Nasociliary nerve


The nasociliary nerve is a branch of the ophthalmic nerve, itself a branch of the trigeminal nerve. It is intermediate in size between the other two branches of the ophthalmic nerve, the frontal nerve and lacrimal nerve.

Structure

The nasociliary nerve enters the orbit between the two heads of the lateral rectus muscle and between the superior and inferior rami of the oculomotor nerve. It passes across the optic nerve and runs obliquely beneath the superior rectus muscle and superior oblique muscle to the medial wall of the orbital cavity. It passes through the anterior ethmoidal opening as the anterior ethmoidal nerve and enters the cranial cavity just below the cribriform plate of the ethmoid bone. It supplies branches to the mucous membrane of the nasal cavity and finally emerges between the inferior border of the nasal bone and the side nasal cartilages as the external nasal branch.

Branches

The branches of the nasociliary nerve provide sensory innervation to structures surrounding the eye such as the cornea, eyelids, conjunctiva, ethmoid air cells and mucosa of the nasal cavity.

Clinical significance

Testing

Since both the short and long ciliary nerves carry the afferent limb of the corneal reflex, one can test the integrity of the nasociliary nerve by examining this reflex in the patient. Normally both eyes should blink when either cornea is irritated. If neither eye blinks, then either the ipsilateral nasociliary nerve is damaged, or the facial nerve is bilaterally damaged. If only the contralateral eye blinks, then the ipsilateral facial nerve is damaged. If only the ipsilateral eye blinks, then the contralateral facial nerve is damaged.

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