 Hi, my name is Jenna Borrell, and I'm a second-year medical student at Indiana University School of Medicine in Fort Wayne, Indiana. My project was the normal invariant clinical anatomy of the sensory supply of the orbit. Orbital and retroorbital pain are relatively common clinical conditions that are associated with such disorders such as trigeminal neuralgia, cluster headaches, inflammatory orbital pseudo tumor, and herpetic neuralgia ophthalmicus, thus making the nerve supplying the orbit of great clinical importance. Surprisingly, how pain from this region reaches conscious levels remains unknown. Classically, it has been assumed that pain reaches the ophthalmic division of the trigeminal nerve, V1, and travels to the descending spinal trigeminal nucleus. However, exactly where the receptors for orbital pain are located and how impulses reach V1 is speculative. Knowledge of the many neural connections within the orbit and cavernous sinus may provide an explanation for orbital pain syndrome, and may prove to have significant implications in the treatment of patients suffering from orbital pain. Conditions causing orbital and retroorbital pain can be classified into those causing generalized pain or localized pain. Onanomic symptoms may also accompany orbital pain syndrome such as conjunctival injection, lacrimation, and rhinorrhea. Neural connections within the orbit have been found to be significant in number. There have been connections between the trigeminal nerve and all of the oculomotor nerves, cranial nerves 3, 4, and 6 after entering into the orbit. Communications between the nasociliary nerve and cranial nerves 3, 4, and 6 have been found and find that the oculomotor nerves could relay sensory information through these connections. Direct muscular, direct sensory branches to the extraocular muscles have also been found. Sensory ganglion cells were found within the rulers of cranial nerves 3 and afferent fibers of the trigeminal origin were found within this nerve. The fibers of trigeminal origin within cranial nerve 3 were hypothesized to contribute to pain pathways and exert inhibitory control on primary trigeminal fibers. Neural connections within the cavernous sinus. Traditionally, sensory and sympathetic are believed to be distributed to oculomotor nerves within the cavernous sinus. It remains unclear if connections are indeed all sensory, all sympathetic, or some combination of both. Reports have been shown to have communication between the trigeminal nerve and cranial nerves 3, presumed to provide a sensory pathway within cranial nerve 3. Other sources have denied any sensory communications between the trigeminal and oculomotor nerves, stating that these, that connection scene were either extremely rare or sympathetic in origin. Other reports denied any connection between the sympathetic carotid plexus and cranial nerves 3, 4, and V1, asserting sympathetics only communicate with cranial nerve 6. Through this information of neural connections within the orbit and cavernous sinus, we suggest that connections between the oculomotor nerves and V1, both intraorbital and within the cranial cavernous sinus, are prevalent and allow pain sensations to be conducted to the spinal trigeminal nucleus. Pain associated with such things, such as cranial nerve 3 tumors, may be explained by variable connections between cranial nerve 3 and V1. The great amount of variability reported in the neural connections within the orbit and cavernous sinus suggests either connections exist in all of us, but have been missed, or they're indeed great variability. If variability within the orbit and cavernous sinus is true, this variability may be comparable to that seen in the brachial plexus and be of equal clinical relevance. Thank you.