Eyelids - Science topic

Blepharoplasty is a frequently performed aesthetic surgery today aimed at enhancing eyelid appearance and correcting age-related changes. The traditional method of subtraction blepharoplasty, which involved removing fat and excess skin, is now considered outdated. This letter explores Gorgy et al's commentary on Miotti et al's study, highlighting a...

Background Basal cell carcinoma (BCC) is the most common malignant tumor of the eyelid. These cancers often necessitate eyelid reconstruction in ophthalmic plastic surgery, which poses significant challenges. This study describes the use of a tarsoconjunctival flap from the orbicularis oculi muscle of the upper eyelid for reconstructing full-thickn...

Background Dry eye disease (DED) is a complex ocular disorder with a significant prevalence worldwide, especially in the Asian population. This study aimed to investigate changes in dry eye symptoms and signs following regular use of a new nanoemulsion eye drop, Systane COMPLETE Multi-Dose Preservative-Free (MDPF), in patients with mild to moderate...

Blepharophimosis syndrome (BPES) is a rare congenital condition primarily affecting the eyelids, leading to distinctive facial features. It is characterized by bilateral ptosis (drooping of the upper eyelids), shortened horizontal palpebral fissures (narrowed eye openings), epicanthus inversus (an upward fold of skin near the inner corner of the ey...

Purpose We sought to examine the demographic and clinical risk factors associated with specific mechanisms of open globe injuries (OGIs) and identify predictors of Zone III injuries across multiple tertiary eye care centers. Patients and methods 1570 patients with OGIs presenting to the Wilmer Eye Institute, the Bascom Palmer Eye Institute, Massac...

An oblique tooth is viewed in the States as requiring straightening, but in Japan it may be thought of as emblematic of a young woman's charm. While a slim body is a prerequisite for beauty today, plump women were considered beautiful in Tang Dynasty China and Heian period Japan. Starting from around the twelfth century in China, bound feet symboli...

Background Ophthalmic pathology at the Eye Center at Medical Center, University of Freiburg, Germany, looks back on a tradition of more than 150 years. Surgical specimens and associated histological diagnoses have been archived since 1945. This study is the first of its size to include 39,256 specimens examined in a single ophthalmic pathology labo...

Oculocutaneous albinism (OCA) is an autosomal recessive disease characterized by the deficiency of the tyrosinase enzyme involved in melanin synthesis. The deficiency of melanin in these patients increases the risk of sun exposure induced cancers. Herein, we report the rare case of multiple basal cell carcinomas (BCCs) with co-occurrence squamous c...

Background Blepharoplasty is a popular facial cosmetic surgery, but research on how gender may influence motivations for this eyelid procedure remains limited. Understanding differences can improve patient counseling. Objective This study examined gender variances in key factors driving blepharoplasty decisions. Methods Medical records of 100 ble...

Background/Aim Dedifferentiated liposarcoma (DDLS) is a rare but aggressive subtype of liposarcoma that arises in soft tissues. In orbital liposarcoma, malignant transformation from well-differentiated to DDLS typically takes at least a year. We herein report a case of a young female with an aggressive DDLS, that developed from an orbital lipoma wi...

Driver fatigue is one of the major causes of traffic accidents, particularly for drivers of large vehicles, who are more susceptible to fatigue due to prolonged driving hours and monotonous conditions during their journeys. Existing vision-based driver fatigue detection methods fail to accurately and timely judge fatigue in complex driving scenario...

Identification of increased intraocular pressure has been conventionally limited by direct, corneal applanation, and indentation measurement procedures, conducted by highly trained eye-care specialists e.g. optometrists and ophthalmologists. This practice greatly limits the numbers of individuals which can and need to be screened, for increased int...

Purpose: This study aimed to investigate quality control (QC) strategies to enhance treatment delivery in inter-ventional radiotherapy (IRT) for head and neck (H&N) cancers, focusing on ensuring the accuracy of therapy while addressing specific challenges, such as catheter displacement and tube misconnection. Material and methods: A retrospective a...

Lupus miliaris disseminatus faciei (LMDF) is a chronic granulomatous disorder affecting the face in young adults with sudden eruption of asymptomatic skin colored to red-brown papules on cheeks, eyelids and few extrafacial sites including ears and neck. There has been disputation about the origin of the disease, but the consensus is that it is an i...

