Normal eyelid crease position in children

Proportions of the upper lid were determined based on the following measurements in 33 children: lash-line-lid crease (LC), lashline-lower brow (LB), vertical fissure, and horizontal fissure. Age-matched mean measurements (mean LC/LB ratio = 0.33) for 26 white vs 7 black children, and for 16 males vs 17 females were not significantly different. However, the mean ratio in 15 preschool and school-age children was significantly greater than that in 18 infants and toddlers (less than 4 years old) (P < .01). We conclude that the normal eyelid crease position in children is one third up the lashline to the lower brow. However, the normal eyelid crease position in infants and toddlers is slightly less than, and, in older preschool and school-age children, slightly greater than this distance up the lashline. Thus, age may determine the surgical placement of the eyelid crease in children with indistinct creases.