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PubMed1978

[Studies on the estimation of the postmortem interval. 4. Spontaneous opening and closing of the eyelids after death (author's transl)].

The authors have investigated the findings of 410 cadavers which were subjected to medicolegal autopsies in our laboratory as to whether their eyelids were open or closed at the time of autopsy and have come to the following conclusions. 1) It has been found that the eyelids of cadavers may open or close spontaneously as a cadaveric phenomenon. In about 27 per cent of cadavers dead from 6 to 12 hours the eyelids were open and thereafter they were closed gradually and all of them were closed from 36 hours to 4 days. After 4 days the eyelids of some cadavers were open again. The mechanism of this cadaveric phenomenon has been discussed. 2) Concerning the opening or closing of the eyelids, neither seasonal variation nor variation by age except newborn infants has been found. In death from exsanguination many were open and in death from drowning and carbon monoxide poisoning all were closed. 3) The findings whether the eyelids of cadavers are closed or open may be utilized as a criterion for estimating the postmortem interval; the cadavers with open eyelids are estimated to have been dead less than 36 hours or over 4 days.

Adolescent↗

PubMed1995

[Frequency and morphological change of double eyelid fold in relation to age].

The frequency of double eyelid fold and its morphological change were followed in 172 infants with cleft lip over the period from 0 to 5 years after birth. Change to double eyelid fold occurred 6 months after birth in 27 of them, at 6 months to 1 year in 20, at 1-3 years in 12 and at 3-5 years in 15. All showed double eyelid fold of the increasingly broadened type. A total of 1,844 residents in Hokkaido were also examined for the frequency and morphological change of double eyelid fold in relation to age-groups divided by decade of life, and actual measurement of double eyelid fold was carried out in 40 subjects. The frequency of double eyelid fold was 45% for those under 10 years of age, 57% for those 10-19 years old, 68% for those in their 20s, 69% for 30s, 76% for 40s, 79% for 50s, 81% for 60s and 57% for 70s. The increasingly broadened type was predominant in individuals under 30 years of age, whereas the parallel type became predominant in those in their 30s or older. The width of the double eyelid fold was 2.5mm when the eyes were open, accounting for 30% of the lid aperture, whereas it was 6.0 mm and accounted for 70% of the lid aperture when the eyes were closed.

Adolescent↗

PubMed1994

Conjugacy of spontaneous blinks in man: eyelid kinematics exhibit bilateral symmetry.

PURPOSE: To provide a quantitative description of the conjugacy of human eyelid movements during spontaneous blinks. METHODS: Eyelid movements occurring during spontaneous blinks were recorded bilaterally using a modification of the electromagnetic search coil technique. In off-line analyses, covariation of amplitude, peak velocity, and duration of blink down phases were determined for the two eyelids. Interocular differences in the timing of blink onset and offset, and time to peak velocity, also were evaluated. RESULTS: Human blink motor control systems act to link tightly the spatial and temporal characteristics of movements of the two eyelids. Data show that human spontaneous blinks are conjugate. Analysis of interocular covariation of blink amplitude, peak velocity, and duration yielded linear functions with high correlation coefficients. Interocular comparison of eyelid movement durations during blinks showed a particularly high correlation. There were negligible interocular differences in blink down-phase onset time, termination time, and time to peak velocity. A small percentage of blinks exhibited interocular differences in amplitude and peak velocity of > 20%; however, even in these cases, blink duration remained tightly linked. CONCLUSION: Spatial and temporal properties of eyelid movements occurring during spontaneous blinks are conjugate. These data support the hypothesis that a bilateral gating mechanism regulates blink duration. Elements downstream from the gate may differentially and unilaterally alter blink amplitude and peak velocity, but the duration of blinks remains time-locked for the two eyelids.

Adult↗

PubMed1993

Upper eyelid retraction after retinal detachment repair.

Two patients with high myopia developed unilateral upper eyelid retraction after retinal detachment surgery with superiorly placed scleral buckles and 360-degree encircling elements. The isolated upper eyelid retraction was stable for 16 and 23 years, respectively. Other common causes of eyelid retraction, including cicatricial processes such as thyroid-related orbitopathy, neurogenic disease, and pseudoretraction of the eyelid, were excluded in both patients. The first patient had no evidence of proptosis or lid lag on downgaze but had exposure keratitis that required recession of Müller's muscle and conjunctiva. The second patient had lid lag on downgaze, and orbital computed tomography demonstrated an enlarged eye with an encircling element that caused mild pseudoproptosis. This patient required no treatment. The unilateral upper eyelid retraction did not progress in either patient. Although the exact mechanism of the upper eyelid retraction in these two cases is unclear, previous retinal surgery that involves superiorly placed implants must be considered in the differential diagnosis of unilateral upper eyelid retraction, especially when the patient has a history of pathologic myopia.