Background: Ophthalmomyiasis, the parasitic infestation of the eye by fly larvae, is a rare but potentially vision-threatening condition. Its association with basal cell carcinoma (BCC) of the eyelid is exceedingly uncommon, posing diagnostic and therapeutic challenges. This systematic review explores the relationship between ophthalmomyiasis and e...

Objective To explore and evaluate the clinical effect of transconjunctival approach combined with orbital septal fat release in correction of lower eyelid pouch in middle‐aged and elderly male patients. Methods A retrospective analysis was performed on the clinical data of 17 middle‐aged and elderly male patients with lower eyelid bags underwent t...

Background Aging causes facial wrinkles, especially dynamic wrinkles related to mimic movements, predisposing areas to static wrinkles from a young age, notably in the periorbital region. This study aims to analyze dynamic wrinkle patterns on periorbital skin during mimic movements in healthy young adults to identify wrinkle precursor regions. Met...

Aim of the study Injectable fillers are a popular treatment for sunken upper eyelid (SUE) deformity, but their efficacy and duration are limited. This study evaluated the clinical efficacy and safety of blunt separation combined with an uncrosslinked sodium hyaluronate compound solution for treating SUE in Asians. Methods Twenty-seven Chinese pati...

Purpose This study aims to evaluate the effect of Müller's muscle-conjunctival resection (MMCR) with tarsectomy on lower eyelid position in patients with unilateral aponeurotic ptosis in the East Asian population. Methods A retrospective review was conducted on patients undergoing unilateral MMCR surgery. Margin reflex distance (MRD) 1 and 2 were...

Myasthenia Gravis (MG) is an autoimmune disease caused by transmission disorders at the neuromuscular junction. Among them, ocular myasthenia (OMG) is the most common type, mainly manifested as ptosis of the upper eyelid, diplopia, and ocular movement disorders. Traditional Chinese Medicine (TCM) treatment for MG has unique advantages. Through over...

The reported patient is a middle-aged farmer from West Sudan who presented with a painless mass in the right upper eyelid that progressively enlarged over time. His medical treatment journey was prolonged and difficult. The mass was initially misdiagnosed as lacrimal gland pleomorphic adenoma. The patient was later referred to a specialised center,...

Purpose: Sebaceous gland carcinomas (SC) are rare neoplasms arising from the eyelids' sebaceous glands. Investigating racial disparities in their occurrence, management, and outcomes is crucial for enhancing patient care. Design: Retrospective database analysis. Methods: Data were extracted from the Surveillance, Epidemiology, and End Results (SEER...

Molluscum contagiosum is an infectious skin disease caused by the molluscum contagiosum virus that affects 6 million people in the United States annually. However, molluscum contagiosum on the eyelid is uncommon. The aim of this article is to describe the clinical diagnosis and effect of curettage using fine forceps under an operating microscope in...

A 2-year-old intact male Persian cat was presented with the history of chronic unilateral ocular irritation and purulent discharge for 2 months. Epiphora, blepharospasm, photophobia, and severe unilateral entropion involving the nearly whole length of lower eyelid (primarily lateral canthus of eye) were seen on clinical examination. Corneal ulcerat...

Myiasis is derived from the Greek word “myia”, which means “fly”. Zumpt, a German entomologist, defined this condition as the infestation of living humans and vertebrate animals by dipterous larvae that feed on living and dead host tissue, liquid body substances, or ingested food for a certain period. Myiasis is a rare complication that can occur i...

Purpose To investigate the conjunctival and eyelid margin bacterial microbiota in children with blepharoconjunctivitis by using 16S rDNA amplicon sequencing. Methods In this prospective cross-sectional study, 20 children aged between 3–15 years with blepharoconjunctivitis or blepharokeratokonjunctivitis formed Blepharitis Group and 21 children age...

A 56-year-old man presented with right-sided drooping of the mouth corner and eyelid, along with weakness in the left lower limb. His MRI revealed a corona radiata lacunar infarction on the left and an acute infarction on the right. However, the needle electromyography (EMG) results were unremarkable. It was determined that his unilateral periphera...

Purpose: Space flights induce periocular facial changes which could contribute to ocular conditions which affect astronauts. This study is to validate parabolic flight as a suitable model for studying gravitational facial changes. Methods: Healthy participants (n = 13; 37 ± 10 years) underwent short-term exposure to microgravity and hypergravity d...

