Oculoplastics Dr Neena Peter Oculoplastics Overview Eyelids Eyelids Functions of Eyelids: Protection: • Light protection & regulation o Keep cornea moist o Mechanical protection of globe o Lacrimal pump • Surface Anatomy Upper Lid [UL] covers superior 2mm of cornea (10 – 2’o clock) Lens Lower Lid [LL] margin JUST touches inferior limbus Surface Anatomy Distance between UL margin & central pupillary reflex is margin reflex distance (MRD1) and normally, is 3.5 mm Surface Anatomy Space between UL & LL is palpebral fissure height (PFH) and normally, it is 9-12 mm. Surface Anatomy A puncta (one in each lid) lies in close apposition to globe To Summarise: Normal parameters for lid position evaluation: A= Skin Crease • 10 mm in females • 8-10 mm in males • B= MRD1 – 3.5 – 4.0 mm • C= PFH – 9 -12mm • Inferior scleral show – Nil • Lagophthalmos (inability to close eyes) – Nil • Bell’s phenomenon (globe movement on eye closure) • – Up and out Eyelids: Internal Anatomy Superioris Orbital Septum (Aponeurosis) Orbital fat Muller’s muscle (Anterior (Posterior lamellae) lamellae) -Tarsus (meibomian -Skin glands) - Orbicularis Oculi - Conjunctiva Outward direction of 9 lashes Two Halves- Lamellae • Septum • Landmark - Gray Line Anatomical o Surgical o