Adult↗

PubMed1996

A comparative study of eyelid cleaning regimens in chronic blepharitis.

PURPOSE: Blepharitis, an intrinsic eyelid inflammation with crusting and irritation, presents a great problem for patients wearing contact lenses. An important part of blepharitis therapy is eyelid hygiene, including the use of either soap, dilute baby shampoo, or commercial lid scrubs. In this study, a comparison was made between these three cleaning regimens in a group of 25 patients, 80% of whom (20/25) wore contact lenses. METHODS: Patients used commercial eyelid scrub on right eyelids and a hypo-allergenic bar soap on left eyelids. Patient symptoms, slit lamp findings, and overall preferences were determined at the end of 4 months. A subgroup of 10 patients using lid scrub on right eyelids and dilute baby shampoo on left eyelids was followed for an additional 3 months. RESULTS: At the end of 4 months, 24% (6/25) of the patients noted no difference between soap and lid scrub, but 89% (17/19) of the others preferred the lid scrub. In the group using baby shampoo, 50% (5/10) noted no difference in 3 months, but 80% (4/5) of the remaining patients preferred the lid scrub. CONCLUSIONS: All patients improved in slit lamp findings with all three regimens, and patient preference was overwhelmingly in favor of the lid scrub regimen for convenience and ease of use.

Adult↗

PubMed1999

Acute inflammation of the eyelid and cornea in Staphylococcus keratitis in the rabbit.

PURPOSE: The inflammatory response during Staphylococcus keratitis was analyzed biochemically and histologically to determine the source of the neutrophils infiltrating the tear film and cornea. METHODS: Rabbit eyes were swabbed and then examined by slit-lamp microscopy at 0, 5, 10, 15, 20, and 25 hours after intracorneal inoculation with Staphylococcus aureus. Bacterial colony-forming units were quantified in the cornea, eyelid, and acute inflammatory exudate. Myeloperoxidase activity of ocular swabs of acute inflammatory exudate, corneal homogenates, and eyelid homogenates was determined. Gross and microscopic examinations of corneas and eyelids were performed. RESULTS: The colony-forming units per cornea exceeded 10(7) after 10 hours, whereas no bacteria were cultured from the eyelid until 15 hours postinfection. Slit-lamp examination revealed progressive pathology, and the myeloperoxidase activities of ocular swabs, corneas, and eyelids increased markedly by 15 hours postinfection. Corneas showed a wave of neutrophils moving from the tear film toward bacteria in the central corneal stroma and early neutrophil migration from the limbus into the stroma. In the eyelid, neutrophils migrated from the stromal vessels to the tear film. CONCLUSIONS: Staphylococcus keratitis in the rabbit causes acute inflammation in the overlying eyelid. Neutrophils of the acute inflammatory exudate interact with the infected cornea, whereas neutrophils migrating through the cornea from the limbus remained distant from the site of infection.

Acute Disease↗

PubMed2002

[Ultrasound biomicroscopy in eyelid lesions - a clinical study on 30 patients].

BACKGROUND: The value of ultrasound biomicroscopy in the diagnosis of eyelid lesions is not well known. METHODS: For the examination of eyelid lesions, we used an ultrasound biomicroscope (Humphrey, Zeiss, Oberkochen) with high-frequency transducers (30 and 50 MHz). Between November 1998 and December 1999, 30 patients with eyelid lesions, range 8 to 86 years, were available for this study. RESULTS: Histological examination of the excised tissue displayed the presence of chalazion (9/30), basal cell carcinoma (7/30), seborrhoic keratosis (4/30), a granulomatous process (4/30), cysts (2/30), an epidermoid cyst (1/30), a nevus (1/30), a pilomatrixoma (1/30), and a comedo (1/30). With ultrasound biomicroscopy we were able to demonstrate a cyst or a cystic tumour in six patients (20 %); i. e. two patients with a cyst of the eyelid, two patients with chalazion, one patient with a granulomatous process and one patient with an epidermoid cyst. In the patients with solid tumours of the eyelid, final diagnosis with ultrasound biomicroscopy only is not possible. CONCLUSION: For evaluation of cystic or solid eyelid lesions, ultrasound biomicroscopy may be an additional diagnostic tool, e. g. for assessment of the margins of the tumour. However, up to now it is not possible to differentiate tumours if only ultrasound biomicroscopic findings are available.