Vitiligo is an autoimmune condition characterized by the destruction of melanocytes, leading to depigmented skin patches. Allergic contact dermatitis, triggered by allergens in cosmetics, can initiate localized immune responses that may progress to systemic immune dysregulation in genetically predisposed individuals. This case explores the potentia...

Background The blink reflex is a neurological response characterised by eyelid movements and can provide important data on the state of anaesthesia. Sevoflurane is a commonly used inhalation anaesthetic agent in cats and evaluation of eye reflexes under this agent may help to better understand the depth of anaesthesia. Objectives The aim of this s...

Accurate anatomical measurements of the eyelids are essential in periorbital plastic surgery for both disease treatment and procedural planning. Recent researches in eye diseases have adopted deep learning works to measure MRD. However, such works encounter challenges in practical implementation, and the model accuracy needs to be improved. Here, w...

Background/Objectives: The management of ocular tumors often necessitates surgery, either alone or in combination with radiotherapy, chemotherapy, or other modalities. While crucial for tumor control, these treatments can significantly impact the ocular surface, leading to both acute and chronic complications. This review examines iatrogenic ocular...

Chronic dacryocystitis is inflammation of the lacrimal sac caused by obstruction of the lacrimal drainage system. The condition often causes chronic epiphora, pain, swelling and recurrent infection. Thermal trauma is a rare but significant cause of chronic dacryocystitis, which contributes to fibrosis and progressive obstruction. This case report b...

Background Epiblepharon is a congenital anatopism characterized by a horizontal skinfold near the eyelid margin, causing corneal irritation and damage. Standard surgical management occasionally results in undercorrection and relatively high recurrence. In addition, a pronounced postoperative lower eyelid crease can be an unfavorable cosmetic altera...

The purpose of this study is to examine and interpret machine learning models that predict dry eye (DE)-related clinical signs, subjective symptoms, and clinician diagnoses by heavily weighting lifestyle factors in the predictions. Machine learning models were trained to take clinical assessments of the ocular surface, eyelids, and tear film, combi...

Background This study aimed to assess a dermal filler’s safety, efficacy, and outcome for inducing temporary mechanical ptosis of the upper eyelid in patients with facial nerve palsy with exposure keratopathy. Methods A prospective interventional study was conducted on 13 patients with facial nerve palsy with various levels of lagophthalmos and ex...

Background Muir-Torre syndrome is a rare disorder characterized by patients suffering from sebaceous gland tumors or keratoacanthoma and visceral malignancies. More cases have been reported in Europe than in Asia. In this study, we report a case of MTS in China. Case presentation A 64 -year-old woman presented with a growth on the left upper eyeli...

Background Conjoint fascial sheath (CFS) and levator muscle (LM) composite flap suspension has been gradually accepted for the treatment of congenital severe blepharoptosis in recent years. This study is to evaluate the clinical efficacy of conjoint fascial sheath with levator muscle (CFS + LM) suspension in the treatment of recurrent severe ptosis...

To maintain the visual potential of individuals with open globe injuries, anatomical integrity must be restored. Preventing further tissue damage & preserving corneal shape to reduce the resulting postoperative astigmatism are the major goals of initial repair surgery. We represent a case of 70-year-old male patient reporting to the OPD of Departme...

Introduction: Conjunctival Pyogenic Granuloma is the most prevalent benign vascular growth appearing as a smooth, red, sessile/pedunculated lesion on the palpebral conjunctiva. The patient's eye is irritated by the growth in the palpebral region, which interferes with daily activities. On a very slight trauma, these lesions frequently bleed. Based...

To evaluate ocular surface and eyelid modifications occurring in glaucomatous patients diagnosed with glaucoma therapy-related ocular surface disease (GT-OSD) and retinal comorbidities who previously underwent serial Intravitreal injections (IVIs) of aflibercept. Thirty-two eyes of 32 patients with a diagnosis of GT-OSD and concomitant retinal dise...

Objective Facial nerve paralysis (FNP) affects eye muscle function causing lagophthalmos. This leaves the cornea vulnerable to irritation and injury which, if untreated, may cause permanent vision impairment. Decreased eye muscle control impacts facial expressions and quality of life. Although non-surgical interventions such as lubrication are rout...

