Eyelid Position (Palpebral Fissure)

I. Eyelid Position (Palpebral fissure) Evaluation of the eye requires assessment of the position of the eyelids. 1. To evaluate eyelid position, ask the patient to look straight ahead. 2. Compare the position of the edge of the upper eyelid to the iris; the eyelid should rest higher than the pupil. 3. Evaluate the width of the patient’s palpebral fissures, which should be symmetric. Sympathetic excitation causes upper eyelid elevation via the superior tarsal muscle. This establishes the size of the palpebral fissure. See Ptosis.