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Quantitative comparison between upper eyelid retraction induced voluntarily and by Graves orbitopathy
Antonio A V Cruz1, Patricia Mitiko Santello Akaishi, Roberto P Coelho
1School of Medicine of Ribeirão Preto, University of São Paulo, Brazil. aavecruz@fmrp.usp.br
Ophthalmic Plastic and Reconstructive Surgery
|August 16, 2003
Summary
Voluntary eyelid retraction in normal subjects increases palpebral fissure asymmetry. However, Graves patients exhibit greater asymmetry than normal subjects even with similar eyelid elevation, suggesting abnormal lateral retraction.
Area of Science:
- Ophthalmology
- Anatomy
Background:
- Graves ophthalmopathy is characterized by upper eyelid retraction.
- Quantifying palpebral fissure dimensions is crucial for diagnosis and monitoring.
Purpose of the Study:
- To compare 2D palpebral fissure measurements between normal subjects with voluntary eyelid retraction and patients with Graves eyelid retraction.
Main Methods:
- Three groups of monocular palpebral fissure images were analyzed: normal resting, normal voluntary retraction, and Graves retraction.
- Digital images were processed using NIH Image software to measure eyelid margin distance and fissure areas.
Main Results:
- Voluntary upper eyelid retraction significantly increased the difference between temporal and nasal palpebral fissure areas in normal subjects.
- Graves patients showed a greater disproportion between lateral and medial fissure areas compared to normal subjects with voluntary retraction.
- A positive correlation was found between eyelid margin distance and fissure area disproportion (r = 0.75, P < 0.0001).
Conclusions:
- Voluntary eyelid retraction in healthy individuals increases fissure asymmetry, with enhanced lateral retraction being a normal finding.
- Graves patients exhibit greater palpebral fissure asymmetry than normal subjects, even with comparable eyelid elevation.
- These differences highlight potential underlying mechanisms in Graves-related eyelid retraction.