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Related Experiment Video

Updated: Sep 22, 2025

Impression Cytology of the Lid Wiper Area
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Blinking and upper eyelid morphology.

William Shew1, Alex Muntz1, Simon J Dean1

  • 1Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.

Contact Lens & Anterior Eye : the Journal of the British Contact Lens Association
|May 22, 2022
PubMed
Summary
This summary is machine-generated.

East Asian individuals predominantly exhibit incomplete blinking and slight eyelid misalignment during habitual blinking, regardless of eyelid crease type. This suggests a common pattern in their natural blinking behavior.

Keywords:
Asian eyelid morphologyDry eyeIncomplete blinkingSagittal lid misalignment

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Area of Science:

  • Ophthalmology
  • Oculoplastics
  • Facial Anatomy

Background:

  • Blinking is a crucial physiological function for ocular surface health.
  • Eyelid morphology, particularly the presence and extent of upper eyelid creases, can vary significantly among different ethnic groups, including East Asians.
  • Understanding these variations is important for diagnosing and managing various ocular conditions.

Purpose of the Study:

  • To investigate the characteristics of spontaneous blinking and the degree of sagittal eyelid misalignment during blinking in individuals of East Asian descent.
  • To determine if eyelid crease morphology influences blinking patterns or eyelid closure during blinking.

Main Methods:

  • A pilot study involving 44 East Asian participants with varying eyelid crease types (single, partial, double).
  • High-speed video recording of spontaneous blinking from multiple angles.
  • Assessment of blink rate, blink completeness, and sagittal eyelid margin misalignment during different types of lid closure.
  • Lissamine green dye test to evaluate complete palpebral apposition during blinking.

Main Results:

  • Average blink rate was 16.9 blinks/minute.
  • A high proportion of incomplete blinks (83% in single, 58% in partial, 59% in double eyelid crease groups) was observed.
  • Sagittal misalignment of the eyelid margins during blinking was consistent across all eyelid morphologies, approximately one-third of the lid margin width.
  • Complete palpebral apposition, assessed by lissamine green dye elimination, was only achieved during voluntary maximal lid contraction and was similar across all groups.

Conclusions:

  • Habitual blinking in East Asian individuals is characterized by a predominance of incomplete blinks and central eyelid margin misalignment.
  • These blinking patterns appear to be independent of the type of upper eyelid crease.
  • The findings highlight a unique aspect of ocular surface dynamics in the East Asian population that may have implications for eye care.