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A. Makino, K.J. Lane, M.J. Chapin, G.W. Ousler, III, M.B. Abelson; A Pilot Evaluation to Identify Morning Eyelid Swelling Using a Three Dimensional (3D) Digital Scanner . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2272.
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Swollen, baggy and droopy eyelids are common complaints associated with the appearance of the eyes after waking up from a period of sleep. Eyelid swelling has been related to age, smoking and sunlight exposure.1 We believe morning lid swelling occurs as a result of decreased skin elasticity and tissue turgor, which is part of the aging process, but could be exacerbated by environmental factors. No published studies to date have objectively measured lid swelling.
To determine if morning eyelid swelling can be detected and quantified using a sensitive 3D scanning technology to detect subtle changes in the structure of the eye and lid tissues in a population of normal subjects.
This was a single–center, 2–visit study. Six subjects under the age of 31 were examined on an afternoon between 14:00 to 18:00 (Visit 1) and on the morning of the subsequent day between 07:00 to 10:30 (Visit 2). A volume of both the upper and lower eyelids combined was obtained per eye, subject, and visit using 3D analysis software. The differences in volume between the two visits were then calculated. Subjects were also asked to grade the swelling in their eyes as absent, mild, moderate or severe.
We found a significant difference between the two visits in the left eye for all subjects using two–tailed Wilcoxon’s signed sum test (p < 0.05). Five out of six subjects showed an increase in volume of at least 50 mm3 in at least one eye, four of which had increases bilaterally. The largest volumetric difference was 744 mm3. Two subjects reported mild lid swelling. Four subjects reported that lid swelling was absent.
Our 3D scanning technique was able to detect and quantify diurnal variations in eyelid swelling, making morning eyelid swelling detection and quantification an objective reality. Our technique was sensitive enough to detect morning eyelid swelling in a young population that normally wouldn’t experience eyelid swelling and in several subjects that did not believe that they’re eyelids were at all swollen, indicating our technique is sensitive beyond clinical relevance. Future studies will focus on refining and improving the sensitivity of the technique and will look at specific regions surrounding the eye for swelling patterns, the relationship of age and history of ocular allergy to lid swelling, and diurnal patterns in eyelid swelling.
1. Piffaretti, HM and Haefliger IO. Etiology of eyelid edema. Ther Umsch. 2004 Nov;61(11):661–3. German.
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