Purpose This study aimed to investigate the morphological features of eyelid margin in dry eye patients and determine their correlations with conjunctival goblet cells, MUC5AC secretion, and clinical tests of tear film. Methods Patients diagnosed with dry eye disease (DED) were asked to complete the evaluations of symptoms and signs of dry eye, in...

The driver's hypnosis detection system will be processed by image processing. The background and purpose of this research is the detection of street hypnosis to increase street awareness. The road hypnosis detection method used is based on eyelid closure and the detection of physiological parameters of the driver's HRV signal to improve the accurac...

Calcium hydroxyapatite (CaHA) is a widely used biostimulatory filler for facial rejuvenation. Although it has a favorable safety profile, complications such as nodules, granulomas, and fibrosis can occur. The use of CaHA in the periorbital region remains limited due to safety concerns, and few reports have detailed its complications in this delicat...

This report describes the ocular manifestations in a cohort of patients with Clade I mpox evaluated in the Democratic Republic of the Congo (DRC) from 2007 to 2011, as well as the clinical course of a pediatric patient with mpox associated with ocular disease. Among 216 patients, ocular manifestations were observed in 8.3% of the patients, includin...

Background: Hypereosinophilic syndrome (HES) is a heterogeneous group of rare disorders defined by the presence of marked eosinophilia resulting in end organ damage. The diagnostic approach is multidisciplinary and treatment goals include reductions in flares and eosinophils with minimal drug-related side effects. Results: Eleven patients (n = 11)...

Background To analyze the clinical features and prognosis of orbital melanoma. Design Retrospective observational case series. Methods A retrospective analysis of the electronic medical records, histopathology, imaging examinations, and follow-up information of 37 patients with orbital melanoma. Results The most common primary site was the conju...

Background Sinus of Valsalva aneurysm is a relatively rare disease accompanied by several severe complications. Patients with an unruptured sinus of Valsalva aneurysm are usually asymptomatic or present with symptoms of dyspnea, easy fatigability, palpitations, or chest pain, whereas a ruptured sinus of Valsalva aneurysm may cause severe symptoms i...

Background Kartagener syndrome is characterized by chronic sinusitis, bronchiectasis, and total visceral transposition. While there are few reports of Kartagener syndrome combined with kidney disease, there are none that specifically report Kartagener syndrome in conjunction with minimal change disease. This is the first report of a rare case of Ka...

Abstract Objective: To report a case of a comatose patient with anoxic brain injury who exhibited periodic oral automatisms (chewing movements) without any physical or noxious stimulation, and to discuss its prognostic value. Background: A 43-year-old female with stage IV adenocarcinoma of the lung, with metastases to the brain and bone, presented...

Background: The reconstruction of extensive full-thickness lower eyelid defects constitutes a challenge for plastic surgeons. Various techniques have been described to cater to patients’ specific defect needs, with the aim of achieving the best results. Materials and Methods: We performed a retrospective observational study assessing our experience...

Dacryoadenitis refers to inflammation of the lacrimal gland, a key component of the ocular adnexa responsible for tear secretion. The condition may present in acute or chronic forms, affect one or both eyes, and arise from infectious, autoimmune, or idiopathic causes. The lacrimal gland is a bilateral, lobulated, almond-shaped structure located in...

Meibomian gland dysfunction (MGD) is a common cause of dry eye disease. It occurs when oil producing glands do not provide enough oil for eye greasing, due to fewer glands, blockage or inflammation. In this paper, the main idea is to segment the meibomian glands present in eyelids, which have complex structures and location variability. They help t...

Objectives Xanthelasma palpebrarum (XP) is a common type of cutaneous xanthoma, typically presenting as yellowish papules or plaques around the eyes. Often associated with dyslipidemia, XP may indicate underlying conditions such as non-alcoholic fatty liver disease and hypothyroidism. Various surgical techniques are employed to remove XP, but simpl...

Dirofilaria repens is the primary etiological agent of human dirofilariosis in the Old World, with Italy reporting the highest number of cases in Europe. This study describes two new cases of D. repens infection in humans, in southern Italy, where canine dirofilariosis is endemic. The first case involved a 33-year-old man from Caserta (Campania, So...

Demodex folliculorum and Demodex brevis are external parasites that reside in human hair follicles and sebaceous glands, most commonly on the cheeks, chin, nose, and eyelids, inhabiting the eyelash follicles. The prevalence of Demodex spp. varies with age. The highest concentration of mites is observed in older people, being almost 100%, and the lo...

