Vertical aperture height from the lower eyelid to the upper eyelid.
Abnormal lower eyelid positions shoul be noted
Normal: 8-12 mm
Marginal reflex distance
Distance from the cornea light reflex and upper eyelid margin.
A negative value is given if the upper lid margin obstructs the corneal reflex
The value is obtained measuring the palpebral shift until the reflex appears
Normal: 4-4.5 mm
Abnormal:
Mild +1.5mm,
Moderate +0.5mm
Severe -0.5mm
Levator function
Distance from upper palpebral margin position in down-gaze and the upper palpebral margin position in up-gaze.
Securing one's tumb over the brow the frontalis muscle contribute is negated.
Distance between the central lid crease to the lash margin in down-gaze
High lid crease – aponeurotic deiscence
Absent lid crease – congenital ptosis
2.5% phenilephrine
To stimulate Müller's muscle. 2 drops and waiting 5 minutes.
A positive response is useful to determine the posterior lamellar feasibility and/or to extimate the postoperative palpebral drop relate to Hering's law.
- compiled & published by Dr Dhaval Patel MD AIIMS