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Anatomic considerations in upper eyelid retraction.

¹Department of Ophthalmology, University of Wisconsin School of Medicine, Madison 53792.

Ophthalmic Plastic and Reconstructive Surgery

|January 1, 1991

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Upper eyelid position is determined by three force planes interacting with orbital and globe characteristics. Lateral retraction is enhanced when the eye

Area of Science:

Ophthalmology
Orbital Mechanics
Anatomy

Background:

Upper eyelid position is crucial for ocular protection and visual field.
Understanding the forces governing eyelid position is essential for diagnosing and treating eyelid abnormalities.

Purpose of the Study:

To identify and analyze the primary integrating factors that determine upper eyelid position.
To elucidate the biomechanical principles underlying upper eyelid retraction.

Main Methods:

Creation of anatomically correct orbital drawings.
Analysis of eyelid vertical retractor plane, protractor plane, and tarsoligamentous plane.
Examination of the influence of orbital and globe variations on eyelid forces.

Main Results:

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Three principal upper eyelid force planes were identified: vertical retractor, protractor, and tarsoligamentous.
Orbital size/shape, globe size/position, and retractor/protractor length-tension characteristics govern these forces.
Enhanced lateral upper eyelid retraction is observed when the eye in primary position deviates from the orbital axis, exposing more lateral sclera.

Conclusions:

Upper eyelid position is a complex interplay of anatomical structures and biomechanical forces.
The described force planes and their governing factors provide a framework for understanding eyelid dynamics.
Lateral gaze alignment with the orbital axis diminishes enhanced lateral upper eyelid retraction.