Demodex infestation of the eyelid is a rare clinical presentation. It is caused by Demodex folliculorum and Demodex brevis mites. Common clinical presentations include eyelid itching, increase lacrimation, erythematous eyelid, and cylindrical dandruff seen at the base of eyelashes. This case report illustrated a 74-year-old diabetic patient who pre...

Article history: Pilomatrixoma is a benign tumor of the hair matrix cells and is usually confused with other entities since there are nonspecific findings. Most of the patients are young individuals, and involvement is usually in the head and neck region; however, rarely, involvement in the periorbital area has been reported. We present the recurre...

The lateral transorbital approach (LTOA) is useful for lesions situated in the middle fossa, adjacent to the lateral wall of the cavernous sinus, as it minimizes brain retraction and provides an extradural corridor. In this video, the authors present the case of a 35-year-old male, complaining of headache and diplopia. MRI revealed a dural-based mi...

Background: Meibomian gland dysfunction (MGD) involves posterior blepharitis, which includes a disruption of the tear and meibum lipids and thereby produces an evaporative dry eye. The most common cause is obstruction of the meibomian glands, which causes inflammatory changes and increases bacterial colonization along the lid margins. Conservative...

In recent years, endoscopic transorbital approaches have found wider applications and more indications. Their use has been described for resection of epileptogenic pathology in the adult population and for lesions located at the temporal lobe. In this video, the authors describe the case of a 47-year-old woman with a 9-month history of episodes of...

Pilomatrixoma is a benign tumor of the hair matrix cells and is usually confused with other entities since there are nonspecific findings. Most of the patients are young individuals, and involvement is usually in the head and neck region; however, rarely, involvement in the periorbital area has been reported. We present the recurrent case of piloma...

Eyelid defects involving posterior lamella loss pose significant challenges in reconstructive surgery due to their functional-anatomical complexity. While our previous autologous auricular chondrocyte-derived tissue-engineered cartilage (TEC) grafts successfully maintained normal eyelid morphology, they lacked functional epithelium. This study deve...

Accurate measurement of eyelid parameters such as Margin Reflex Distances (MRD1, MRD2) and Levator Function (LF) is critical in oculoplastic diagnostics but remains limited by manual, inconsistent methods. This study evaluates deep learning models: SE-ResNet, EfficientNet, and the vision transformer-based DINOv2 for automating these measurements us...

Necrotising eyelid inflammation, also known as necrotising fasciitis (NF) of the orbit, is a rare but severe soft tissue infection. Prompt and appropriate treatment is crucial, as delayed intervention can result in the bacteria entering the bloodstream. Typical predisposing factors for NF include skin breaks after surgery or trauma, which may be sm...

Necrotizing fasciitis is aggressive and rapidly progressive infection along the subcutaneous facial plane. Necrotizing fasciitis is usually located in the extremities, abdomen, perineurium. It is extremely rare in the eyelid region. A better prognosis relies critically on early diagnosis, prompt medical treatment and timely surgical intervention. W...

Introduction. Septorhinoplasty is one of the most commonly performed cosmetic surgical procedures, used both to enhance the aesthetic appearance of the nose and to restore its function. Traditionally, the bony vault and lateral walls are reshaped using mechanical instruments such as saws, chisels, osteotomes, and rasps. Additionally, electrically p...

Kaposi sarcoma associated with Human Herpesvirus-8 (HHV8) infection, is a low-grade malignant vascular spindle-cell tumour, commonly linked to acquired immunodeficiency syndrome (AIDS). This case report highlights a rare presentation of ocular KS leading to diagnosis of Human Immunodeficiency Virus (HIV) infection. A 25-year-old otherwise healthy I...

Early detection, regular monitoring of eyelid tumors and post-surgery recurrence monitoring are crucial for patients. However, frequent hospital visits are burdensome for patients with poor medical conditions. This study validates a novel deep learning-based mobile application, based on YOLOv5 and Efficient-Net v2-B architectures, for self-diagnosi...

Purpose To evaluate the effect of 4 commonly used eyelid speculums on intraocular pressure (IOP) among children undergoing examination under anesthesia. Methods In this comparative cross-sectional study, IOP of children undergoing EUA at Soroka Medical Center was measured by manually opening the eyelids and the result was compared to measurements...

