Oriental eyelids. An anatomic study.

Dissection of the eyelids and sagittal sections of the orbital blocks identified the anatomic features of the oriental eyelids responsible for their unique appearance. The basic distinction involves the formation of the eyelid crease and fold. In the occidental eyelid, the orbital septum fuses with the levator aponeurosis below the superior tarsal border. However, in the oriental eyelid, the orbital septum fuses with the levator aponeurosis below the superior tarsal border. The accompanying preaponeurotic or orbital fat is allowed to proceed to the anterior tarsal surface, resulting in a full or thickened eyelid. The inferior extension of the orbital septum, beyond the superior tarsal border, prevents anterior aponeurotic fibers from fanning toward the subcutaneous tissues to produce the normal eyelid crease. Appreciation of the unique anatomic features of oriental eyelids is important for those persons who evaluate or surgically explore these eyelids.