Quantitating the Change in Upper Eyelid Position during Downgaze

Abstract

To derive normative data on eyelid position in primary gaze, upgaze, and downgaze in subjects of various ages. Upper eyelid margin to corneal light reflex distance (uMRD), lower eyelid to corneal light reflex distance (IMRD), and vertical interpalpebral fissure (IPF) measurements were obtained on 50 healthy subjects. In downgaze, a mean decrease of 1.0 mm uMRD (P < 0.001) and 2.3 mm IPF (P < 0.001) was noted. Linear regression analysis demonstrated that older subjects tended to have a greater decrease in uMRD on downgaze (P = 0.012). Decrease in upper eyelid position on downgaze is a common phenomenon. Increased blepharoptosis on downgaze noted in patients with acquired blepharoptosis may largely reflect normal physiologic processes.