Eyelid tumors in about 80–95% of cases belong to benign lesions. Because of the complex anatomy of the eyelids and the resulting diversity of potential sites of initiation of the neoplastic process, as well as because of the morphological similarity of the observed lesions, making a correct diagnosis at the initial stage of the diagnostic process i...

Purpose The insulin-like growth factor-1 receptor (IGF-1R) plays a role in the pathogenesis of Graves’ orbitopathy (GO). A possible protective role of autoantibodies against IGF-1R (IGF-1R-Abs) on GO has been suggested. Methods We conducted a cross-sectional study to investigate IGF-1R-Abs in 147 consecutive Graves’ disease (GD) patients, with (n...

The skin is a barrier between the body and the external environment, it is the largest human organ. Healthy skin microbiota is harmless and beneficial to the skin. As a microbiological barrier, it protects against harmful microorganisms. In turn, the eyelids protect the surface of the eyeball from the adverse effects of external factors. The skin o...

Lower eyelid entropion is malposition of the lower eyelid, potentially leading to loss of vision. The most common causes of entropion are involutional changes, less often cicatricial or paralysis factors. In order to treat involutional entropion there are multiple surgical techniques, referred to its cause, which may be vertical laxity, horizontal...

Background lacrimal gland prolapse (LGP) is a rare yet significant condition in oculoplastic surgery, characterized by the downward displacement of the lacrimal gland leading to upper eyelid bulging. This study aimed to understand LGP’s defining characteristics and clinical implications for accurate diagnosis and tailored treatment planning. Metho...

Papilliferous syringocystadenoma is a rare cutaneous adnexal tumor, described in the literature as benign and of hamartomatous origin, although the underlying mechanisms are not fully understood. This tumor is usually seen on the lower eyelids and cheeks. Vulvar syringoma, on the other hand, is an extremely rare condition, with only a few cases rep...

Purpose To report IgG4-related ophthalmic disease (IgG4-ROD) presenting as posterior scleritis in a pediatric patient. Observations A 7-year-old girl presented with proptosis, painful eyelid swelling, and restricted extraocular movements (EOM) of her left eye (OS). Visual acuity (VA) was 20/20 in right eye (OD) and counting fingers (CF) at 1 foot...

Upper blepharoplasty addresses aging-related changes by removing excess skin, muscle, and fat from the upper eyelids. This systematic review, which was registered a priori, improves upon previously published reviews regarding functional and aesthetic outcomes following upper blepharoplasty. Custom search strategies were applied across multiple data...

BACKGROUND The high prevalence of human papillomavirus (HPV) infection in oropharyngeal squamous cell carcinoma (SCC) is well established, and p16 expression is a strong predictor. HPV-related tumors exhibit unique mechanisms that target p16 and p53 proteins. However, research on HPV prevalence and the combined predictive value of p16 and p53 expre...

Burn injuries are a global health issue affecting millions of people annually, more so in developing countries. Electric burns are severe and uncommon forms of burn injuries which account for approximately less than 5% of all burn injuries, and are associated with high morbidity and mortality. Ocular complications occur in approximately 5% of elect...

Purpose Basal cell carcinoma (BCC) is the most frequent malignant tumor of the eyelid and recurrences of BCC may lead to massive destruction of the orbital region. The objective of this study was to evaluate predictors for surgically difficult-to-control or uncontrollable recurrences. Methods All BCCs of the periorbital region treated in the Depar...

Being the intricate architecture of the maxillofacial region, rehabilitation of maxillofacial abnormalities is relatively hard for most maxillofacial surgeons. Orbital roof fractures are among the most uncommon craniofacial abnormalities. The fact that these fractures “grow” makes treatment challenging. An encephalocele can form as a result of a he...

Plain Language Summary Evaporative dry eye disease (DED) is one of the most common pathologies of the ocular surface. This multi-factorial disease is mostly due to poor function of meibomian glands within the eyelids (MGD). Patients with DED due to MGD suffer from discomfort, visual disturbances, and a deterioration in the quality of life. The cond...

Introduction Ptosis surgery outcomes are measured by one-dimensional metrics like Marginal Reflex Distance (MRD) and Palpebral Fissure Height (PFH) using ImageJ. However, these methods are insufficient to capture the full range of changes post-surgery. Eyeball Exposure Rate (EER) offers a more comprehensive two-dimensional perspective as metric. Th...