Adolescent↗

PubMed2002

[Spontaneous regression of an eyelid tumour].

BACKGROUND: The differential diagnosis of eyelid tumours is often a challenging task. A correct anamnesis can be very important for the further treatment plan. CASE REPORT: A 73-year-old female patient presented with a tumour of her left lower eyelid which occurred two months ago. The suspected clinical diagnosis of a basal cell carcinoma was confirmed. After one month the patient was admitted for tumour excision and eyelid reconstruction, but the tumour showed marked regression. Because of a now clinically suspected keratoacanthoma, we decided to observe the tumour and cancelled surgery. Fourteen days later there was no tumor visible on her left lower eyelid. It seemed to be a spontaneous regression of a keratoacanthoma. CONCLUSIONS: If there is a short case history of a rapidly growing eyelid tumour one should also consider keratoacanthoma as differential diagnosis. In suspected cases initial observation and control can save the patient from extended excision and eyelid reconstruction. However, an unnecessary delay of treatment due to prolonged observation without any signs of regression should be avoided. Unclear situations require a diagnostic excision to exclude a squamous cell carcinoma or basal cell carcinoma.

Aged↗

PubMedDate not supplied

Orbicularis-levator fixation in double-eyelid operation.

One of the characteristic features of the East Asian person's eyelids is the lack of a supratarsal fold. A relaxed upper eyelid skin, due to the lack of supratarsal fixation, causes coverage of the tarsal margin of the upper eyelid. Thus the palpebral fissure looks smaller, giving a slit-eye appearance. Unlike those lids with a natural supratarsal crease, the levator palpebrae muscle and/or aponeurosis does not extend and attach to the pretarsal skin. The purpose of the double-eyelid operation is to create a supratarsal fold in the eyelids of Asian patients. Numerous surgical procedures have been developed to establish adherence between the levator aponeurosis and the eyelid skin. There are 2 main goals for this procedure: (1) a smooth, tight skin below the newly created supratarsal crease and (2) firm fixation between the levator aponeurosis and the skin to prevent relapse to a single eyelid. Most procedures described rely on loose cicatrization between the skin and the levator aponeurosis.

Adipose Tissue↗

PubMed1997

Floppy eyelid syndrome in a child with chronic unilateral conjunctivitis.

PURPOSE: To report a 2-year-old child who had chronic unilateral conjunctivitis and spontaneous left upper eyelid eversion during sleep consistent with the floppy eyelid syndrome. METHODS: The patient's parents used a video camera to document nocturnal ectropion of the left upper eyelid. Examination demonstrated left upper eyelid swelling and left palpebral conjunctival hyperemia with papillary hypertrophy. RESULTS: All signs and symptoms of the floppy eyelid syndrome resolved with taping of the left upper and lower eyelids to close the palpebral fissure and to prevent ectropion during sleep, and with application of ocular lubricants. CONCLUSIONS: Floppy eyelid syndrome may manifest in childhood without other contributing conditions and should be considered in the differential diagnosis of chronic papillary conjunctivitis in patients at any age.

Child, Preschool↗

PubMed1998

A new physical finding in floppy eyelid syndrome.

OBJECTIVE: The authors noted that many of their patients with the floppy eyelid syndrome had a unique finding of eyelash ptosis and lashes that curled in many directions. The purpose of this study was to determine how many of these patients had this physical finding. DESIGN: Case series. PARTICIPANTS: The authors retrospectively reviewed the charts and photographs of eight consecutive patients with the floppy eyelid syndrome. They also examined four new patients with floppy eyelid syndrome. INTERVENTION: Surgical tightening of 13 upper lids was performed in 9 patients. MAIN OUTCOME MEASURES: Relief of symptoms and normalization of eyelash position. RESULTS: All of the 12 consecutive patients with floppy eyelid syndrome demonstrated eyelash ptosis with loss of eyelash parallelism. All patients treated with surgical shortening of the affected eyelid were asymptomatic at follow-up. CONCLUSIONS: The authors have identified a new physical finding in the floppy eyelid syndrome: eyelash ptosis with loss of eyelash parallelism. The authors believe that this new physical finding is characteristic of the floppy eyelid syndrome, and will aid in the timely diagnosis and treatment of this sometimes obscure syndrome.

