Table of ContentsView AllTable of ContentsAnatomyFunctionAssociated ConditionsTreatment
Table of ContentsView All
View All
Table of Contents
Anatomy
Function
Associated Conditions
Treatment
The ophthalmic nerve is the first branch of thetrigeminalnerve, which is also known as the fifth cranial nerve. The ophthalmic nerve supplies sensory innervation to the structures of the eye, including the cornea, ciliary body,lacrimalgland, and conjunctiva.
It also supplies nerves to the part of the mucous membrane of the nasal cavity and to the skin of the eyelids, eyebrows, forehead, and nose.
The ophthalmic nerve is purely a sensory nerve, and it doesn’t provide any motor function. It is the smallest division of the trigeminal nerve, which is one of the 10cranial nerves, which emerge from the brainstem.
The ophthalmic nerve branches from the trigeminal nerve in the skull and begins in the lateral wall of the cavernous sinus, a cavity between the bones in the front and middle of the skull. The ophthalmic nerve lies below the oculomotor andtrochlearnervesand divides into the frontal, lacrimal, andnasociliarynerves.
These nerves then enter the orbital cavity (eye socket) through the superior orbital fissure. They branch out to supply the skin and mucous membranes of the front of the head and nose, as well as structures of the eye.
A map of the areas it innervates includes the forehead, front of the scalp, eyes, and anterior surface of the nose, but not the sides of the nose.
The ophthalmic nerve supplies sensory fibers to the following areas:
The ophthalmic nerve exchanges nerve fibers with the three motor nerves of the eye including the trochlear nerve, the oculomotor nerve, and the abducent nerve.
Mimi Haddon / Getty Images
If the ophthalmic nerve is damaged, a person may experience symptoms related to sensory malfunctions.
Supraorbital neuralgiais a rare condition that involves the ophthalmic nerve. Thesupraorbital nervearises from fibers of the frontal nerve, which is the largest branch of the ophthalmic nerve.
The frontal nerve branches into the supraorbital nerve and the supratrochlear nerve, which both exit the orbit anteriorly. The supraorbital nerve sends fibers to the scalp and provides sensory innervation to the forehead, upper eyelid, and anterior scalp.
Supraorbital neuralgia produces persistent pain in the supraorbital region and forehead with occasional sudden paresthesias (prickling plain) in the distribution of the supraorbital nerves.A person suffering from supraorbital neuralgia may complain of painful hair on the front of the head. A supraorbital nerve block is useful in the treatment of supraorbital neuralgia.
Treatment and rehabilitation of problems with the ophthalmic nerve mainly depend on the treatment of the underlying condition, such as with herpes zoster. If an antiviral is prescribed early enough—within 72 hours of the onset of a rash—then neuralgia is limited.
However, sometimes it’s difficult for physicians to diagnose the exact underlying condition, and they must resort to treating the source of where the pain is stemming from. For example, since the ophthalmic nerve is an extension of the trigeminal nerve, procedures focus on changes to the trigeminal nerve or ganglion itself.
Medications
Anticonvulsantsand muscle relaxants are prescribed to block the pain signals from the nerve. In severe cases, surgery may be needed.
Nerve Sheath Fenestration
This surgery method creates space around the optic nerve sheath to relieve pressure. It’s usually used for those experiencing severe swelling in the optic nerve orpapilledemathat’s threatening their vision in an effort to preserve vision.
Microvascular Decompression
This surgery works to reroute a blood vessel from pressing on the trigeminal nerve. Sometimes a Teflon sponge is placed between the blood vessel and the nerve, though studies have reported the Teflon can cause inflammation.As a last resort, sometimes the nerve is actually cut so pain signals are stopped.
Trigeminal Plasticity
Scientists feel that this phenomenon—which allows for adjacent nerves to partially adopt the role of the main nerve and cover areas of the injured branch—may allow for some rehabilitation of nerve function after non-surgical nerve damage.
Other areas of treatment research are covering electro-stimulation, vitamins, antioxidants, alpha-lipoic acid, and neurotrophins.
