For clinicians dealing with eyelid disease, eyelid saccades are interesting movements, because they reflect the interaction between the activity of the levator palpebrae superioris (LPS) muscle and passive forces stored in the eyelid. The upper eyelid position in alert subjects results from the tonic activity of the LPS, which stretches the tarsal plate, eyelid ligaments, and orbicularis oculi muscle. In the absence of any LPS muscle function (third nerve palsy) there is complete ptosis. When the eye rotates down, both the superior rectus and LPS are inhibited. The resultant downward movement of the upper eyelid is entirely dependent on the relaxation of the LPS muscle and the passive force generated by the stretched eyelid structures, superposed on the dissipative forces represented by friction between the lid and the eyeball and also by an intrinsic friction of the elements of the system. The upward phase of the saccades results from the contraction of the LPS muscle, which overcomes the downward passive forces to raise the lid. During both phases, the orbicularis oculi muscle remains silent.
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Our findings agree well with data reported in the previous studies, which have described the metrics of upper eyelid saccades in normal subjects.
5 6 7 Downward saccades are faster than upward movements and exhibit an overshoot that takes the eyelid to a position lower than the final one. These oscillations are typically less marked for the upward movements.
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A point that deserves some comment is the units used in the present study (millimeters and millimeters per second). Vertical eyelid displacements are rotational movements,
6 and thus it seems more appropriate to express lid saccades in degrees and degrees per second. However, rotational movements are mathematically related to linear displacements
(Appendix). Clinicians have always recorded lid movements in terms of linear displacements. All data on levator function are based on millimeters and not degrees. It is doubtful that expressing lid movements as curvilinear displacements increases the precision of the measurement. A study with search coils has demonstrated that coil position is a critical parameter for recording eyelid saccades, suggesting that different parts of the upper eyelid have different rotational axes.
7 If it is assumed that 2.4 mm of lid displacement equals 10° of lid rotation,
5 our results of downward upper eyelid peak velocities (43.29 mm ± 1.66 for 20° and 72.49 mm ± 3.21 for 40° of eye rotation) are slower than reported by other authors.
5 6 7 However, when results of maximum velocities are pooled from different studies, there is a large variation in the data, which suggests that specific experimental and recording conditions strongly influence the absolute velocity values. Therefore, we agree with Guitton et al.
5 that absolute values of velocity must be interpreted with caution if they are used as normative data. More interesting is the analysis of the shape of the functions described by the saccadic movements and the study of the relation between the parameters that characterize these functions.
In the studies published thus far on eyelid saccades, the metrics of the movements were not mathematically modeled, and typically only the maximum amplitude and peak velocity were quantified.
1 5 6 7 Overshoots have been identified in several of those studies but were explicitly mentioned for the first time by Evinger et al.
6 In one study, the presence of the overshoots was taken as an indicator that the orbicularis muscle was being activated at the end of the downward saccadic movement.
7 Our results show that normal upper eyelid saccades are described by functions that are extremely well fitted by the underdamped solution of the harmonic oscillator model. As discussed in detail in the
Appendix, this model assumes that the overshoot is a normal characteristic of the dynamics of the lid saccades. It reflects an oscillation of the elastic eyelid components that can be large or small, depending on the magnitude of the damped coefficient. The idea that the dynamics of the upper eyelid saccadic movements are strongly influenced by the elastic components of the eyelid tissues was clearly elaborated by Evinger et al.
6 The mathematics used in the present study is merely a formal description of the data shown in Figure 13 of Evinger et al.
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The metrics of the lower eyelid saccades have never been measured. The results of the few old studies that have been performed using millimeter rules were extremely variable. Shore
9 measured the vertical excursion of the lower eyelid from extreme infraduction to full upgaze in 188 normal subjects of different ages and found a range of amplitude of 0 to 8 mm. Similar results were published in the 1960s by Fox.
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Our results demonstrated that the lower eyelid saccade metrics can also be described by the underdamped solution of the model. Their peak velocities are also linearly correlated with movement amplitude. Overshoots are detected in the downward movements, and their velocity–time function is similar to the functions obtained for the upper eyelid saccades.
Lower eyelid saccades are small (almost four times smaller than the upward saccades), stereotyped movements. Their duration does not change when the eye rotation increases from 20° to 40°, and they do not show the asymmetry in velocity displayed by the upper eyelid saccades. Their velocity is essentially the same for upward and downward movements.
The characteristics of the lower eyelid saccades dynamics can be explained by the fact that these movements are entirely passive. They do not result from the contraction or relaxation of an independent muscle such as the levator. During vertical eye rotations, it is the transmission of forces through the capsulopalpebral fascia that produces the vertical lower eyelid motion.
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A fine analysis of the eyelid saccade metrics may be clinically important. It may detect early abnormalities of the levator muscle in Graves’ upper eyelid retraction and also assess the transmission of forces to the lower eyelid in cases of entropion.