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Among the many excellent presentations at the recent International Symposium in Toronto, Canada, were several from the American Society of Ophthalmic Plastic and Reconstructive Surgeons. These included a discussion of lower eyelid stability and lower eyelid malposition by John W. Shore, MD, Boston, Mass, and correction of lower eyelid position by Arthur J. Shaefer, MD, Buffalo, NY.
In his presentation, "The Importance of Lower Eyelid Stability in the Prevention and Correction of Lower Eyelid Malposition," Dr Shore discussed the forces acting on the position of the lower eyelid in a superior, horizontal, inferior, or posterior direction.
The levator muscle and the preseptal and pretarsal orbicularis oculi muscle pull the lower eyelid in a superior direction. Due to its long elastic tendon, the levator muscle can transfer force through the lateral canthal tendon and raise the lower eyelid. Tightening of the preseptal and pretarsal orbicularis oculi muscle exerts force on the
MILLARY DJ. Oculoplastic Surgery. Arch Otolaryngol Head Neck Surg. 1990;116(4):398–399. doi:10.1001/archotol.1990.01870040020005
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