Embryologic and Fetal Development of the Eyelid and the Lacrimal Drainage System

Abstract

The embryological and fetal morphogenesis of the eyelids and lacrimal drainage system is multifactorial and complex. This protracted process begins in the 5th week of prenatal life and involves a successive series of subtle and tightly regulated morphogenetic events. Major milestones of the embryological and fetal development of the eyelids include the beginning of eyelid formation during the 6th week, eyelid fusion by the 8th week, and the development of eyelid structures beginning in the 9th week (immediately following eyelid fusion), with progression until eyelid separation by the 24th week. After eyelid separation, the eyelids begin to assume their newly developed shape. Around the 32nd week, eyelids are almost fully developed and fully separated but still visibly closed. Key development steps of the lacrimal drainage system include formation of the lacrimal lamina (the primordium of the future lacrimal system) and the lacrimal cord (the primordium of the lacrimal canaliculi) in the 7th week, with canalization starting from the 10th week. During the 10th week, the excretory lacrimal system displays a lumen with a true lacrimal duct that can be distinguished. The epithelium of the lacrimal canaliculi is in contact with the palpebral conjunctival epithelium. The two epithelia form a continuous epithelial lamina. The caudal extreme of the lacrimal duct and the inferior meatal lamina join and the latter begins to cavitate. Understanding this multidimensional process of development in prenatal life, as well as identifying and linking signaling cascades and regulatory genes to existing diseases, may pave the way for developing minimally invasive interventions and scar reducing surgical methods, controlling the spread of malignancies, and the use of progenitor/stem cell and even regenerative therapy.

Zusammenfassung

Die embryologische und fetale Morphogenese der Augenlider und des Tränendrainagesystems ist multifaktoriell und komplex. Dieser Prozess beginnt in der Regel in der 5. Woche post conceptionem (p. c.) und beinhaltet eine Reihe meist streng regulierter morphogenetischer Entwicklungsschritte. Wichtige Meilensteine der embryologischen und fetalen Entwicklung der Augenlider sind u. a. der Beginn der Augenlidausbildung in der 6. Woche p. c., die Augenlidfusion, die normalerweise bis zur 8. Woche erfolgt, und die Entwicklung der einzelnen Lidstrukturen ab der 9. Woche p. c. Diese schreitet bis zur Lidteilung der 24. Woche p. c. fort. Nach der Augenlidteilung beginnen die Augenlider ihre fast endgültige Form anzunehmen. In der 32. Woche p. c. sind die Augenlider vollständig entwickelt und meistens komplett getrennt, aber noch geschlossen. Zu den wichtigsten Entwicklungsschritten des Tränendrainagesystems gehört: 1. Die Bildung der Lamina lacrimalis (das Primordium des zukünftigen Tränensystems). 2. Die Bildung des Tränenstranges (das Primordium der Tränenkanäle) in der 7. Woche. 3. Die Kanalisation der Tränenwege, die ab der 10. Woche beginnt. In der 10. Woche zeigt das Tränensystem dann ein Lumen mit einem echten Tränengang. Das Epithel der Tränenkanäle geht nun zum palpebralen Bindehautepithel über und das kaudale Ende des Tränenkanals und des Meatus nasalis inferior wachsen zusammen. Das Verständnis für diese Entwicklungsprozesse sowie die Identifizierung und Verknüpfung der Signalkaskaden mit regulatorischen Genen kongenitaler Erkrankungen könnte den Weg für die Entwicklung neuer Therapieoptionen ebnen. Diese könnten minimalinvasive Interventionen und narbenreduzierende Operationsmethoden umfassen. Zudem könnten Therapiemöglichkeiten zur Ausbreitungskontrolle von Malignomen eröffnet werden. Durch die Verwendung von Stammzellen könnten sogar regenerative Therapien in Zukunft möglich sein.

Key words

embryology - morphogenesis - milestones - lacrimal system - anatomic abnormalities

Schlüsselwörter

Embryologie - Morphogenese - Meilensteine - Tränenwegsystem - anatomische Anomalien

Publication History

Received: 23 July 2021

Accepted: 08 December 2021

Article published online:
04 February 2022

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