levator palpebrae superioris

Definition of levator palpebrae superioris

levator-palpebr--ae superior- — Muscle that elevates and retracts the upper eyelid (“the lifting muscle of the superior eyelid”)

1. The levator palpebrae superioris (LPS) is a triangular skeletal muscle in the orbit that originates from the periosteum of the lesser wing of the sphenoid bone (superior to the optic foramen), travels anteriorly above the superior rectus muscle, and fans out into the levator aponeurosis, which inserts onto the skin of the upper eyelid and the superior tarsal plate; it is the primary elevator of the upper eyelid and functions under both voluntary and involuntary control; its smooth muscle counterpart, the superior tarsal muscle (Müller’s muscle), arises from its undersurface and is innervated by postganglionic sympathetic fibers from the superior cervical ganglion; damage to either structure or their innervation results in ptosis (drooping of the upper eyelid).

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Etymology of levator palpebrae superioris

Classical latin New Latin anatomical terminology: • Levator-: Latin levare = “to lift, to raise” + -tor (agent noun) = “one who raises.” • Palpebr-: Latin palpebra = “eyelid” (possibly from palpare = “to touch gently, to stroke”). • Superior-: Latin superus = “above, upper,” comparative form = “higher of the two.” • Literal: “The raiser of the upper eyelid” — a precise anatomical description of function.

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Anatomical Profile

Feature	Detail
Origin	Periosteum of lesser wing of sphenoid bone, superior to optic foramen
Insertion	Skin of upper eyelid; superior tarsal plate (via levator aponeurosis)
Innervation	Superior division of CN III (oculomotor nerve)
Blood Supply	Muscular branches of ophthalmic artery; supraorbital artery
Muscle Type	Skeletal (voluntary) + smooth component (superior tarsal muscle)
Antagonist	Orbicularis oculi (closes the eyelid)
Primary Function	Elevates and retracts the upper eyelid

Coding Context

ICD-10-CM:

Code	Description
H02.401	Unspecified ptosis of right eyelid
H02.402	Unspecified ptosis of left eyelid
H02.403	Unspecified ptosis of bilateral eyelids
H02.411	Mechanical ptosis of right eyelid
H02.421	Myogenic ptosis of right eyelid
H02.431	Paralytic ptosis of right eyelid
H02.432	Paralytic ptosis of left eyelid
H02.433	Paralytic ptosis of bilateral eyelids
Q10.0	Congenital ptosis

CPT (Ptosis Repair — Blepharoptosis):

Code	Description
67901	Repair of blepharoptosis; frontalis muscle technique with suture
67902	Repair of blepharoptosis; frontalis muscle technique with fascial sling
67903	Repair of blepharoptosis; (tarso)levator resection or advancement, internal approach
67904	Repair of blepharoptosis; (tarso)levator resection or advancement, external approach
67906	Repair of blepharoptosis; superior rectus technique with fascial sling
67908	Repair of blepharoptosis; conjunctivo-tarso-Müller’s muscle-levator resection

Clinical Significance / Causes of Dysfunction

• CN III palsy: Loss of oculomotor nerve function → complete ptosis (LPS fully denervated); often with blown pupil and “down-and-out” gaze.
• Myogenic ptosis: LPS muscle weakness (e.g., myasthenia gravis, chronic progressive external ophthalmoplegia).
• Aponeurotic/involutional ptosis: dehiscence or disinsertion of levator aponeurosis — most common cause of adult-acquired ptosis.
• Congenital ptosis: Maldevelopment of LPS muscle fibers (fibrous replacement); coded Q10.0.
• Sympathetic disruption (Horner syndrome): Affects only smooth muscle component (Müller’s) → mild ptosis (1-2 mm) with miosis + anhidrosis.
• Trauma/surgical: Direct injury to muscle or aponeurosis post-blepharoplasty or orbital surgery.

Related Terms

• ptosis: Drooping of the upper eyelid; primary clinical consequence of LPS dysfunction.
• superior tarsal muscle (Müller’s muscle): Smooth muscle component of the LPS system; sympathetically innervated.
• orbicularis oculi: Antagonist muscle; closes the eyelid (innervated by CN VII).
• levator aponeurosis: Fibrous tendon extension of the LPS; attaches to tarsal plate and lid skin.
• blepharoptosis: Clinical/billing term for pathological ptosis.
• blepharoplasty: Surgical eyelid repair; CPT 15820-15823.
• oculomotor nerve (CN III): Motor nerve to LPS; damage → complete ptosis.
• Horner syndrome: Sympathetic chain disruption → partial ptosis via Müller’s muscle.
• extraocular muscles: The 7 extrinsic eye muscles, of which LPS is one.
• superior rectus: Runs inferior to LPS in orbit; shares fascial connections.

Clinical Details

Assessment: Margin-reflex distance 1 (MRD1) — normal ≥3.5 mm; levator function measured by excursion (normal ≥12 mm); fatigue test for myasthenia gravis. Symptoms of dysfunction: Drooping upper lid, visual field obstruction superiorly, head tilt/chin-up posturing, amblyopia risk in children. Surgical repair: Approach and CPT code selection depend on levator function — good function (≥5 mm) → levator resection (67903/67904); poor function → frontalis sling (67901/67902); Müller’s muscle resection (67908) for Horner’s ptosis. Botox use: CN injection into LPS intentionally induces temporary ptosis to protect the cornea in facial nerve palsy.

One-Sentence Summary The levator palpebrae superioris (Latin: “raiser of the upper eyelid”), innervated by the superior division of CN III, is the primary elevator of the upper lid via its aponeurosis and superior tarsal muscle; dysfunction at any level — neurogenic (H02.433), myogenic (H02.421), or aponeurotic (H02.401) — produces ptosis, repaired surgically via levator resection (CPT 67903/67904) or frontalis sling (CPT 67901/67902).

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DERIVATIONS of levator palpebrae superioris

TABLE definition AS Definition 
WHERE length(filter(roots, (word) => econtains([[levator palpebrae superioris]].roots, word))) > 0 AND file.name !=[[levator palpebrae superioris]].file.name
SORT file.name ASC

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Query

TABLE definition AS Definition
FROM #medroot
WHERE length(filter(definition, (word) => econtains([[levator palpebrae superioris]].definition, word))) > 0 AND file.name != [[levator palpebrae superioris]].file.name

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Med roots Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms