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Eyelid Retraction

Eyelid retraction is an upper eyelid that is higher than normal or a lower eyelid that is lower than normal with respect to the corneal limbus. The causes are multifactorial and may include protrusion of the eye (proptosis) and levator muscle or Muller's muscle overaction. It is most commonly seen in thyroid eye disease but can also be associated with traumatic eyelid or post-surgical scarring. Pseudoretraction is an apparent lid elevation due to contralateral ptosis and Hering's law. Patients present with lagophthalmos (inability to completely close the eyelids), incomplete blink, and corneal exposure. Treatment is largely with lengthening or disinsertion of the upper eyelid retractors.

Eyelid retraction of the upper eyelids from thyroid eye disease

Eyelid retraction from thyroid eye disease

Eyelid retraction from surgical scarring

Eyelid retraction from multiple eyelid surgeries

Pseudoretraction of the right upper eyelid from Hering law associated with ptosis of the left upper eyelid

Right eyelid pseudoretraction from left eyelid ptosis due to Hering's law

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