Lower eyelid position change in the upright and supine positions

Abstract

This study is designed to identify the change of lower eyelid positionbetween the upright and supine positions.We included patients who visited Severance Hospital betweenDecember 2010 and February 2011 and had no eye and eyelid problem.Patients were grouped by gender and age (less than 10 years, 10 to 19years, 20 to 29 years, 30 to 39 years, 40 to 49 years, 50 to 59 years, 60 to69 years, and more than 70 years). Each group included 20eyes of 10subjects. Digital images were taken with an 8 mm diameter circular tapeplaced in the middle of the glabella and used as a guideline for the analysis.Exophthalmos was measured in the upright and supine positions. Thedistraction test was also performed in the upright position. Marginalreflex distance (MRD)-1, MRD-2, interpalpebral fissure (IPF), and lowerlid margin-limbus distance (LMLD) were compared between the twopositions.In the upright position, MRD-1 was 2.46 ± 1.00 mm, MRD-2 was 5.09± 0.79 mm, IPF was 7.54 ± 1.31 mm, and LMLD was -0.15 ± 0.52 mm. Inthe supine position, MRD-1 was 2.48 ± 1.06 mm, MRD-2 was 4.62 ±0.85 mm, IPF was 7.10 ± 1.39 mm, and LMLD was -0.62 ± 0.57 mm.MRD-2, IPF, and LMLD were significantly different between the twopositions (p value < 0.001), but MRD-1 was not (p value = 0.496). And2the difference in MRD-2 between two positions, was correlated withdistraction test (p value = 0.002), which means lower lid laxity influencesMRD-2.The lower eyelid position in the supine position is significantly movedupward from that in the upright position. Therefore, while we do surgeryaffecting eyelid position, such as ptosis or lid retraction, the difference in eyelidpositions between the upright and supine positions should be considered,especially when treating patients with lower eyelid laxity.