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August 1993

Magnetic Resonance Images of Eyelid Anatomy

Author Affiliations

Madison, Wis

Arch Ophthalmol. 1993;111(8):1024. doi:10.1001/archopht.1993.01090080018006

The new glimpses of eyelid anatomy viewed through the high-resolution magnetic resonance imaging technology provided by Goldberg et al1 in the November 1992 issue of the Archives are splendid. Their concept of Whitnall's superior transverse ligament (STL) acting "... as a suspender that changes the vector force of the aponeurosis but travels anteriorly and posteriorly with the excursion of the levator muscle" is consistent with Whitnall's original description of the structure as a check ligament. Anderson and Dixon2 are to be commended for recognizing the STL's function in modifying the force vector of the levator complex. It should be borne in mind that the globe also provides significant vertical support to the upper eyelid, as evidenced by severe ptosis accompanying phthisis bulbi or enucleation. The view of Shore and McCord3 that medial STL dystrophy noted during acquired ptosis surgery is associated with postoperative medial contour flattening is interesting;

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