{"name":"King Khaled Eye Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohiko","family":"Kakizaki","sequence":"additional","affiliation":[{"name":"Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan"},{"name":"Asami Eye Surgery Clinic, Obu, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"R3-20250628","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.ajo.2005.09.019","article-title":"Eisler and his pocket","volume":"141","author":"Bartley","year":"2006","journal-title":"Am J Ophthalmol"},{"key":"R4-20250628","article-title":"Semin Ophthalmol 2024 Feb 26: 1-3","author":"Teope"},{"key":"R5-20250628","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1080\/08820538.2024.2427788","article-title":"Orbital septum in lateral canthus","volume":"40","author":"Teope","year":"2025","journal-title":"Semin Ophthalmol"},{"key":"R6-20250628","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1016\/j.ophtha.2009.04.005","article-title":"Orbital septum attachment on the levator aponeurosis in Asians: In vivo and cadaver study","volume":"116","author":"Kakizaki","year":"2009","journal-title":"Ophthalmology"},{"key":"R7-20250628","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/IOP.0b013e3181be3097","article-title":"Orbital septum attachment sites on the levator aponeurosis in Asians and whites","volume":"26","author":"Kakizaki","year":"2010","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R8-20250628","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1136\/bjo.2009.172353","article-title":"Posterior approach white line advancement ptosis repair: The evolving posterior approach to ptosis surgery","volume":"94","author":"Patel","year":"2010","journal-title":"Br J Ophthalmol"},{"key":"R9-20250628","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/IOP.0000000000002805","article-title":"Microscopic anatomy of orbital septum","volume":"41","author":"Gouigoux","year":"2025","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R10-20250628","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/00000637-198410000-00001","article-title":"Surgical anatomy of the upper eyelid fascia","volume":"13","author":"Siegel","year":"1984","journal-title":"Ann Plast Surg"},{"key":"R11-20250628","doi-asserted-by":"crossref","DOI":"10.1097\/IOP.0000000000002848","article-title":"Orbital septum posterior to medial canthal tendon area","author":"Teope","year":"2024","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R12-20250628","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/01.IOP.0000129013.86760.92","article-title":"Microscopic anatomy of the lower eyelid in Asians","volume":"20","author":"Lim","year":"2004","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R13-20250628","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1001\/archopht.1982.01030040291018","article-title":"The microscopic anatomy of the lower eyelid retractors","volume":"100","author":"Hawes","year":"1982","journal-title":"Arch Ophthalmol"},{"key":"R14-20250628","doi-asserted-by":"crossref","first-page":"2346","DOI":"10.1016\/j.ophtha.2006.06.017","article-title":"The lower eyelid retractor consists of definite double layers","volume":"113","author":"Kakizaki","year":"2006","journal-title":"Ophthalmology"}],"container-title":["Saudi Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sjopt.sjopt_58_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:36:20Z","timestamp":1787067380000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sjopt.sjopt_58_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/sjopt.sjopt_58_25","relation":{},"ISSN":["1319-4534","2542-6680"],"issn-type":[{"value":"1319-4534","type":"print"},{"value":"2542-6680","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2025-02-09","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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