Br J Ophthalmol 1999;83:347-352 ( March )
Topographic anatomy of the eyelids, and the effects of sex and
age
Willem A van den Bosch,a
Ineke Leenders,b
Paul Mulderc
a Department of
Oculoplastic Surgery, The Rotterdam Eye Hospital, Rotterdam,
Netherlands, b Havenziekenhuis, Rotterdam, Netherlands, c Department of Epidemiology
and Biostatistics, Erasmus University Medical School, Rotterdam,
Netherlands
Correspondence to: Willem A
van den Bosch MD, The Rotterdam Eye Hospital, PO Box 70030, 7000 LM
Rotterdam, Netherlands.
Accepted for publication 15 October 1998
AIMS
To describe the
effects of sex and age on eyeball, eyelid, and eyebrow position.
METHODSA cross
sectional cohort study was performed in which both eyes of 320 normal
subjects aged between 10 and 89 years were included. Of each 10 year
age cohort, there were 20 men and 20 women. Frontal, as well as
lateral, slides were taken of both eyes. On projected slides, a
reference line through the medial canthi and vertical lines through the
pupil centre and the lateral canthus were constructed. Using these
lines, we measured the size of the horizontal eyelid fissure, the
distance from the reference line to the pupil centre and to the lateral
canthus, the distance between the pupil centre and the upper and lower
eyelid margin, and the distance between the upper eyelid margin and the
skin fold and eyebrow. On lateral slides, the distance between the
lateral canthus and the anterior corneal surface was measured.
RESULTSBetween the
ages of approximately 12 and 25 years, the horizontal eyelid fissure
lengthened 3 mm, while the position of other eyelid structures remained
virtually unchanged. Between the average ages of 35 and 85 years,
the horizontal eyelid fissure gradually shortened again by about 2.5 mm. Meanwhile, the distance between the lateral canthal angle and
the anterior corneal surface decreased almost 1.5 mm. Aging caused an
increase of the distance between the pupil centre and the lower eyelid
of about 1 mm in men, and 0.5 mm in women. Aging also caused a higher
skin crease and raised eyebrows in men and women, but it did not affect
the position of the pupil centre and the lateral canthus. Men showed an
0.7 mm larger horizontal eyelid fissure than women. In women, however, the eyebrows were situated about 2.5 mm higher than in men.
CONCLUSIONAging
mainly affects the size of the horizontal eyelid fissure, which
lengthens by about 10% between the ages of 12 and 25, and shortens by
almost the same amount between middle age and old age. Aging causes
sagging of the lower eyelid, especially in men, and a higher skin fold
and eyebrow position in both sexes. Aging does not affect the position
of the eyeball proper, or of the lateral canthus.
Keywords:
aging;
eyelid anatomy;
sex
© 1999 by British Journal of Ophthalmology
