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Lockwood’s ligament

Lockwood’s ligament, also known as the suspensory ligament of the eyeball, is a specialized connective tissue structure in the orbit. It serves as a hammock-like support for the globe of the eye, stretching across the lower part of the orbit from the medial to the lateral orbital wall. This structure is essential for stabilizing the eyeball and maintaining its position, especially when the eye is at rest or during eye movements. Understanding Lockwood’s ligament is crucial for interpreting orbital imaging and for surgical procedures involving the inferior orbit.

Synonyms

  • Suspensory ligament of the eyeball

  • Inferior check ligament

  • Inferior orbital ligament

  • Ligamentum suspensorium bulbi

  • Lockwood’s suspensory ligament

Function

  • Provides support and stabilization for the globe of the eye within the orbit

  • Acts as a hammock, preventing downward displacement of the eyeball

  • Forms the inferior boundary of the periorbital fat

  • Helps anchor the medial and lateral rectus muscles through connections with their sheaths

  • Contributes to the maintenance of ocular alignment and function during eye movements

MRI Appearance

  • T1-Weighted Images:

    • Appears as a thin, low-signal intensity band (dark line) beneath the globe of the eye

    • Surrounded by higher signal intensity from the adjacent orbital fat

    • Not always distinctly visualized unless high-resolution or fat-suppressed sequences are used

  • T2-Weighted Images:

    • Typically low to intermediate signal intensity

    • May blend with the surrounding orbital fat (high signal), but a thin linear low-signal structure can sometimes be appreciated

    • Best seen in the coronal or axial plane with thin slices

  • STIR (Short Tau Inversion Recovery):

    • Low signal intensity relative to the high signal of suppressed fat

    • May enhance ligament visualization in the presence of orbital pathology or inflammation

    • Useful for detecting edema or abnormal thickening, though the normal ligament is not usually prominent on STIR

CT Appearance

  • Non-contrast CT:

    • Lockwood’s ligament appears as a thin, soft-tissue density band beneath the inferior aspect of the globe

    • Can be challenging to delineate clearly due to its small size and similar density to adjacent connective tissues

    • Best visualized on high-resolution coronal or axial sections

MRI images

Lockwood’s ligament mri image