What are the findings under the eyelids and conjunctival examination in a patient with normal eyes?

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From the Research

Eyelid Examination Findings

  • The skin-orbicularis complex appears hyperechoic 1
  • The tarsal plate and capsulopalpebral fascia form a hypoechoic band, continuous and of almost uniform thickness in normal eyelids 1
  • The glandular structure of meibomian glands can be identified in 100% of cases 1
  • The retractor-conjunctiva complex appears as a hyperechoic layer below the capsulopalpebral fascia 1
  • The mean thickness of pretarsal and pre-septal orbicularis is 0.68 ± 0.18 mm and 0.89 ± 0.16 mm, respectively 1
  • The tarsal plate measures 0.57 ± 0.12 mm, capsulopalpebral fascia 0.42 ± 0.13 mm, and the retractor-conjunctiva complex 0.79 ± 0.18 mm 1

Conjunctival Examination Findings

  • Conjunctival concretions may be present in asymptomatic patients, with advanced to severe tear deficiency detected in 42.8% of patients 2
  • Tear film break-up time (BUT) is shorter in younger patients (younger than 45 years of age) with conjunctival concretions 2
  • Patients with conjunctival concretions are potentially affected with dry eye syndrome 2
  • Viral conjunctivitis is the most common overall cause of conjunctivitis, while bacterial conjunctivitis is less frequent 3
  • Allergic conjunctivitis is common, with findings including itching, mucoid discharge, chemosis, and eyelid edema 3

Upper Eyelid Structures

  • Orbicularis oculi muscle and Müller muscle-conjunctival complex are echo-dense, while levator aponeurosis and tarsus are echo-lucent 4
  • The mean thickness of orbicularis oculi muscle, levator aponeurosis, tarsus, and Müller muscle-conjunctival complex is 0.74 ± 0.11 mm, 0.44 ± 0.67 mm, 0.91 ± 0.15 mm, and 0.38 ± 0.64 mm, respectively 4
  • There is no significant difference in the thickness of these structures between patients younger than 40 years old and older patients, or between male and female patients 4

References

Research

Ultrasound biomicroscopic features of the normal lower eyelid.

Orbit (Amsterdam, Netherlands), 2021

Research

[Dry eye syndrome in patients with conjunctival concretions].

Ceska a slovenska oftalmologie : casopis Ceske oftalmologicke spolecnosti a Slovenske oftalmologicke spolecnosti, 2006

Research

Conjunctivitis: A Systematic Review.

Journal of ophthalmic & vision research, 2020

Research

Ultrasound biomicroscopy of the upper eyelid structures in normal eyelids.

Ophthalmic plastic and reconstructive surgery, 2007

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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