Adult↗

PubMed2001

Transcaruncular approach to medial canthal tendon plication for lower eyelid laxity.

PURPOSE: A new operation to correct lower eyelid laxity was evaluated. METHODS: A new transcaruncular, orbital approach to posterior medial canthal tendon plication was performed on eight orbits of four cadavers, which were then analyzed with computed tomography or histologic techniques. The procedure was also performed on 23 eyelids of 15 patients with lower eyelid medial canthal tendon laxity, alone or in conjunction with other procedures. These patients were followed up for a mean of 12 months. RESULTS: Improved postoperative eyelid position, epiphora, and superficial punctate keratopathy were found. Radiographic and histologic analysis demonstrated consistency of suture placement without involvement of contiguous anatomical structures. CONCLUSIONS: This procedure appears to be a safe, reproducible, and effective corrective procedure for medial canthal tendon laxity and lagophthalmos. When combined with lateral lower eyelid tightening, it is also an effective treatment for lower eyelid retraction and superficial punctate keratopathy. Other potential advantages and complications of this procedure are described in comparison to other reported surgical methods used to address medial canthal tendon laxity and malpositions of the medial lower eyelid.

Blepharoplasty↗

PubMed2005

Müllerectomy for upper eyelid retraction and lagophthalmos due to facial nerve palsy.

BACKGROUND: Facial nerve palsy often results in symptoms of ocular irritation due to inadequate eyelid closure. Weakened protractor function results in relative upper eyelid retraction and contributes to lagophthalmos. OBJECTIVE: To evaluate the role of müllerectomy in the comprehensive surgical treatment of ocular exposure due to facial nerve palsy. METHODS: Thirty-four patients with chronic facial nerve palsy underwent unilateral transconjunctival removal of Müller muscle and were followed up for an average of 20 months postoperatively. Other procedures were performed to treat lower eyelid retraction, as required. Preoperative and postoperative ocular exposure symptoms, upper eyelid position, lagophthalmos, and keratopathy were compared. RESULTS: Of the 59 preoperative symptoms, 15 (25%) resolved and 39 (66%) improved. Upper eyelid position was lowered by an average of 1.35 mm (P<.001). Lagophthalmos (P = .002) and corneal exposure (P<.001) were significantly improved. Three patients required levator aponeurosis repair, 2 for preexisting dehiscence and 1 for inadvertent aponeurosis transection. CONCLUSION: Müllerectomy is a rapid, safe, and reproducible surgical method for lowering the upper eyelid and reducing ocular exposure symptoms and signs due to chronic facial nerve palsy.

Adolescent↗

PubMed1988

Full-thickness unipedicle flap for lower eyelid reconstruction.

We developed a technique for lower eyelid reconstruction using a full-thickness unipedicle flap from the upper tarsal portion of the upper eyelid. The lost tissue is replaced with identical tissue from the ipsilateral upper eyelid. The technique is best suited to shallow defects of the temporal lower eyelid. The levator aponeurosis and Müller's muscle are recessed to avoid upper eyelid retraction. The key to performing this operation is a thorough knowledge of eyelid anatomy and preservation of its microvascular supply. This procedure has produced satisfactory to excellent results in 17 patients and offers the reconstructive surgeon several advantages over other techniques.

Eyelid Neoplasms↗

PubMed1997

Secondary healing of Mohs defects of the forehead, temple, and lower eyelid.

OBJECTIVE: To analyze the results of secondary healing of Mohs defects of the forehead, temple, and lower eyelid. DESIGN: Scars resulting from secondary healing in these 3 sites were rated by patient interviews and by analysis of postoperative photographs by 3 board-certified members of the American Academy of Facial Plastic and Reconstructive Surgery. SETTING: Private facial plastic and reconstructive surgery practice in Florida. PATIENTS: Patients with Mohs wounds of the forehead, temple, and lower eyelid that were allowed to heal by secondary intention between January 1, 1989, and December 31, 1993, who were available for follow-up. There were 10 wounds of the forehead, 6 of the temple, and 10 of the lower eyelid that were available for analysis. MAIN OUTCOME MEASURES: Wound color, contour, distortion of surrounding structures, presence of telangiectasias or paresthesias, pain or infection during healing, and overall cosmetic result. RESULTS: Color, contour, and overall scar cosmesis were rated using the following scale: poor (0), fair (1), good (2), and excellent (3). Telangiectasias, paresthesias, and pain or infection during healing were recorded as present or absent. The respective color and contour ratings for the 3 sites were 2.2 and 2.2 for the forehead, 2.5 and 2.7 for the temple, and 2.7 and 3 for the lower eyelid according to patient interview and 1 and 1.3 for the forehead, 1 and 1.4 for the temple, and 2.6 and 2.5 for the lower eyelid according to surgeon analysis. Pain, infection, paresthesias, and distortion of surrounding structures were rare, but 7 of 10 forehead and 4 of 6 temple wounds had telangiectasias. CONCLUSIONS: Many defects of the forehead and temple will heal with acceptable results. Partial-thickness or small full-thickness lower eyelid wounds heal with excellent cosmetic and functional results. Patient satisfaction is greater than might be predicted by surgeon analysis of wound healing.

