Measuring Eyelid Function and Ptosis (droopy upper eyelid)

Individualized Education

Function:

The eyelid lifting can come from its own (levator, and Muller's) muscles, and from the forehead (frontalis) muscle.

Ptosis is the the distance the eyelid is below its normal position. At rest, the lid is just below the top part of the iris (the colored part of the eye.) This is measured with the patient looking straight forward with the head vertical.

In this patient with congenital ptosis, the right eye had been operated on as a child. Even in direct ahead gaze, the forehead muscles were needed to barely keep the lids up out of the way of the pupils for vision. Looking up, it is clear this patient could not see.

Photograph before surgery with the patient looking straight ahead	Photograph before surgery with the patient looking up. The forehead muscles are helping.

Levator function is measured by blocking the effect of the forehead, in this case with a thumb. The ruler permits measurement of the extent of eyelid movement on maximum down and up gaze.

Photograph with this patient looking down, a ruler is used to measure the motion of the eyelid with the forehead muscles blocked.	Photograph with the patient looking up with the thumb blocking the frontalis forehead muscle's contribution to the eyelid.

Eyelid function does not need to be the same on each eye. Both need to be measured.

Picture of patient looking up and the right forehead muscles blocked.	Picture of patient looking up and the left forehead muscles blocked.

See other photographs of this patient before and after surgery.

Other topics of interest:

Ptosis of the eyelid (dropping of the upper eyelid).
Ptosis classification
Muscle function and dysfunction in drooping eyelid problems.
Measuring eyelid function in eyelid ptosis.
Congenital eyelid ptosis reconstructive surgery options.
Recurrent congenital eyelid ptosis in a 26 year old black male.
Ptosis associated with paralyzed eyebrow muscle.
Ptosis associated with Blepharophimosis (congenital eyelid deformity).
Blepharoplasty (Cosmetic surgery of the eyes)
Ectropion (Drooping of the lower eyelid) Recurrent ectropion after multiple cancer resections and then skin cancer excision with Mohs' chemosurgery and full thickness skin grafts. Reconstruction of the lower eyelid

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Ptosis (drooping of upper eyelid)

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Ptosis of the eyelid (drooping of the upper eyelid)

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Recurrent ectropion after multiple cancer resections and then skin cancer excision with Mohs' chemosurgery and full thickness skin grafts.

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This page last updated on: October 6, 2008

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