To the Editor.
—The need for preoperative and postoperative measurements in oculoplastic surgery and their accurate documentation is well recognized. A variety of methods are used. The most common method currently used in ophthalmology for documenting sizes of lesions and for the assessment of oculoplastic cases (eg, the measurement of ptosis, the palpebral fissure, and levator function) is with the use of a ruler held next to the lesion or lids. Although this is an easy and convenient method of documentation, accuracy varies from one observer to another. The proximity of a ruler to the eye also causes apprehension in the patient and can affect the accuracy of the measurements.A review of recent studies on the treatment of ptosis and lid retraction published in ophthalmic journals reveals that photographs are sometimes taken with a ruler held next to the face before and after surgery for the documentation and illustration
Bhupendra C. Patel, Laurence Morgan, Richard Hancock. A Photographic Method for Evaluation of Oculoplastic Surgery. Arch Ophthalmol. 1988;106(10):1346–1347. doi:10.1001/archopht.1988.01060140510007