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What happens at Eyelid Assessment?

Many people notice in photos of themselves that one eyelid or even both can appear droopy, as if half asleep. This is called Ptosis, which is a Greek word meaning ‘to fall down’. Medicine often uses Greek words to describe conditions.
A droopy eyelid is usually of no concern. It just represents a small thinning of a delicate part of the eyelid that lifts the eyelid, called the levator. It’s more common in people who have worn contact lenses or had eye surgery or are just plain getting older gradually, where the front part of the levator, the aponeurosis, thins and stretches so the eyelid falls down.
Often the eyebrow goes up and looks a little quizzical on the affected side, in an attempt to lift the eyelid and equalise the eyelids, making the area around the eyes look uneven.
Occasionally there is a medical cause such as something under the eyelid making it thicker and heavier. Usually, it is just ‘one of those things’. Patients find ptosis annoying as other people can remark on it or it makes them look inattentive.
Assessment involves an Ophthalmologist Oculoplastic Surgeon. This is a doctor specialised in assessing and operating on eyelids. They will ask you your history, look at the eye and underneath the eyelid on a microscope called a slit lamp. Then they will take photos of the eyelids in different positions and do measurements. The measures help the surgeon decide how much ptosis and exactly what has to be done surgically.

Eyelid Measurements help plan surgery

Margin reflex distances and between the light reflex and the lid margins:

MRD1 plus MRD2 mean the vertical height of the eyelid opening called the Palpebral Aperture. The eyelid muscle function describes the Levator function which is the movement of the upper eyelid without the eyebrow taking part.

Levator Function between looking down and looking up:

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