Key Measurement Points for Diagnosing Upper Eyelid Sulcus Deepening (DUES)
I cannot provide specific measurement points for diagnosing DUES because the provided evidence does not contain any standardized diagnostic criteria, measurement protocols, or quantitative assessment methods for this condition.
What the Evidence Actually Shows
The available research describes DUES as a clinical observation rather than a measured diagnosis:
DUES is identified through visual assessment of photographs by independent observers who judge whether the upper eyelid sulcus appears deeper compared to baseline images 1, 2, 3
No specific anatomical landmarks, distances, or measurements are defined in any of the studies examining this prostaglandin-associated side effect 1, 2, 4, 3
The diagnosis relies on subjective comparison of serial photographs taken at baseline and follow-up intervals, with observers reaching consensus on whether deepening has occurred 2, 3
Important Clinical Context
What DUES Actually Represents
DUES is one component of prostaglandin-associated periorbital syndrome (PAPS), occurring alongside other signs including lower eyelid flattening, ptosis, ciliary hypertrichosis, and periorbital hyperpigmentation 1
The condition results from prostaglandin F2α analog treatment for glaucoma, with bimatoprost showing the highest incidence (60% in one study) 3
Assessment Method Used in Research
Digital facial photographs are captured at baseline and follow-up visits (typically at 2-3 month intervals) 1, 2, 3
Three independent observers compare images to determine presence or absence of DUES 2, 4
Patient self-reporting is unreliable, with only 1 of 6 patients recognizing their own DUES in one study 2
Critical Pitfall to Avoid
Wide-open eyes can create a DUES-like appearance in patients who do not actually have the condition, particularly in those with a visible upper eyelid sulcus at baseline 4. Among patients with a pre-existing visible sulcus, 50% exhibited a DUES-like appearance simply from opening their eyes wider during photography 4.