3. On one eyelid, make a vertical incision in the superior lid to expose the tarsal plate and its relation to the conjunctiva and levator apparatus, and the lacrimal gland.
Next, make a vertical incision in the right upper eyelid and fold back the lateral portion of the lid. This will reveal the layers of the eyelid. The outermost layer is the skin. Notice that as the skin approaches the eyelid it loses its underlying fat. Deep to the skin is the muscle layer, the orbicularis oculi. The orbital and palpebral portions attach to the skin. Deep to the muscle layer is the tarsal fascia layer. This layer is continuous with the periosteum of the frontal bone. It swoops down across the orbit at the orbital septum and attaches to the superior tarsal plate. Deep to this, is the muscle that raises the eye, the levator palpebrae superioris, shown here. It penetrates the orbital septum and ends in the skin of the lid. Deep to this, is a thin layer of smooth muscle attached to the tarsal plate. This layer is the superior tarsal muscle. Deep to the superior tarsal muscle is the lining of the inside of the lid, the conjunctiva. The conjunctiva lines the lid and covers the globe of the eye, and therefore has palpebral and bulbar portions.