Adult↗

PubMed2026

The effect of compression dressing on postoperative outcomes after upper eyelid blepharoplasty: a randomized, controlled, observer-blinded evaluation study.

PURPOSE: This study aimed to evaluate the impact of a compression dressing on postoperative pain, ocular surface changes, edema, ecchymosis, and aesthetic outcomes following upper eyelid blepharoplasty. METHODS: This observer-blinded, randomized, controlled trial included 112 eyelids from 56 patients who underwent bilateral upper eyelid blepharoplasty between June and August 2025. After surgery, one eyelid received a compression dressing (CD), while the other eyelid received no dressing (ND). Edema and ecchymosis were graded by masked observers on postoperative days 1, 7, 30, and 90. Aesthetic outcomes were evaluated using the Global Aesthetic Improvement Score. Pain was evaluated using a visual analog scale, and patient comfort was assessed by side preference. RESULTS: On postoperative day 1, ecchymosis scores were significantly lower in the CD group than in the ND group (unadjusted p = 0.002; Holm-adjusted p = 0.012). Edema scores were also lower on the CD side (unadjusted p = 0.012) and aesthetic scores were higher (unadjusted p = 0.046); however, neither difference remained statistically significant after Holm-Bonferroni correction for multiple comparisons (adjusted p = 0.060 and p = 0.138, respectively). No significant differences were observed in any parameter on postoperative days 7, 30, or 90 (all adjusted p > 0.05). Corneal staining scores were comparable between groups at all follow-ups, and no corneal erosions were observed. Pain scores on day 1 were similar (p = 0.977). CONCLUSIONS: Compression dressing after upper eyelid blepharoplasty was associated with a significant reduction in early postoperative ecchymosis, an effect that persisted after correction for multiple comparisons. Reductions in edema and improvements in aesthetic scores were observed on postoperative day 1 but did not remain statistically significant after adjustment. Overall, the benefits of compression dressing were limited in magnitude and transient, and routine use may not be necessary; its application should be individualized according to patient needs. TRIAL REGISTRATION: ClinicalTrials.gov, NCT07701265 (retrospectively registered on July 8, 2026).

Humans↗

PubMed1983

Simultaneous treatment of lower eyelid dermatochalasis and abnormal-appearing skin.

Abnormal, thin, crinkly, or pigmented nasal lower eyelid skin is sometimes associated with dermatochalasis (excessive skin). In these cases, excision of temporal lower eyelid skin by conventional cosmetic blepharoplasty draws and diffuses this abnormal skin temporally and worsens the appearance of the lower eyelid skin. A new procedure in which excessive abnormal skin is excised nasally rather than temporally draws and diffuses the more normal temporal skin nasally and improves the appearance of the lower eyelid skin. This approach simultaneously resolved dermatochalasis and abnormal-appearing lower eyelid skin in six eyelids of three patients without complications.

Cutis Laxa↗

PubMed2004

Congenital eyelid imbrication syndrome.

PURPOSE: To describe congenital eyelid imbrication syndrome and its possible pathophysiology. DESIGN: Clinical observational case report. METHODS: A full-term newborn was examined after a vaginal delivery and uneventful pregnancy. RESULTS: The upper eyelids were overlapping the lower eyelids when the eyes were closed or when the newborn was asleep. The upper eyelids resumed normal position gradually over a week without causing any symptoms or residual sequelae. CONCLUSIONS: Eyelid imbrication syndrome is a rare cause of congenital eyelid malposition. It may be caused by inborn laxity of the upper medial and lateral canthal tendons that are tightened during the postnatal period, causing resolution of this condition.

Eyelid Diseases↗