The anatomy of the lacrimal portion of the orbicularis oculi muscle (tensor tarsi or Horner's muscle)

Horner's muscle (the palpebral part of the orbicularis oculi muscle) has a fan-shaped origin in the lacrimal bone. Its muscle fibers are oriented from 160 to 210 degrees relative to the ear-eye plane and converge towards the medial palpebral commissure. Then the muscle divides into superior and inferior bundles of fibers. Some of the lower fibers participate in the formation of the superior bundle and some of the higher fibers participate in the formation of the inferior bundle and, thus, some of Horner's muscle is twisted. Each bundle courses laterally to the lateral palpebral commissure and has three insertions. The first insertion is located at the medial margin of the tarsi. The second insertion is into the subcutaneous tissue along the palpebral margins. Minute fascicles of Horner's muscle are fastened to the palpebral margins. The third insertions are into the lateral palpebral ligament and subcutaneous connective tissue of the lateral commissure. Serial histological sections of a fetus at 14 to 16 weeks gestation revealed that the extent of the envelope formed by Horner's muscle around the lacrimal canaliculus decreases gradually from the lacrimal papilla to the lacrimal sac. The various observations suggest the following roles for Horner's muscle: (1) it closes the medial canthus of the eye and closes the lacrimal punctum; (2) it pulls the tarsus medially; (3) it tautens the palpebral margins and presses against the eyeball; and (4) it squeezes the lacrimal canaliculus with a decreasing gradient of pressure from the lacrimal papilla to the lacrimal sac. These actions are likely to be important for the flow of lacrimal fluid in the lateral to medial direction on the eyeball, for maintenance of the thickness of tear film over the cornea, for opening and closing of the lacrimal punctum, and for passage of the lacrimal fluid from the canaliculus to the sac. Horner's muscle appears, thus, to be a muscle of prime importance in all phases of the flow of lacrimal fluid.