Summary
The ophthalmic nerve, a sensory branch of the trigeminal nerve, supplies the eye’s structures—like the cornea and lacrimal gland—as well as the upper eyelid, forehead, and nasal cavity. It leads into the frontal, lacrimal, and nasociliary nerves, which pass through the superior orbital fissure to innervate areas in the orbital cavity. This allows for protective responses, like blinking.
Damage to the ophthalmic nerve can cause sensory issues, including pain or loss of sensation in affected areas, as seen in conditions like shingles or supraorbital neuralgia. Treatment often targets the underlying cause, with options like antiviral medications, nerve blocks, and in severe cases, surgeries such as microvascular decompression.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sanders RD.The trigeminal (V) and facial (VII) cranial nerves: head and face sensation and movement.Psychiatry (Edgmont). 2010;7(1):13-6.Jadhav V, Patil D, Mane M.Supraorbital neuralgia.Med J DY Patil Univ. 2014;7:208-10. doi:10.4103/0975-2870.126346Saguil A, Kane S, Mercado M, Lauters R.Herpes zoster and postherpetic neuralgia: prevention and management.Am Fam Physician.2017 Nov 15;96(10):656-663.Ore-ofe Adesina; Bhupendra C. Patel.Optic Nerve Decompression. National Center for Biotechnology Information.Cheng J, Meng J, Lei D, Hui X.Repeat microvascular decompression for patients with persistent or recurrent trigeminal neuralgia: prognostic factors and long-term outcomes.Medicine (Baltimore). 2019;98(18):e15167. doi:10.1097/MD.0000000000015167
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sanders RD.The trigeminal (V) and facial (VII) cranial nerves: head and face sensation and movement.Psychiatry (Edgmont). 2010;7(1):13-6.Jadhav V, Patil D, Mane M.Supraorbital neuralgia.Med J DY Patil Univ. 2014;7:208-10. doi:10.4103/0975-2870.126346Saguil A, Kane S, Mercado M, Lauters R.Herpes zoster and postherpetic neuralgia: prevention and management.Am Fam Physician.2017 Nov 15;96(10):656-663.Ore-ofe Adesina; Bhupendra C. Patel.Optic Nerve Decompression. National Center for Biotechnology Information.Cheng J, Meng J, Lei D, Hui X.Repeat microvascular decompression for patients with persistent or recurrent trigeminal neuralgia: prognostic factors and long-term outcomes.Medicine (Baltimore). 2019;98(18):e15167. doi:10.1097/MD.0000000000015167
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sanders RD.The trigeminal (V) and facial (VII) cranial nerves: head and face sensation and movement.Psychiatry (Edgmont). 2010;7(1):13-6.Jadhav V, Patil D, Mane M.Supraorbital neuralgia.Med J DY Patil Univ. 2014;7:208-10. doi:10.4103/0975-2870.126346Saguil A, Kane S, Mercado M, Lauters R.Herpes zoster and postherpetic neuralgia: prevention and management.Am Fam Physician.2017 Nov 15;96(10):656-663.Ore-ofe Adesina; Bhupendra C. Patel.Optic Nerve Decompression. National Center for Biotechnology Information.Cheng J, Meng J, Lei D, Hui X.Repeat microvascular decompression for patients with persistent or recurrent trigeminal neuralgia: prognostic factors and long-term outcomes.Medicine (Baltimore). 2019;98(18):e15167. doi:10.1097/MD.0000000000015167
Sanders RD.The trigeminal (V) and facial (VII) cranial nerves: head and face sensation and movement.Psychiatry (Edgmont). 2010;7(1):13-6.
Jadhav V, Patil D, Mane M.Supraorbital neuralgia.Med J DY Patil Univ. 2014;7:208-10. doi:10.4103/0975-2870.126346
Saguil A, Kane S, Mercado M, Lauters R.Herpes zoster and postherpetic neuralgia: prevention and management.Am Fam Physician.2017 Nov 15;96(10):656-663.
Ore-ofe Adesina; Bhupendra C. Patel.Optic Nerve Decompression. National Center for Biotechnology Information.
Cheng J, Meng J, Lei D, Hui X.Repeat microvascular decompression for patients with persistent or recurrent trigeminal neuralgia: prognostic factors and long-term outcomes.Medicine (Baltimore). 2019;98(18):e15167. doi:10.1097/MD.0000000000015167
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