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Srinivas Sai A Kondapalli, Craig Czyz, Jill Foster, Kenneth Cahill; Perceived Age of Patients with Eyelid Ptosis.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3108.
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A drooping eyelid is associated with a tired, aged and cosmetically unappealing facial appearance. However, no clinical research on the perceived age of patients based on eyelid ptosis has ever been performed. Our study examines the perceived age of a patient with a variable degree of eyelid ptosis.
A total of 50 Patients with unilateral ptosis were recruited into the study. Standardized photographs were obtained. Frontal face photos were selected and modified using Photoshop CS2 Version 9.0. Each facial photograph was divided in the vertical midline (Fig 1). A mirror image of each resulting half image was produced. These images were merged to provide two resulting images (Fig 2 and 3). The marginal reflex distance 1 was measured in Photoshop. The final two resulting images were all compiled and randomized. These resulting 100 images were then evaluated for perceived age by 5 oculoplastic surgeons and 5 laymen.
hysician graders evaluated patients with ptosis to have an average combined age of 65 and those without ptosis to have an average combined age of 63 (p=0.406). Non-physician graders evaluated patients with ptosis to have an average combined age of 63 and those without ptosis to have an average combined age of 61 (p=0.491). Of note, the ptosis group had a measured MRD1 of 1.3mm while the non-ptotic group had a measured MRD1 of 2.3 mm.
: By creating mirror images of a patient with unilateral ptosis, we were able to create two photographs with identical facial wrinkles, fat distribution and bony contour but with different eyelid positions. In doing so, this study is the first of its kind to determine the effect of eyelid ptosis on perceived age. Although our data does not demonstrate an effect on perceived age with a eyelid ptosis, there are some important limitations. The difference of eyelid position in our patient group was on average 1 mm, which may be too small for any changes in perceived age. Additionally, other clues including hairline and rhytides may have influenced our graders.
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